Overuse of Reflux Medications in Infants

Study on Nocturnal Infant Crying Evaluation (NICE) and Reflux Disease (RED)

“…Instead, many studies demonstrated a poor correlation between crying and GERD [6][7][8][9][10]16,17,20]. Nonetheless, acid suppressant drugs are frequently empirically prescribed in these infants, although evidence of efficacy is limited, and possible adverse effects have been reported [7,[10][11][12][13][14][15][16]. By contrast, correct identification of the subgroup of infants that have GERD may relieve symptoms, reduce complications, parental anxiety and depression [65] and avoid misclassification and overtreatment.…”

“…Despite a lack of evidence of efficacy, empirical acid suppressant drugs continue to be mis-and over-used for infantile distress and persistent crying, especially when episodes of regurgitation are reported [6][7][8][9][10][11][12]. Nonetheless, since acid suppressant drugs may cause adverse events, including an increased rate of respiratory and gastrointestinal infections, fractures, allergies and microbiota alterations, the appropriateness of prescription is of the utmost clinical relevance, particularly in early life [9][10][11][12][13][14][15][16]. Contrarily, the identification of the subgroup of infants with crying associated with GER may alleviate related symptoms and sleep problems and reduce possible esophageal and general complications [1][2][3][4][5]9,[17][18][19][20].…”