GPs are over-prescribing acid suppressant medicines for babies with GORD and reflux, new research has found
The report, in Archives of Disease in Childhood, is based on a prospective study of about 1000 GPs who were surveyed annually and who recorded details of 100 consecutive visits with consenting, unidentified patients between 2006-2016.
Of all infants’ visits, 512 (2.7%) included a diagnosis of reflux (n=413, 2.2%) or GORD (n=99, 0.5%). From 2006 to 2016, diagnostic rates decreased for reflux and increased for GORD.
Prescribing of acid suppressants occurred in 43.6% visits for reflux and 48.5% visits for GORD, similar to rates of counselling, advice or education (reflux: 38.5%, GORD: 43.4% of visits).
Prescribing of PPIs increased (statistically significant only for visits for reflux), while prescribing of H2RAs decreased.
“Research shows prescribing acid suppressant medicines for babies doesn’t work,” says Professor Natasha Nassar of the University of Sydney.
“Acid suppressant medicines are no better than placebo and may have negative side effects such as increased risk of infection, but prescribing guidelines are inconsistent.
“Clear, consistent guidance is needed,” says Prof Nassar.
“The Paediatrics and Child Health Division of the Royal Australian College of Physicians recommend health care professionals do not routinely treat GORD in infants with acid suppression therapy.
“GPs and parents need to understand what is normal, and the limits of medical therapy. We need a greater understanding of the influences on GP prescribing practices, of parents’ knowledge and attitudes, and of the pressures on parents of infants with these conditions.
“It important that GPs advise parents about the lack of evidence about the use of these medicines for babies, and that they may be harmful. While it can be a distressing time for parents, it is important they know that by the first birthday, most babies will have grown out of this stage without needing any medicines.”