Infants prescribed antacids have increased risk of fractures during childhood: Research

New York [US], January 3 (ANI): Drugs that reduce the formation of stomach acids, such as proton pump inhibitors (PPIs) and histamine H2-receptor antagonists (H2-blockers), are widely used to treat acid reflux, also known as gastroesophageal reflux disease (GERD). There hasn't been enough research to determine whether these medications have the same effect on children as on adults, who have been linked to an increase in bone fractures.
8,74,447 healthy children born within the Military Healthcare System (MHS) between 2001 and 2013 and who had at least two years of care were the subjects of the study. They discovered that in the first year of life, almost 10 per cent of the children received antacid prescriptions. These included H2-blockers like ranitidine (Zantac) and famotidine (Pepcid), as well as PPIs like omeprazole (Prilosec) and pantoprazole.
Children who used PPIs had a 22 per cent increased likelihood of fracture, while children who used both PPIs and H2-blockers had a 31 per cent increased likelihood of fracture. The use of H2-blockers was not associated with an immediate increase in fractures, the study found, but there was an increased likelihood of fracture with time.
In addition, the number of bone fractures children experienced increased with the number of days they took these medications. The younger a child first began using antacid medications, the higher the fracture risk. Those who started on antacid medications earlier -- under 6 months old -- had the most increased fracture risk. Children who started using antacids after the age of 2 years did not have increased fractures as compared to children who have not been prescribed antacids in the first five years of life.
The use of antacid medications in infants should be weighed carefully against possible fracture, said U.S. Air Force Capt. Laura Malchodi, MD, lead author of the study and a paediatrics resident at Walter Reed National Military Medical Center.
"With many antacids easily available over-the-counter for adults, these medications may seem benign," Dr Malchodi said. "However, our study adds to a growing body of evidence suggesting antacid medications are not safe for children, especially very young children, and should only be prescribed to treat confirmed serious cases of more severe symptomatic gastroesophageal reflux disease (GERD), and for the shortest length of time needed."
GER is a common condition that affects roughly 40 to 65 per cent of all infants. It usually begins at approximately 2 to 3 weeks of life and peaks between 4 to 5 months. In most babies, GER disappears by about 1 year of age as the upper digestive tract functionally matures. The American Academy of Pediatrics believes it is important for all pediatric healthcare providers to be able to properly identify and treat children with reflux symptoms, and to distinguish GER from more worrisome disorders so as to avoid unnecessary treatments. (ANI)