Infants
prescribed antacids have increased risk of fractures during childhood

Research suggests antacid medications should be used only be used for more
severe symptomatic gastroesophageal reflux disease

Date:

May 4, 2017

Source:

American Academy of Pediatrics

Summary:

New
research found infants prescribed antacids to manage acid reflux, or spitting
up, under age 1 had more bone fractures later in childhood.

New research being presented at the 2017
Pediatric Academic Societies Meeting found infants prescribed antacids to
manage acid reflux, or spitting up, under age 1 had more bone fractures later
in childhood.

An abstract of the study, “Early
Antacid Exposure Increases Fracture Risk in Young Children,” will be
presented on Sunday, May 7, at the Moscone West Convention Center in San
Francisco.

Acid reflux, also known as
gastro-esophageal reflux (GER), is frequently treated with drugs such as proton
pump inhibitors (PPIs) and histamine H2-receptor antagonists (H2-blockers) that
decrease production of stomach acids. These types of medications have been
linked with increased bone fractures in adults, but there has been a lack of
research into whether they might have the same effect in children.

Researchers examined the records of 874,447
healthy children born within the Military Healthcare System (MHS) from 2001 to
2013 who received care within the system for at least 2 years. They found
approximately 10 percent of the children were prescribed antacids in the first
year of life, including H2-blockers such as ranitidine (Zantac) and famotidine
(Pepsid) as well as PPIs such as omeprazole (Prilosec) and pantoprazole
(Protonix). A small percentage was prescribed both.

Children who used PPIs had a 22 percent
increased likelihood of fracture, while children who used both PPIs and
H2-blockers had a 31 percent increased likelihood of fracture. Use of
H2-blockers was not associated with an immediate increase in factures, 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 started on antacid medications earlier — under
6 months old — had the most increased fracture risk. Children who started
using antacids after age 2 years did not have increased fractures as compared
to children who were not prescribed antacids in the first five years of life.

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 pediatrics 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 percent 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
health care 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.

Dr. Malchodi will present the abstract,
“Early Antacid Exposure Increases Fracture Risk in Young Children,”
at 11:45 a.m.

Story Source:

Materials provided by American
Academy of Pediatrics. Note:
Content may be edited for style and length.

American Academy of
Pediatrics. “Infants prescribed antacids have increased risk of fractures
during childhood: Research suggests antacid medications should be used only be
used for more severe symptomatic gastroesophageal reflux disease.” ScienceDaily.
ScienceDaily, 4 May 2017.
<www.sciencedaily.com/releases/2017/05/170504083149.htm>.

American
Academy of Pediatrics. (2017, May 4). Infants prescribed antacids have
increased risk of fractures during childhood: Research suggests antacid
medications should be used only be used for more severe symptomatic
gastroesophageal reflux disease. ScienceDaily.
Retrieved June 28, 2017 from
www.sciencedaily.com/releases/2017/05/170504083149.htm

American
Academy of Pediatrics. “Infants prescribed antacids have increased risk of
fractures during childhood: Research suggests antacid medications should be
used only be used for more severe symptomatic gastroesophageal reflux
disease.” ScienceDaily.
www.sciencedaily.com/releases/2017/05/170504083149.htm (accessed June 28, 2017).