IT’S 3 A.M. and baby is unhappy. He has spit up the contents of his last feeding, and is now crying inconsolably. It’s not the first time this has happened, nor do his exhausted parents imagine it will be the last.
Later, at the pediatrician’s office, baby’s stressed-out mom and dad express concern: What is going on? And, more to the point, what can we do to make our child feel better?
In recent years, according to findings by MU psychological sciences assistant professor Laura Scherer, physicians are more and more inclined to answer that gastroesophageal reflux — a condition commonly known as reflux disease — may be to blame. The diagnosis typically results in doctors’ writing a prescription for acid-reducing medications. From 1999 to 2004, in fact, the use of prescription medications to treat gastroesophageal reflux, or GERD, in infants has increased by some 700 percent.
Unfortunately, according to Scherer, GERD is often not the problem. Not only does this make prescriptions to alleviate it superfluous, she has found, but using diagnostic labels like “GERD” may cause parents to mistakenly believe drugs are needed to deal with a range of common, if harrowing, challenges of infant development.
“Over-diagnosis of GERD can make a medical condition out of a normal behavior,” says Scherer.
“When a set of behaviors is labeled a ‘disease,’ this can make parents think that medication is appropriate for their child, regardless of whether the drugs are effective or not. Doctors may feel the need to give parents a name for their child’s problem, but by doing so they can inadvertently increase parents’ perceived need for medical treatment.”
It may be tough, she counsels, but parents must be prepared to trust what their pediatrician tells them — even when the message is that medications are not needed.
“The over-use of medications can be a needless expense,” says Scherer. “In addition, the long-term effects of these acid-reducing medications have not been fully studied in infants, although the medication has been associated with slightly higher rates of pneumonia.”
The study was published in the April issue of Pediatrics, the journal of the American Academy of Pediatrics. Brian Zikmund-Fisher, Angela Fagerlin and Beth Tarini, each from the University of Michigan in Ann Arbor, were co-authors.