Infants on Antacids Develop More Bone Fractures

Antacids for Infant Reflux Could Cause Bone Fractures

While adult use of antacids has been linked to increased risk of bone fractures, these same medications have been used in infants without research on their risks of bone fracture until now. The American Academy of Pediatrics reports that "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."

Acid reflux or gastro-esophageal reflux (GER/GERD) are commonly thought to be related to overproduction of stomach acid in adults, or weak muscles around the stomach in babies. Doctors frequently recommend medications to reduce acid production in adults and now appear to be doing the same in very young children to control the symptoms.

High Antacid Use in Infants

Researchers analyzed records of 874,447 healthy children and "found approximately 10% 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% increased likelihood of fracture, while children who used both PPIs and H2-blockers had a 31% increased likelihood of fracture. 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."

Antacids "Not Safe for Children"

Researcher also noted that the younger a child started antacid medication, and the longer a child was on antacid medication further increased the risk of bone fractures. The lead researcher noted, "With many antacids easily available over-the-counter for adults, these medications may seem benign...However, our study adds to a growing body of evidence suggesting antacid medications are not safe for children..."

Avoiding Antacids and Fractures in Children

Spit up is fairly common in the first year of life as a child's digestive system continues to fully develop. Most cases are mild and should not require medical intervention. Reflux tends to be less common and less severe when breastfeeding children, so breastfeeding is a good way to avoid problems to start with. When breastfeeding, mom's diet may also have an affect on the baby's digestion. In children with more severe symptoms, there may be functional issues that could be addressed with hands-on treatment or diet changes.

Using antacids to prevent the body from producing a proper amount of stomach acid can also increase other risks, like infection due to reducing the digestive systems' ability to kill a "bug." Some reflux symptoms actually result from too little stomach acid, reducing the body's ability to digest food well, and allowing food to essentially rot in the stomach and cause reflux symptoms. It's worth trying non-drug treatments to improve the problem before starting on a lifetime of antacids. And it appears these antacid medication should rarely be used in children due to risk of fractures and other health problems.

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