Infant Reflux Misrepresented in the Media
The media has a way of oversimplifying things. Look, for example, at the December 16, 2007 piece from the Baltimore Sun, Reflux Among Babies Often a Misdiagnosis. The article suggests that acid reflux in babies is "widely misdiagnosed and often overtreated with unnecessary doses of heartburn medicine developed for adults."
The piece rests on the results of a small, recently published retrospective study of the practices of some rural Louisiana physicians. The study published in the November 2007 journal Pediatrics concluded that infants who do nothing other than spit up don't need medication. While not news to those of us who do this for a living, I'll agree that it should serve as a gentle reminder that healthy babies don't need treatment.
My problem comes with the suggestion that all babies with acid reflux are overtreated. Articles such as this overlook the fact that reflux can create problems that go well beyond spitting up. Severe pain, chaotic feeding, failure to thrive, and airway disease are just a few of the problems created by unrecognized acid reflux in infancy.
As a pediatric gastroenterologist at one of the busiest pediatric gastroenterology clinics in the U.S., I would suggest that most GERD babies with symptoms such as these are often underdiagnosed. Most often the misery and pain of infants with reflux is characterized as "colic." But as I discuss in my new book, Colic Solved - The Essential Guide to Infant Reflux and the Care of Your Crying, Difficult-to-Soothe Baby, this term is going the way of the hula hoop as we learn that most screaming babies are suffering with treatable conditions.
While articles such as this may seem to serve as evidence that America's physicians don't know what they're doing, it's more likely a case of convenient oversimplification. GERD in babies can be tricky and understanding the difference between a happy spitter, a sick infant and a grey-zone baby requires time, patience and the recognition that acid reflux is a real condition worthy of our attention.