I have worked with children and their parents navigating the "reflux rollercoaster" for nearly 14 years. During that time, many of the medications used to treat acid reflux have been placed on over-the-counter (OTC) status, including proton pump inhibitors (PPIs). Easier access to medications can be helpful, but I have personally seen it cause problems, too.
I see many well-meaning parents on message boards seeking non-professional guidance (without talking to their physicians) about a medication dose for their child and how to make a PPI (or sometimes H2 blocker) concoction work for a child so they can use the OTC medication. There are many reasons why parents reach the level of frustration that causes them to self-treat their child with OTC medications. These range from having no health insurance to poor communication with their physician, or the belief that their current treatment isn't working or should work faster.
I asked the person I trust the most with my own children, Dixie Shrum, APN, PNP-BC (advanced practice nurse, practicing nurse practitioner, board-certified), who practices medicine at Cornerstone Medical Clinic in our town, what her thoughts were on the subject. Shrum said:
"PPIs should only be used in children under the direct supervision of a healthcare practitioner. There are significant side effects possible, as well as potential medication interactions that must be closely monitored."
At HealthCentral, we have talked frequently about the many potential issues regarding PPI medications, including (but not limited to): cardiovascular disease including increased heart attack risk, vitamin and mineral absorption problems, kidney function and other issues, increased risk of pneumonia and even an increased risk of fracture in older adults. The newest studies recognize that children who were on acid reflux medication as infants may also be at an increased risk for fractures as older children.
These issues of medication interactions, side effects, as well as the potential for giving too much medication are why you shouuld stick with your physician when it comes to treating your child with OTC PPI medications. As a mom, I know how hard it is to see your child in pain. If that's happening, tell your child's doctor that the current regimen is not working for your little one so they can make treatment changes.
If those subsequent changes do not help to alleviate your child's pain, it may be time for further testing or a referral to a pediatric gastroenterologist. A gastroenterologist specializes in all of these types of issues and may have a few extra tricks up their sleeve, be able to use higher doses of medications as well as having additional diagnostic procedures in their arsenal.