True GERD means gastroesophageal reflux,with the "D" standing for
"DISEASE", no? And that requires symptoms and a diagnosis that are way more
specific than the spitting-up and actions of babies who display discomfort
and squiriming, or are continually fussy in the early weeks. Babies have
immature sphincters and may be recovering from labor drugs. But many peds
will prescribe meds for a crying, non-settling newborn through the first
months, even though that baby is growing and gaining normally.
It's the rare peds who will take the risk and dare to tell a mother to try
holding her newborn more, and doing more S2S on a daily basis, to help
maturation of the baby's brain and body, along with positional and other
"lifestyle" changes.
In recognition of the overuse of meds for asymptomatic babies.babies who are
acting like babies, and not displaying symptoms of actual disease.the AAP
published new guidelines in 2013, (AAP: Not All Infant Reflux is DiseaseBy
Cole Petrochko, Staff Writer, MedPage Today,April 29, 2013, Reviewed by
<http://www.medpagetoday.com/reviewer.cfm?reviewerid=55> Robert Jasmer, MD;
Associate Clinical Professor of Medicine, University of California, San
Francisco) encouraging the use of meds only for those with "intractable
symptoms or life-threatening GERD-related complications."
The actual recommendation from the Pediatrics clinical report and guideline
says "It cannot be overemphasized that pediatric best practice involves
both identifying children at risk for complications of GERD and reassuring
parents of patients with physiologic GER who are not at risk for
complications to avoid unnecessary diagnostic procedures or pharmacologic
therapy". Pediatrics. Published online April 29, 2013.
Here are some more salient quotes from the Medpage article about these
guidelines:
.
. " Pediatricians should differentiate between gastroesophageal
reflux (GER) and gastroesophageal reflux disease (GERD) before determining a
course of treatment for infants"."The pediatric patient populations [that]
may be at elevated risk for GERD and GERD-related complications include
patients with neurologic impairment, obesity, history of esophageal atresia,
hiatal hernia, achalasia, chronic respiratory disorders, and history of lung
transplantation, as well as preterm infants"
. "GER is common to more than two-thirds of infants who are
otherwise healthy and is considered a normal physiologic process that occurs
several times a day in healthy infants, children, and adults". The condition
is "generally associated with transient relaxations of the lower esophageal
sphincter independent of swallowing, which permits gastric contents to enter
the esophagus."
.
."While GER is short lived and can cause few to no symptoms in the healty,
GERD is characterized by mucosal injury on upper endoscopy and can result in
vomiting, poor weight gain, dysphagia, abdominal or substernal/retrosternal
pain, and esophagitis. Symptoms of GERD can also include cough, laryngitis,
and, in infants, wheezing, as well as dental erosion, pharyngitis,
sinusitis, and recurrent otitis media. Infants may present with feeding
refusal, recurrent vomiting, poor weight gain, irritability, sleep
disturbance, and respiratory symptoms".
Our "industry" hopes for, works towards and supports the meme that babies
should fed nothing but breastmilk for 6 months at least, so putting meds
into those immature guts, to block and disrupt the newly-developing
digestive acids and enzymes, seems to me to be counter-productive.
Best to all and Happy New Year 5777,
Jackie Levine
***********************************************
Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome
|
