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Infant Reflux & Losec

Let’s talk about infant reflux and Losec. Losec is a prescription medication that is a proton-pump inhibitor (PPI), prescribed as an acid suppressant for infant reflux.

Before I can on, this has proven to be a triggering topic of conversation for some. What I am not saying is that Losec doesn’t give symptomatic relief, because it does. What I am saying is that Losec can’t solve the issue as, as you will learn, acid isn’t the cause of reflux. If you have tried absolutely everything and still need Losec in the short term, then that is absolutely a discussion you will have as a parent, with your primary care provider. It is not my role to comment on your personal decisions and I would never judge another parent, especially when I have never walked a mile in their shoes. I do believe however, that it is my role to present the research, and make sure that we can all make the most informed health decisions possible.

Let’s take a closer look at why PPIs in infants might not be a good idea:

  1. Acid is vital. It is essential that our stomach is extremely acidic to digest our macronutrients and to act as our defence mechanism to the outside world, preventing infections including Helicobacter pylori.
  2. Babies are not born with excess acid (not that this is the cause).
  3. Reflux is a location issue. It is not a problem of too much acid, but acid in the incorrect location. Examples of the causes are dysfunction of the valve that separates the stomach from the oesophagus, low tone of the diaphragm and surrounding areas, and/or the microbiome.

Valve dysfunction is a symptom of increased intra-abdominal pressure (IAP), which is essentially pressure that forces stomach contents into the oesophagus. Low stomach acid has been shown to contribute to IAP which of course means that Losec can make this worse. It may appear to work because PPIs remove all acid, including that in the incorrect location which is causing the pain. PPIs do not treat the root cause.

Babies have immature gastrointestinal tracts and immature microbiomes. All babies will have a biome that reflects their mother’s, whether from inoculation of the vaginal microbiome via a natural birth, or once a C-section baby starts to develop their biome from mumma’s breast milk. This is just one of the many reasons why preconception health is more than just folate, as establishing a robust microbiome is essential for mum and bub.

We need to do our very best to treat reflux naturally. There are incredible natural alternatives to PPIs (and over the counter antacids) including chamomile, fennel, globe artichoke, licorice and gentian. Please do reach out if you need support here. I’m also an advocate of paediatric chiropractic care, especially if the cause is low tone.

If you’ve had success with your bubba, please share below? There have been some incredible success stories shared, including that with paediatric chiropractic care, both on my Facebook and Instagram, which may be really empowering for you to read too 💗

Note: much of this certainly applies to PPI use in adults too. There are often additional causes however longer term use of PPIs including Losec, Nexium and Somac has been shown to compromise the assimilation of nutrients causing deficiencies of essential amino acids and micronutrients such as B12, iron, folate, calcium and zinc. There is also emerging research linking long term use of PPIs to stomach cancer. Read the side effects here.

References:

Czinn SJ, Blanchard S. 2013. Gastroesophageal Reflux Disease in Neonates and Infants. Pediatric Drugs, 15, 19–27.

Heidelbaugh JJ. 2013. Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications. Therapeutic Advances in Drug Safety, 4, 3, 125–133.

Leung AK, Hon KL. 2019. Gastroesophageal reflux in children: an updated review. Drugs Context, 8, 212591. 

Lightdale JR, Gremse DA. 2013. Gastroesophageal Reflux: Management Guidance for the Pediatrician, 31, 5, e1684-e1695.

Meneghetti AT, Tedesco P, Damani T, Patti MG. 2005. Esophageal mucosal damage may promote dysmotility and worsen esophageal acid exposure. Journal of  Gastrointestinal Surgery, 9, 9, 1313-1317.

Savarino V, Marabotto E, Zentilin P, et al. 2020. Pathophysiology, diagnosis, and pharmacological treatment of gastro-esophageal reflux disease. Expert Review of Clinical Pharmacology, 13, 4, 437-449.

Xie Y, Bowe B, Li T, Xian H, Yan Y, Al-Aly Z. 2017. Risk of death among users of Proton Pump Inhibitors: a longitudinal observational cohort study of United States veterans. BMJ Open. 7, 6, e015735.

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