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Gastroesophageal Reflux Disease (GERD) Over-Diagnosed In Newborns, As Anxious Parents Rush To Medicate

Parents Of Newborns Opt For Medications, Against Reason
Even when told medication wouldn't help, parents of newborns were more likely to opt for treatment when their child had been given a disease label for excessive spitting up, crying. CDC.gov

The power of word alone causes many parents of newborns to rush to the pharmacy -- even when told medication won't help, a new study shows.

By simply uttering the term "gastroesophageal reflux disease," a pediatrician might cause unnecessary alarm leading to over-diagnosis of the condition, also known as GERD.

Most babies spit up and don't experience an acid reflux problem, researchers reported today in the journal Pediatrics. During the first half-year or so of life, the upper stomach valve is still developing, making the bib industry a constant for parents of newborns.

Still, many doctors today label such babies with GERD, even though a definitive diagnosis requires an invasive test.

"Roughly 50 percent of babies during the first six months are spitting up enough to bother their parents," said Dr. William Carey, of The Children's Hospital of Philadelphia, who wrote a commentary alongside the study. "I never offered medication for a kid who was just spitting up and gaining weight well and happy," Carey told Reuters. "I could confidently tell the mother, 'Look, it's going to be a nuisance until about six months, and then it's gradually going to get better.'"

Excessive spit-ups are an "irritating version of normal," Carey said.

In the study, Laura Scherer and colleagues at the University of Missouri in Columbia surveyed 175 patients, offering them a hypothetical situation. Let's say you had a one-month old baby that was spitting up and crying a lot. And let's say the doctor diagnosed your baby with GERD or did not-and told parents medication would either help or not help.

Although research suggests medication to be ineffective, a disease label alone trumps rationality. In the study, hypothetical parents were more likely to want prescriptions for their newborns following a GERD diagnosis. When told the medication probably wouldn't work, parents rated their interest in the treatment at approximately 2.5 on a five-point scale, whereas parents receiving no diagnosis reported a 1.5.

"It shows how these kinds of labels can influence how people respond to symptoms," Scherer told Reuters. "Words can make an otherwise normal process seem like something that requires medical intervention."

Scherer said current recommendations for health care guidelines stipulate that such symptoms should not be labeled as GERD, though doctors may try a two-week acid-reduction treatment after ruling out other possibilities -- e.g. the normal range of experience.

These guidelines continue to confuse doctors and patients alike into thinking the medication might help, Scherer said.

"Parents need to know that there are some annoying or insignificant variations of normal which one really needs to just put up with and not treat as a disease," he said. "Be darn sure that there is an abnormality before treating it as such."

Scherer likened over-diagnosis of GERD to the labeling of active children as sufferers of attention deficit hyperactivity disorder (ADHD), which many experts believe stigmatizes -- and medicates -- a range of normal human experience.

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