If your baby or toddler is using reflux medicine, maybe it’s time to quit. Here’s why, and how.
This is one of my least favorite findings in a little one’s history. Why? Because the longer reflux medicines are used, the weaker a child’s digestion becomes. The weaker your baby’s digestion becomes, the harder it is to absorb food and nutrients. This creates a domino effect of trouble! Just click through this FDA powerpoint presentation to the Pediatric Advisory Committee to see what I mean. From fractures to fecal impactions, it’s not pretty.
Most parents report to me that reflux medicine seems to help a little at first, especially for quelling colic and crying. But soon, the benefit fades.
Then the baby becomes more picky, appetite more sluggish, stools more constipated and slow, belly more bloated. Feeding gets harder, not easier – and the reflux medicine dose goes up. After a few months, we have a fussy eater who is having tantrums about feeding, who is dependent on Miralax to have bowel movements, and growth pattern has slowed down. After a few years on reflux medicines, it’s common for me to be looking at a stunted child who is barely getting taller; who is epically picky, cranky, or anxious; who is struggling to learn, behave, or develop normally; and who is so stuck on Miralax even at ever increasing doses, it doesn’t work so well anymore.
The whole point of these medicines is to weaken stomach acid – presumably because too much acid is irritating the esophagus. Reflux medicines (“proton pump inhibitors” or PPIs) are the second most prescribed drug for infants and children, behind antibiotics. Does your baby even need it?
These medicines were created and approved for use in adults who may actually have too much acid gurgling up from the stomach into the esophagus. But this may not be what is happening in a baby or toddler’s digestion. Reflux medicines are not FDA approved for use in infants (kids under a year old) but are routinely prescribed anyway. Even if actual reflux was the issue, the only way to know for sure is to put the baby through an invasive procedure with something called a pH probe. A probe is stuck down the baby’s throat in “dip-stick” fashion so that a reading on the stomach’s acidity can be taken. Infants may need sedation and hospitalization to get through this procedure. Obviously, it’s all too easy for your pediatrician to hand you a prescription instead and say “try this”.
Before you try that, you should know that there are many drug-free options that work well, and leave your child’s digestion in tact. Try these instead – because reflux medicines have been found to have these negative side effects:
• increase risk of breaking bones
• impede absorption of vitamin B12, and reduce serum levels of B12
• enhance fungal (yeast) infections in the gut or esophagus
• reduce the helpful bacteria in the gut (which makes digesting food even harder) while encouraging pathogenic bacteria
• cause bacterial infections of the small intestine
• cause Clostridia difficile infections, a hard to treat bacteria that causes diarrhea
• seizures under certain predisposing conditions
Yuck! Imagine all this going on in a tiny infant’s gut, which is just getting started in learning to digest and absorb food.
Basically, these medicines weaken stomach acid – and thus, make the stomach less capable of digesting anything. The ability to digest and absorb food is gradually weakened. Effects from using these for more than a few weeks? Examples from my own practice include linear growth grinding to a halt (kids can’t grow taller), delayed bone age (kids’ bones are not growing normally), and fractures of hip, wrists, or spine – in kids. Other nutrients become harder to absorb too, especially vitamin B12. Anxiety becomes prominent – and this is not surprising, as we learn more about how gut bacteria are linked to mood and anxiety.
But that’s not all. Changing the acid level of a human digestive tract means you change which microbes can grow there. The microbes we carry in our intestines do a lot for us. They help us digest food, communicate with our immune systems, and help fight off invading infectious microbes that can make us sick. Using reflux medicines favors microbes that are not ideal – such as Clostridia difficile (linked to seizures and autism like features in tests on rats) and fungal infections (Candida or other yeast species). These definitely do not help your baby or child. A healthy gut has a pH that will favor helpful species, like Lactobacillus strains or Bifido strains.
So what to do? Try these steps – and learn more detail in my book Special Needs Kids Go Pharm Free. The first chapter is all about babies, from feeding to colic to sleep, reflux, and more.
1) If you’re breastfeeding, trial a diet without the usual suspects. Remove dairy, gluten, nuts, eggs, or soy. Some babies fare better when brassicas are removed (cauliflower, broccoli, Brussel sprouts). Don’t remove all these foods at once. Experiment with rotations. Always put back in a strong, nutritious replacement for any food you take out. Use ample organic fats including eggs, ghee, meats and poultry, legumes, and vegetables. You may need to use alternate protein supplements to keep you strong and energized while your own diet is restricted. A gentle whey protein like ImmunoPro Whey may be well tolerated for you. Or, you may need a collagen protein support. You can find these in my practice supplement dispensary here.
2) Change up the feeding routine. Cow’s milk, pea or rice protein concentrates, and soy proteins are not what your baby was built to digest. So, if you’re using a formula based on those proteins, change it. This alone may ease reflux symptoms. Use a partly digested (“hydrolyzed”) formula instead. This one is organic, with lactose as the carbohydrate (just like breast milk), and hydrolyzed whey protein instead of whole cow’s milk protein – very gentle! Formulas like Nutramigen or Alimentum are made with hydrolyzed casein protein and may work too. These aren’t organic and may contain GMO ingredients, but may be better tolerated than a standard whole milk protein infant formula. For toddlers, plant based options exist. I don’t like using pea or rice protein concentrates in my practice – these seem tough on baby and toddler bellies in my experience. If almond is safe, give this organic option a try. Your baby may also do just fine with a goat milk formula option (which I’ve only found here so far – see all their options for ages and stages), or even a camel milk formula recipe (not commercially available …yet!).
3) Switch to organic, GMO-free formula and foods as much as you can. GMO ingredients in conventional formula and foods are injurious to your baby’s gut biome. Read here for why I tell my patients to avoid GMO foods. More scientists are expressing concern that GMO foods alone may be triggering autism in our children. This simple step can help your baby’s gut.
4) Use probiotics. Lactobacillus retueri is a strain that has been shown to reduce colicky symptoms and crying. Bifido bacteria are crucial for healthy gut biome development, as are other Lactobacillus strains. Consider starting with a simple product like ProBiota HistaminX probiotic. To order, tap my practice supplement dispensary here, set up an account, and order. You can also start with a product that only contains Lactobacillus called Primadophilus L. reuteri, also available in my dispensary.
5) Use an herbal tincture designed for babies and toddlers, in a glycerite base, that supports digestion. These are often called “digestive bitters” – there are many brands – and they can gently support normal stomach acid secretion and digestion. Here’s an example of one of my favorites. For a baby under one year, 1/8-1/4 teaspoon is plenty before or just after a feeding.
6) Put Epsom salts in your baby or toddler’s bath at night. This is calming, and delivers both magnesium and sulfur via absorption through skin. Sulfur is a key mineral for many digestive functions. Dissolve one half cup in the bath and soak for twenty minutes.
7) Clear fungal infections. If your baby had thrush, he may need some stronger medicine to clear any lingering fungal load from the digestive tract. Fungal infections alone can alter the acidity of the digestive tract, and keep it sub-optimal – thus causing more reflux! See my blog on fungal infections and how these affect the GI tract.
These are so easy to do. Use these steps to prevent ever getting on a reflux med, and to help your baby or toddler wean off. Let me know how it goes!