By: Jean Johnson for Reflux1Linda and Raymond Thompson of Williams, Ariz., had a premature baby in the late 1990s. Tiny Raymond Jr. remained in the hospital for three weeks after Linda was released while he developed sufficiently to go home with his parents.
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Caring for Your Family
Become an active part of your infant’s health care team.
Ask about the drugs and treatments that are being used to treat your baby, along with any risks that are associated with various therapies.
Also, when deciding on a physician, inquire about participation at professional conferences, articles in journals, and other continuing education opportunities that indicate the physician is keeping up in his or her field.
Make use of reliable consumer health web sites like those within the Body1 Network to stay current on studies and trends that enable you to knowledgeably discuss approaches with your physician.
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“To hear about this study now makes me really sad, even though I know nothing we do in life is ever perfect – even medicine,” said Linda Thompson. “But back when Little Ray was just a preemie, we believed in our doctor and everything that the hospital did. He was so very, very tiny and fragile. My husband and I would go up to the hospital and put on the gowns and masks and go in and sit by his incubator. Tears would just come. He was so tiny and helpless there all alone.” Thompson pauses for a moment to collect herself from the memory of the difficult experience. “Now to think that they might have been giving him something that could have harmed him is frightening. I just hate to think of the mothers out there whose babies might be in harm’s way when all the time their doctors think they are treating them with the best available drugs.”
How Can We Help Infants without Harming Them?
It’s tough when a preemie is born and you’re trying to do everything you can to help him or her develop into a normal weight infant with full life potential. That’s why good health insurance programs devote much of their work to providing the education and care mothers-to-be need to increase their chances of carrying their babies to full term.
That said, premature infants are born all the time and using the full complement of state-of-the-art pharmacopoeia and technology, physicians have considerable success giving these fragile human beings a chance.
What happens, though, when things don’t go as planned? When a drug used to treat one problem turns around and creates another that is equally if not more harmful – even life threatening?
That’s what physicians wondered at the National Institutes of Health’s (NIH) National Institute of Child Health and Human Development Neonatal Research Network. Specifically, their questions were directed to drugs known as H2 blockers, which are regularly prescribed to treat acid reflux in preemies.
Preemies, Reflux and the Worry
Because the digestive tract is not fully formed in premature infants, the contents of their stomachs may wash back into the esophagus where acids can harm the tender lining. Unlike the stomach where a protective lining keeps harsh, acidic digestive juices from harming the walls, the delicate esophagus is designed as a passage way for undigested food only.
Also, there are fears that excessive stomach acid in preemies causes stomach ulcers. Finally, some physicians ascribe to the controversial belief that reflux in preemies causes sleep apnea, or the cessation of breathing for brief periods when the babies are sleeping. In, turn sleep apnea is sometimes associated with Sudden Infant Death Syndrome.
H2 Blockers
Thus, it’s not surprising that physicians often prescribe H2 blockers that prevent or treat acid reflux in premature infants. Common names under which these H2 blockers are sold are cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac), and nizatidine (Axid).
Possible Unintended Side Effects – Fatal Ones
According to the NIH’s researchers – who published results of their study in the February 2006 issue of Pediatrics – the problem is that H2 blockers might be putting infants at risk for what can be a fatal complication; a phenomenon called necrotizing enterocolitis in which the intestines become seriously inflamed.
“This study strongly suggests that the common practice of prescribing H2 blockers to prevent or treat acid reflux in premature infants be discontinued until more evidence on the safety of this practice becomes available,” said director of the NIH, A. Elias Zerhouni, M.D.
Still, first author of the Pediatrics paper, Ronnie Guillet, MD, Ph.D., noted that her team did not definitively correlate the use of H2 blockers with necrotizing enterocolitis. Rather, Guillet observed that further work to determine the relationship between these two dynamics is indicated. She did point out, however, that the NIH team’s hypothesis and initial interest in the study was prompted by results in animal studies that do show clear correlations between the H2 blockers and fatal intestinal inflammation.
