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Crying and spilling--time to stop the overmedicalisation of normal infant behaviour

Ben Hudson1, Anna Alderton, Claire Doocey

  • 1Department of Public Health and General Practice, University of Otago, Christchurch, New Zealand.

The New Zealand Medical Journal
|January 17, 2013
PubMed

Insights

Infant unsettledness and spilling are normal developmental phases, not conditions requiring acid suppressants. Medical treatments for these common infant behaviors carry increased risks and lack evidence of benefit.

Area of Science:

  • Pediatrics
  • Infant Development
  • Gastroenterology

Background:

  • Infant unsettledness and spilling (posseting) are common in the first year of life.
  • These behaviors are typically normal developmental patterns that resolve over time.
  • Pathological attribution of these normal behaviors has led to increased medical interventions.

Purpose of the Study:

  • To evaluate the role of acid suppressants in managing infant unsettledness and spilling.
  • To assess the evidence for and against medical treatment of these common infant behaviors.
  • To highlight the risks associated with acid suppression in infants.

Main Methods:

  • Review of current medical literature and clinical data.
  • Analysis of evidence regarding the efficacy of acid suppressants for infant reflux and irritability.
  • Examination of adverse event data associated with acid-suppressing medications in infants.

Main Results:

  • Clear evidence indicates acid suppression is ineffective for managing infant unsettledness and spilling.
  • Recent data show increased risks of adverse effects from acid-suppressing drugs in infants.
  • Normal infant behaviors are increasingly misdiagnosed and treated inappropriately.

Conclusions:

  • Acid suppression has no role in the management of normal infant unsettledness and spilling.
  • The risks of acid-suppressing medications in infants outweigh any perceived benefits for these conditions.
  • Re-evaluation of diagnostic and treatment approaches for common infant behaviors is warranted.

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