Parenting Solved

Is There an Epidemic of Acid Reflux in Children?

You might think so if you look at the new data released by Medco, one of America’s largest pharmacy benefit managers. Medco is privy to the prescribing habits of America’s physicians.

After looking at 575,000 prescriptions, it seems acid is the hot thing in kids. Between 2002-2006 the numbers of acid suppressant prescriptions in children between the ages of 0-4 years rose by a 56%. It’s estimated that 3% of all children in this age group received some form of acid suppression last year. Amazing numbers, really.

Why is this? Is acid reflux on the rise in kids? Is there some type of prescription abuse in play? Is obesity the explanation as suggested by the American Academy of Pediatrician president-elect Renee Jenkins? The answer isn’t perfectly clear although as a man on the street I suspect that there’s greater recognition of acid related disorders in kids. The incontrovertible role of reflux in asthma, feeding problems and even dental disease is generally accepted by pediatricians. Many are even beginning to recognize that colic, the scourge of infancy, may represent overlooked reflux disease or milk protein allergy. It’s important to note that these numbers may be influenced by the fact that Prevacid received FDA approval for children down to age 1 year during the time period cited by Medco.

Once considered a non-entity in children, it seems that acid reflux, for whatever reason, is finally seeing the light of day.

The Colic Kabuki Dance

During a recent Colic Solved Seminar I was approached by a woman who worked in daycare and claimed to have the cure for colic. She was so excited about her methods that she asked to demonstrate technique with the infant doll that I had on hand for my seminar. I sensed I didn’t have a choice. So holding the doll in a cradling hold with arms nearly extended and head well supported, she swung the doll in a dramatic arc sweeping from below her hips up to the level of her shoulders. Deep, lunging steps were made in rhythmic time with the swinging of the baby. The maneuver bore a striking resemblance to a nocturnal tribal dance that I had witnessed years before as a medical student working with the Zuni Pueblo. She called her moves “the colic dance” and swore that it fixed every baby that she ever touched.

Out of respect, I made note of her dance and assured her that I would keep it in mind.

But there are no magic moves, noises, sounds or recordings to ease the baby suffering with fatigue or pain. Various neutralizing sensations are known to settle the disorganized baby. Be it the hair dryer, music, or a particular rhythmic pattern of bouncing, every parent finds what works and in each case their colic dance can create transient moments of magic. While dancing will always serve to take a baby’s brain off of things, parents should always be aware that babies suffering with identifiable causes of pain need to be treated. And that’s a dance that I can’t seem to stop.

Infant Reflux and the Race for the Magic Bullet

The game is afoot. It seems Astra-Zeneca (Nexium), Wyeth (Protonix), and TAP (Prevacid) are engaged in a pharmaceutical arms race of sorts as they seek to be the first with an FDA approved PPI for use in infancy. Clinical studies are underway and those who lack active research protocols are closing in fast. Whoever wins will potentially take the prize for the next great unclaimed market for acid suppression. FDA approval for proton pump inhibitors in babies is, of course, a moot point since their off-label use is already the treatment du jour for the bundle of misery. The gubment will offer that warm, fuzzy feeling that nervous pediatricans get when prescribing something that Uncle Sam says is a-okay. But don’t hold your breath – I wouldn’t expect anything substantive before 2009-2010. In the meantime I’d bet on Prevacid with their vast assortment of creative PPI delivery options for kids.

Wondertime Interview on Colic Solved

You can read an interview with yours truly in the Disney magazine, Wondertime. The interview discusses the myth of colic, the conception of Colic Solved, and my perceived state of the miserable baby. If you’re brave enough to want to know what’s going on inside my head, give it a look. Editor Kathy Whittemore who conceived the piece did a wonderful job of capturing the conversational tone of our interview.

Favorite question: Do you consider yourself a radical? You’ll have to read it to learn the answer to this one.

As an interesting side note, most of the mothers pictured in the hard copy article are patients of mine. The photo shoot was interesting in that all the babies wailed in unison. I don’t think photographer Terry Vine had any idea what he was getting into. Despite the stress of the situation, Terry did a fantastic job working with our babies and capturing the maternal experience.

For those who are unfamiliar, Wondertime is a relatively new parenting magazine published by Disney. It offers a new, fresh look at the issues facing those with young children. I recommend taking a peek if you’re tired of some the material that tends to get regurgitated in the parenting media.

Harvey Karp to Undergo Cardiac Bypass

Harvey Karp, author of Happiest Baby on the Block, is scheduled for cardiac bypass on Tuesday according to Happiest Baby educator Colleen Newman of My Baby and More. Our thoughts and prayers go out to Dr. Karp for a speedy recovery.

End Stage Colic

When I stumbled on this I was about in tears laughing. It seems a mother was told by her doctor that her daughter had stage 4 colic (Now I assume this is one step worse than stage 3 colic and two steps worse than stage 2 colic). The good Dr. Sears sets momma straight and puts the kibosh on one doctor’s smoke and mirror act. No word as to whether the doctor referred the baby to hospice.

Mother Accused of Killing Her Baby with Cleaner Spray

A California mother is standing trial for first-degree murder in the case of her crying baby. The 19-year-old admitted to spraying her 4-month-old with aerosolized household cleaner when she wouldn’t feed and wouldn’t stop crying. The baby’s autopsy revealed lethal levels of para cresol, a chemical found in cleaners. The mother testified that her baby’s crying “ruined her life.”

This is a tragic story. While this mother is clearly impaired, it’s another example how a miserable baby can push a teen mom to the brink.

The reports suggests that Lysol was the product used in this baby’s demise but it seems this isn’t the case. The folks at Lysol are apparently working feverishly to avert a brand crisis.

Via the Jay Allen at Parents Behaving Badly.

Dr. Phil Gets Real with Colic

Dr. Phil hosted pediatrician William Sears recently. The c-word came up and Dr. Sears rose to the occasion suggesting that the jig’s up on one of the 20th century’s greatest pediatric boondoggles. Dr. Sears notes that colic is a 5-letter word used when doctors don't know what's going on. Amen.

Go to the bottom of this page under "Colic Questions" and click the film icon to read the manuscript.

The Vast Colic Conspiracy

This week marks the release of Colic Solved. For those unfamiliar with Colic Solved, it discusses the fuzzy nature of the colic “diagnosis” and addresses the miserable baby in the context of what we know about why babies scream. Despite the controversy that it may generate, Colic Solved will hopefully serve as a valuable resource for the parents of babies suffering with acid reflux and milk protein allergy.

I’m excited to be partnering with Babies R Us in a seminar tour for expectant and new parents. My Colic Solved seminar offers practical information to help new parents understand the basics of nutrition and digestive health in their infant. Over the next couple of months I’ll be offering the seminar at stores in Atlanta, San Diego, LA, Denver, Seattle, Dallas, Austin, and San Antonio. It’s been well received in the Houston area over the past year and this success will hopefully translate nationally. It’s is free and open to anyone interested in understanding how to keep their baby’s digestive system happy and healthy. I’ll post a schedule in the side column in the next few days.

You can find the Colic Solved wherever fine books are sold.

Screaming Baby Robots Avert Teen Pregnancy

The latest tool for reining in teen pregnancy is a colic robot. The computerized bundle of misery known as Baby Think it Over burps, screams, and carries on just like a real baby with reflux esophagitis or milk protein allergy. And living just one night with BTIO seems to put the kibosh on teen mojo. It was apparently modeled after the natural prophylactic effect observed in exhausted parents. I was shocked to Google this – Lots of teen programs have this infantile terminator in use. Genius.

The Baby Think it Over is manufactured by Realityworks, Inc.