Doctors Say Not All Infant Reflux Is Disease

Tuesday, April 30th, 2013

New guidelines from the American Academy of Pediatrics (AAP) urge doctors to distinguish between gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) when diagnosing infants who suffer from the very common complaint of reflux.  The guidelines follow a study published earlier this month in the journal Pediatrics, which concluded that high rates of GERD may be resulting in over-medicated infants.

More on the AAP’s new recommendations:

Making the appropriate diagnosis will identify patients who can be treated with lifestyle changes alone or those who require more intensive therapies, according to Jenifer Lightdale, MD, MPH, of Boston Children’s Hospital, David Gremse, MD, of the University of South Alabama Health System in Mobile, and colleagues from the AAP section on gastroenterology, hepatology, and nutrition.

Among patients with either condition, lifestyle changes — such as modifying maternal diets in breastfeeding mothers or avoiding spicy foods in older children — are recommended as a first-line therapy, while more intensive treatments are recommended for those with intractable symptoms or life-threatening GERD-related complications, they wrote online in Pediatrics.

GER is common to more than two-thirds of infants who are otherwise healthy and “is considered a normal physiologic process that occurs several times a day in healthy infants, children, and adults,” they wrote.

The condition is “generally associated with transient relaxations of the lower esophageal sphincter independent of swallowing, which permits gastric contents to enter the esophagus,” they explained.

While GER is short lived and can cause few to no symptoms in healthy adults, GERD is characterized by mucosal injury on upper endoscopy and can result in vomiting, poor weight gain, dysphagia, abdominal or substernal/retrosternal pain, and esophagitis.

Symptoms of GERD can also include cough, laryngitis, and, in infants, wheezing, as well as dental erosion, pharyngitis, sinusitis, and recurrent otitis media.

Image: Upset infant, via Shutterstock

Doctors: Same Sex Marriage Is Good for Kids

Thursday, March 21st, 2013

In a new policy statement, the American Academy of Pediatrics (AAP) has come out in favor of same sex marriage, saying that partners who are raising children together can offer better benefits and security for their children if they are married.

“Children thrive in families that are stable and that provide permanent security, and the way we do that is through marriage,” said Benjamin Siegel, MD, FAAP, chair of the AAP Committee on Psychosocial Aspects of Child and Family Health, and a co-author of the policy statement. “The AAP believes there should be equal opportunity for every couple to access the economic stability and federal supports provided to married couples to raise children.”

The AAP’s previous policy statement, which was last affirmed in 2010, supported second-parent adoption in cases where one member of a couple had a child, but stopped short of calling for the legalization of gay marriage.

“The AAP has long been an advocate for all children, and this updated policy reflects a natural progression in the Academy’s support for families,” said Ellen Perrin, MD, FAAP, co-author of the policy statement. “If a child has two loving and capable parents who choose to create a permanent bond, it’s in the best interest of their children that legal institutions allow them to do so.”

The AAP cited scientific research that indicates no relationship between parents’ sexual orientation and the well-being of children in the policy statement.

Image: Same sex couple with child, via Shutterstock