Antacid use in first year of life tied to later fracture risk

(HealthDay)—Infants who are given acid suppression therapy (AST) in their first year of life are more likely to subsequently break a bone, according to a study published online June 7 in Pediatrics.

Laura Malchodi, M.D., from the Walter Reed National Military Medical Center in Bethesda, Maryland, and colleagues retrospectively analyzed data from children born in 2001 to 2013 who were followed for at least two years. ASTs administered before age 1 year were identified from prescription data.

The researchers found that roughly 11 percent of 851,631 children were prescribed an acid suppressant in the first year of life (0.9 percent were prescribed a proton pump inhibitor [PPI], 8 percent a histamine H₂-receptor antagonist [H₂RA], and 2 percent both). Median age of first fracture was earlier for infants prescribed AST (3.9 versus 4.5 years). Increased fracture risk was associated with PPI use (21 percent increase) and combined PPI and H₂RA use (30 percent increase), but not H₂RA use alone after adjusting for other confounders. Fracture hazard was increased with longer duration of AST treatment and earlier age of first AST use.

"Use of ASTs in infants should be weighed carefully against possible fracture," the authors write.

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