Disease over-diagnosis can result in needlessly medicating infants

The American Board of Internal Medicine Foundation recently recommended against routine use of medications to treat infants for gastroesophageal reflux (GERD), commonly known as reflux disease. From 1999-2004 the use of prescription medications to treat this disease in infants increased 700 percent. However, these acid-reducing medications have been found to be ineffective at alleviating symptoms commonly diagnosed as GERD, such as excessive crying and spitting up. This suggests that GERD is often over-diagnosed in infants. In a new study, MU Psychology Professor Laura Scherer found that when physicians label common symptoms in infants, such as crying and spitting up, as "GERD", this increases parents' desire for medication even when parents are told that the medications are probably ineffective. As a result, using diagnostic labels like "GERD" may cause parents to believe that their infant needs medications, and contribute to overtreatment and use of ineffective medications.

"Over-diagnosis of GERD can make a medical condition out of a normal behavior," said Scherer, assistant professor of psychological science in the College of Arts and Science. "When a set of behaviors is labeled a "disease," this can make parents think that medication is appropriate for their child, regardless of whether the drugs are effective or not. Doctors may feel the need to give parents a name for their child's problem, but by doing so they can inadvertently increase parents' perceived need for medical treatment. Parents should follow doctors' advice, which sometimes means accepting a doctor's explanation of why medications are not needed."

"The over-use of medications can be a needless expense," said Scherer. "In addition, the long-term effects of these acid reducing medications have not been fully studied in infants, although the medication has been associated with slightly higher rates of pneumonia."

The study, "Influence of 'GERD' label on Parents' decision to medicate infants," was published in the journal Pediatrics. Co-authors were University of Michigan researchers Brian Zikmund-Fisher, Angela Fagerlin and Beth Tarini.