Medications are frequently used to treat gastroesophageal reflux (GER) in premature infants.1,–4 However, diagnostic modalities for GER are poor and clinical diagnosis is highly variable. Like all medications, GER medications have side effects specific to their drug class. In addition, a number of these medications have been associated with significant harm (eg, sepsis, necrotizing enterocolitis [NEC]) in large cohort studies.2,5,–7
In this issue of Pediatrics, D’Agostino et al use an electronic health record from 30 sites in Pennsylvania and New Jersey to document the use of GER medications in infants ≤35 weeks’ gestation at birth born between January 2005 and January 2009.8 They find that 37% (812 of 2217) of the cohort was treated with GER medications in the first year of life. Strikingly, in >75% of cases, these medications were started after the initial presentation to the...
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