Proton pump inhibitors for irritable infants.

QUESTION Crying is common in infants; however, caring for infants with inconsolable crying, previously also known as colic or reflux, is often extremely distressing for parents. Is there a benefit to using gastric acid suppression (eg, proton pump inhibitors [PPIs]) in these infants? ANSWER The use of PPIs in infants and children has increased in recent years. The efficacy of proton pump inhibitors has not been demonstrated in the treatment of irritability and excessive crying in otherwise healthy infants younger than 3 months of age. Conversely, while PPIs are generally well tolerated, there is some evidence to link the use of PPIs with increased susceptibility to acute gastroenteritis, community-acquired pneumonia, and disorders of nutrient absorption and utilization. Irrespective of treatment, crying and irritability in infancy generally improve with time. Proton pump inhibitors do not improve symptoms in the interim.