Reflux medication can be downright harmful for a preemie baby, and very sick newborns don’t need a daily X-ray to check their breathing tubes, experts say.
A team of doctors polled more than 1,000 professionals to tease out the top five tests or treatments that babies can do without. They submitted a list of more than 1,600 tests and 1,200 different treatments to a panel of 51 top experts and settled on these top five, as detailed in the journal Pediatrics:
Antireflux drugs for reflux in preterm babies
“Gastroesophageal reflux is normal in infants,” Dr. Timmy Ho of Beth Deaconess Israel Medical Center in Boston and colleagues write. Reflux doesn’t appear to interrupt breathing in the babies and there’s some evidence that drugs such as proton pump inhibitors can harm them — including causing a condition called necrotizing enterocolitis, when the intestines become inflamed and tissue starts to die.
Overuse of antibiotics
Sometimes clinics give a full course of antibiotics to premature babies, just to be sure, but there’s no evidence giving the drugs past a day or two helps them, and after that blood tests can show whether they are infected. Antibiotics can cause necrotizing enterocolitis in preemies and can kill them.
No sleep studies
Babies don’t need routine pneumograms, more commonly known as sleep studies, before they get checked out of the hospital, the experts agrees. “Although there may be a role for pneumograms in selected cases in which the etiology of the events is in doubt, they have not been shown to reduce acute life-threatening events or mortality from their routine use,” they wrote.
Take it easy on the X-rays
When preterm infants get a breathing tube, hospitals often take a daily X-ray to make sure everything’s OK with that plastic tube down a tiny infant’s throat. No need, the experts agreed. “Although intermittent chest radiographs may identify unexpected findings, there is no evidence documenting the effectiveness of daily chest radiographs to reduce adverse outcomes,” they write. “Furthermore, this practice is associated with increased radiation exposure.”
Skip the MRI
MRIs — magnetic resonance imaging scans — can predict how a baby’s brain will develop up to age 5, but there’s no evidence it tells doctors or parents anything useful about how a child will do past age 5, the experts agreed.
Finally, Ho and colleagues note, there are always exceptions.
“It is important to acknowledge that there may be specific circumstances in which these tests and treatments may be appropriate or even indicated,” they wrote.