The following is the summary of “Infant Exposure to Acid Suppressant Medications Increases Risk of Recurrent Wheeze and Asthma in Childhood” published in the November 2022 issue of Allergy and Clinical Immunology: In Practice by Robinson, et al.

In infants, providing Acid suppressant medications (ASMs) is routine practice. The link between ASM exposure and the development of asthma and other allergic diseases in children is poorly understood. Researchers aimed to investigate whether infants exposed to ASM were more likely to experience recurrent wheezing, allergen sensitization, and asthma as young children. Investigators analyzed information from a prospective cohort trial of 921 infants with a history of bronchiolitis that was conducted across multiple centers.

Parental report and medical record review were used to determine ASM exposure (histamine-2 receptor antagonists and/or proton pump inhibitors) before 12 months. Consequences included persistent wheezing before the age of 3, allergy sensitization (serum-specific IgE), and the development of asthma before the age of 6. To account for potential confounding factors, we built multivariate models of Cox proportional hazards and multivariate logistic regression models. Among the cohort’s 921 kids, 202 were exposed to ASMs as infants (that’s 22%). 

Exposed children had a greater risk of developing recurrent wheezing by age 3 (adjusted hazard ratio 1.58, 95% CI 1.20-2.08, P=.001) and asthma by age 6 (adjusted odds ratio 1.66, 95% CI 1.22-2.27, P=.001). Premature sensitization to allergens in early childhood was not linked with exposure to ASM in infancy (adjusted odds ratio: 1.00, 95% CI: 0.70-1.44, P=.99). The likelihood of developing allergies is not increased by exposure to ASMs in infancy, but the risk of developing recurrent wheeze and asthma is increased.