Watch this video from the creator of the MarciKids study!
Marci Kids Study page explains the principles of PPI treatment in infants and small children and why they work if they are dosed properly That's the difference between our success when other PPI treatments have failed.
Jeffrey Phillips Pharm D., the lead in the study explains it in the video above.
The “MarciKids Study" was a three center study ( done at the University of Missouri and two other centers) performed by a group of physicians, nurses and pharmacists that specialized in infant GERD.
The basis of the study was, that because infants and small children metabolize many medicines (including PPI medicines) much faster than adults, infants and small children required higher doses, more frequently to control acid reflux disease symptoms.
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PPI stands for proton pump inhibitor and they block the production of acid at the parietal cell where production occurs. PPIs can only block the proton pumps that are active (producing acid at that moment). If the pumps aren’t producing acid then the PPI has no effect.
A drug regimen is the drug that you take, how much you take per dose, and how often you take it, and the length of treatment is in duration (number of days, weeks, months etc).
Half-life is the time required for the drug concentration in the
bloodstream to drop by ½.
Does that make sense so far?
The graph below, created during the Marci Kids Study, shows the half-life of lansoprazole compared to age in infants and children. As you can see there is a relationship between age and half-life with some degree of variability. This is important to consider because half-life effects the acid inhibition in PPI medicines.
Tran A, Rey E, Pons G, Pariente-Khayat A, d'Athis P, Sallerin V, Dupont C. Pharmacokinetic-pharmacodynamic study of oral lansoprazole in children. Clinical Pharmacology and Therapeutics. 2002;71: 359-367.
As shown in the graph, the estimated half-life for the child indicated here in the chart would be 0.5 hours.
The average adult takes 1 dose per day (baseline from above) to achieve good acid control, so this one year old child would be expected to need 3 doses per day. The Marci Kids study showed that infants responded best to 3 doses a day because they metabolize so quickly.
In the Marci Kids study, they calculated the dose as follows: The amount of PPI was determined by multiplying the volume of distribution and the child's weight. An example below would show a typical calculation of a PPI dosing regimen to be prescribed by your medical care team if they agree to the Marci Kids Study dosing suggestions.
3.5 x 0.2 mg/pound = 0.7 mg/pound
Some infants or children required a higher dose to control acid reflux symptoms so there may be times when your doctor would want to increase the milligram (mg) per milliliter (mL) concentration and/or the dose. We know finding the right doctor is key which is why we offer care to those looking for help in our online telemedicine appointments. You'll have the benefit of working with a medical professional that can provide you with the specialty treatment your baby needs.
It is absolutely required that you contact a doctor and work with them on any medical treatments. This chart is ONLY here to show what the Marci Kids study used as a guideline. We are not suggesting that you use these dosing regimens for your child unless a doctor is involved with treatment. If you need a medical care team connect here.
 Childs Age |  Doses per pound of body weight |  Doses per  day |
Under 3 months old | 0.7mg to 0.8mg of PPI per pound of body weight | 3 times per day |
3 to 6 months old | 0.6mg to 0.7mg of PPI per pound of body weight | 3 times per day |
7 months to 2 years old | 0.45mg to 0.6mg of PPI per pound of body weight | 3 times per day |
2 years old or older | 0.45mg of PPI per pound of body weight | 3 times per day |
5 years old or older | 0.35mg to 0.45mg of PPI per pound of body weight | 2 times per day |
 Childs Age | Doses per pound of body weight |  Doses per  day |
Under 3 months old | 0.7mg of PPI per pound of body weight | 3 times per day |
3 to 6 months old | 0.6 to 0.7mg of PPI per pound of body weight | 3 times per day |
7 months to 2 years old  | 0.45 to 0.6mg of PPI per pound of body weight | 3 times per day |
2 years old or older | 0.45mg of PPI per pound of body weight | 3 times per day |
5 years old or older | 0.35mg to 0.45mg of PPI per pound of body weight | 2 times per day |
A common question is: Can I give too much to my baby? The short answer is NOT REALLY!
PPIs are very specific in where they work in the body and are only active in a very specific place, the acid secreting portion of a cell, called the parietal cell. Since PPI drugs only work on the acid secreting cell they have generally a good safety profile. PPI drugs are known as pro-drugs because they are not active in the bloodstream. PPIs only become active when they pass into the acid secreting portion of the parietal cell (the cells in the stomach that make acid). This is important because we get this question a lot. Whatever the body does not put to use gets passed through the system.