Wang YH, Wintzell V, Ludvigsson JF, et al. - In this nationwide register-based cohort study, researchers intended to determine if there is a connection between proton pump inhibitor (PPI) use and risk of fracture in children. Data were obtained from Sweden from July 2006 to December 2016. Children younger than 18 years of age who initiated PPI use were compared with those who did not initiate PPI use on propensity score and age. A total of 115,933 pairs included children. Five thousand three hundred fifty-four and 4,568 cases of any fracture occurred among those who initiated PPIs vs those who did not, respectively, during a mean (SD) of 2.2 (1.6) years of follow-up. Use of PPIs was not associated with head fracture or spine fracture but with increased risk of upper-limb fracture, lower-limb fracture, and other fractures. PPI use in this large pediatric cohort was associated with a limited but significantly increased risk of any fracture. The risk of fracture should be weighed when assessing the benefits and risks of childhood PPI treatment.