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MANAGING UNCOMPLICATED REFLUX |
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Treatment > Managing Uncomplicated Reflux |
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Babies with uncomplicated reflux are often described as "happy chuckers". These babies vomit or spill frequently, but are otherwise completely happy, sleep well, gain weight and have no other obvious reflux complications.
Happy Chucker
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Breastfed
Try a dairy-free diet for Mum for up to 2 weeks*.
Not working?
Karicare Food Thickener or Baby Rice fed from a spoon before a breastfeed.
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These thickeners are all safe from birth. Try them one at a time. You will need to give them at each feed for about three days before you should try to decide if they are helping. |
Bottle-fed
Try an non-dairy formula for one week**.
Not working?
Try these thickeners/formulas: Karicare AR, S-26 AR, Karicare Food Thickener, Baby Rice, Cornflour (cooked).
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General Management Techniques
Raise the head of baby’s bassinette/cot and changing surface to 30 degrees.
Put baby to sleep on his/her side (only if you can provide a stable side sleeping position e.g.. safe-t-sleep), not back. Wrap baby to stop rolling over or sliding down.
Use a front pack, jolly jumper, walker, exersaucer etc, to keep baby upright when awake.
Not working?
| As a last resort, the medication Gaviscon Infant and/or a motility medication may be prescribed. However, neither of these will consistently reduce/stop the vomiting in every baby tried on them. They may also have unwelcome side effects. Infant Gaviscon may cause constipation; with motility medications stomach cramps, diarrhoea and headache are common. |
All happy chuckers will outgrow the vomiting/spilling with time. Many parents make a decision just to "ride it out". There may be long term benefits to these babies for doing this. |
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If you have a child who gets both pain from reflux and vomits/spills, you will need to refer to the charts showing treatment options for both "Silent Reflux" and the "Happy Chucker".
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However, an important point to note is that with babies who get pain from reflux as well as vomit, it is important to control the pain and acid first before considering the use of thickeners or thickened formulas. When the pain/acid is under control with appropriate acid reducing medications, then try the options on the 'Happy Chucker' chart. Babies who get pain due to reflux all have some degree of oesophagitis (inflammation/ulceration of the oesophagus). Studies have shown that although thickeners and thickened formula may reduce the number of episodes they prolong the length of time of the remaining episodes as thickened fluid does not drain as well from the oesophagus. It is these prolonged reflux episodes, when they contain acid that can do the most damage.
*The time frames mentioned for this diet is the length of time that the diet should be trialled for by the breastfeeding mother before deciding that it is not helping and before returning to a normal diet. The dairy free diet needs to be a complete removal of these foods as cheating does matter. A positive response may be seen earlier than the time frame indicated. If the baby has started solids then these also need to be free of dairy. If the diet is successful in resolving symptoms then it needs to be continued or another form of feeding considered. Breastfeeding is nearly always best for the baby with gastric reflux but the mother’s health is also important, so consider this decision carefully with the help of a paediatrician for future feeding options.
**There are three options for non cow’s milk based formulas.
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Soy based formulas are not recommended when soy is the only source of nutrition. Therefore, a child who is bottle fed only (with no solids) would be best not to be on a soy formula.
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Goat milk formula is often effective in children with reflux problems due to cow's milk protein intolerance. (Opinions vary about the suitability of goat’s milk due to the proteins being similar to cow’s milk so this may need to be discussed with your health professional.)
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Hypoallergenic formulas are best recommended by a paediatrician as a special authority number is required to receive these subsidised (otherwise they are around $100 per tin).
See our fact sheet on “Infant feeding” for more information. If the baby has started solids then these also need to be free of dairy.
© Gastric Reflux Association for the Support of Parents/babies (GRASP) and Crying Over Spilt Milk Gastric Reflux Support Network New Zealand for Parents of Infants and Children Charitable Trust (GRSNNZ) 2004. Used and edited by GRSNNZ with permission.
www.cryingoverspiltmilk.co.nz
Page may be printed or reproduced for personal use of families, as long as copyright and Crying Over Spilt Milk's URL are included. It may not be copied to other websites or publications without permission and acknowledgment. This information (unedited) was also provided (by GRASP) to health professionals in New Zealand to use " to continue to support and inform families with babies/children with Gastro-oesophageal Reflux."
Page last modified 02-Sep-2007 by Roz (Website Manager, Crying Over Spilt Milk).
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