Your breast milk is the best food available for your baby. It was designed especially for them and has a whole range of benefits for both you and your baby. There are even more benefits involved in breastfeeding if your baby has gastric reflux. Breast milk is cheap, easily replaced if vomited, smells less when regurgitated and most importantly is more easily digested than formula, which means that the stomach remains full for a shorter period of time thereby decreasing reflux episodes. Studies have shown that breastfeeding may reduce the risk of developing allergies but it can depend on the diet of the mother as well. I breastfed my first two children (not refluxers) until they were 14 months old and my third child who has reflux until she was approximately 11 months. I strongly advocate breastfeeding until at least one year of age, but also acknowledge that this isn’t always the best for both mother and child (usually the mother). A happy baby requires a happy mother!
There are a variety of circumstances that may lead to formula feeding, and my reason is only one of these. My third child had a cow’s milk intolerance, which meant I had to have a cow’s milk free diet. Whenever I consumed cow’s milk in any form she suffered for at least a week. Eventually I found the restrictions on my diet too much and changed to formula very slowly as it took some time to find one she could also tolerate. I do wish in hindsight that I had persevered for another few months, which would have been of benefit to both of us. Please discuss with your child’s doctor/paediatrician or Plunket nurse about which formula would be the best for your baby. Formulas are either whey based or casein based. Whey based formulas tend to be slightly more expensive but better tolerated as they are more like breast milk.
La Leche League , a lactation consultant or your local Plunket family centre may be of help also if you wish to continue breastfeeding and are having problems of any kind.
Some formulas are available on prescription if your paediatrician applies for a special authority number. These include hypoallergenic formulas such as Neocate, Elecare or Pepti Junior. The hypoallergenic formulas are very expensive to purchase. Neocate and Elecare are not readily available without a special authority number and prescription. Neocate is ‘elemental’, which means that all the nutrients are in their simplest form (i.e.. amino acids) and are easy to digest. Pepti Junior is a hydrolysed protein formula with proteins broken down to peptides, which may still cause an allergic reaction in some infants. For prices of these formulas on prescription see the PHARMAC Interactive Schedule or contact a dietician at Nutricia (Phone 0800 688 742) for further information, as they may be able to advise you how you can obtain these cheaper or offer some practical help with your infant’s feeding. Your own dietician or doctor should be able to help also.
For the infant that has not shown any sign of a cow’s milk allergy but is at risk of developing allergies due to family history there is a formula by Karicare called SensiKare HA. The proteins are partially hydrolysed i.e. not as broken down as Pepti Junior. It is available from supermarkets and internet mail order at a reasonable cost (less than Goat’s and Soya Formula).
Goat’s milk and Soya Formula are not recommended by some paediatricians and allergy experts due to the risk of an allergy also developing to these. Others experience has indicated that these may be suitable so this is something you need to discuss with your health professional if you are considering either of them. 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.
There are also a number of already thickened formulas available, but I have been told that most of these do not remain thickened once they are in the stomach and that Karicare AR is the only one available in New Zealand that does. There is also information on thickening feeds available from GRSNNZ, including thickeners suitable for both breastfeeding and formula feeding. A document on AR formula is also available. Thickening feeds should not be attempted until any pain from gastric reflux has been controlled with the appropriate medication.
There are lactose free formulas for those babies with a lactose intolerance. One of these is Karicare De-Lact, which is available on prescription. Soy formulas and Neocate are also lactose free. Pepti junior is “clinically lactose free”. More information is available on Lactose intolerance vs. Milk protein allergy.
NB: This page was designed for New Zealanders. If you are from another country and require assistance with infant feeding, please contact the appropriate health professionals to obtain help.
This was prepared on December 2002, updated June 2005 and to the best of my knowledge is accurate.
Breastfeeding (at Everybody)
Composition of formulas from the Karicare site (no longer available on the website) and Karicare infant formula
Karicare Soy formula, Infasoy formula (Health answers site – website no longer available), Isomil (Ross Paediatric Products)
Pepti Junior (Health Answers site – website no longer available)
Dr Rodney Ford, Paediatrician
Karicare SensiKare HA Infant Formula
Cows Milk Allergy – An Update on Adverse Reactions – http://www.allergyclinic.co.nz/guides/43.html
Written by Roslyn Ballantyne (RN), National Coordinator for © Crying Over Spilt Milk Gastric Reflux Support Network New Zealand for Parents of Infants and Children Charitable Trust (GRSNNZ) 2005.
This page may be printed for the personal use of families, as long as the copyright and source (i.e. Crying Over Spilt Milk‘s URL) is also printed. It may not be copied to other websites or publications without permission.
Hi there, just wanted to say that this page and your website has been a huge help! It has provided ideas, helping me and my 8 week old son cope with his reflux. He was diagnosed @ 4 weeks old, and has been on gaviscon since. I have also gone dairy free, not sure if it's helping but he's definitely settled over the weeks. Hopefully he 'grows out of it' as the Dr says, grateful for all tips and advice from other parents experiencing the same...'I'm not alone'....this is a photo of our son in his Happy Place, where he goes from crying to smiling straight away!
Hi, Just wondering if you could help me with a question please. I got given Losec Suspension today. Since it's in suspension form and not the granules how long before a feeding should I give it to my baby or can it be given at the same time?
My baby has been diagnosed with reflux, her dr prescribed her ranitidine 150 mg/10 ml. It says 1 ml 3x a day, shes 5.7 kgs, does this sound right? That seems alot to me...
Hi there. I've been reading your website and Facebook page with interest over the past few months and it's been really helpful. My daughter is coming up 4 months old and her reflux seems to be improving. We tried gaviscon but it didn't make much difference. Main thing for us has been that I cut dairy out of my diet. I now have food with dairy in it but just don't do the core basics like cheese, yoghurt, milk etc and although she still spills often, the associated pain seems to be almost gone. Am hoping she's growing out of it but the dairy still seems to have a bit of an effect. Anyway, in two months time I have to go back to part-time work and will need to start using a formula on those days. I usually used karicare gold with my kids but have no idea what options would be best for my reflux baby. Can you make some suggestions? I'd like to try some out to see how she reacts etc before I go back to work but don't know what brands to try. Thanks.
Hi, I have a wee girl Matilda, 3.5 months, who has been diagnosed with gerd and is currently on Ranitidine and Domperidone. We have tried Losec and gaviscon infant too, and after trying pepti jnr and neocate we are now on elecare formula. Also have done the usual, raise cot, chiro, upright after feeds etc. We don't seem to be making much progress and its really heart-breaking to try all these medications on such a wee person! We do seem to have 3-4 great days when she is happy and contented but then have 3-4 terrible days with constant crying, not much drinking, so much vomit and terribly unsettled, not much sleeping etc; my question is, is this 'normal' ?! Is gerd cyclonic? Thanks, Amanda :)
My four month old son has recently been diagnosed with reflux after his feeding has become worse and worse over the last month. He will cry before and during a feed and constantly turns his head from side to side. It takes alot of coaxing to get him to drink. He has also started waking almost hourly through the night. We have tried gaviscon which gave him terrible constipation and now ranitidine. After reading the dosages on the spilt milk site we realized the dose we were given was far too low so have now been on a high ish dose for a week with little change. How long should it take to see a change? We also have a script for omeprazole so can try that next. Anyone else with a reflux baby also had these sleeping issues? Any tips welcome, we have raised the bed and keep him upright after feeds. Thanks in advance
Anyone recommend a good paediatrician in Auckland, son has reflux and looking to get some help!
How can I give my omeprazole granules to a 5 month old? I have been putting in pear puree but now want to introduce food and think this is putting her off wanting to eat!
Our membership form is now working again. Sorry for the delay. We are looking forward to meeting some new members. http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz.../ Joining Gastric Reflux Support Network NZ for Parents of Infants and Children Charitable Trust gives access to our Newsletters and Private Local and National Support Networks. Membership is free, and this gives you opportunities to discuss gastric reflux related issues with others in a safe and confidential setting.
hi i have a nearly 8 month old girl, she is on ''Kari-care anti reflux AR'' now they say by six months the reflux or spewing up heaps of milk should be fine now. but im scared to put her on normal kari care cause she use to vomit like crazy, what formula should i be going on? thanks :)
Advice sought please. My bf 11mo has reflux which is basically under control with restricted diet (no dairy, no soy and query gluten intolerance too, so no gluten) for us both and 10mg omeprazole daily. Gaviscon as required. Acid symptoms generally improved. However still no sleep due to wind/tummy pain etc. and we are exhausted (waking hourly to 2-hourly in discomfort/wanting to feed). Found this remarkable thread re windy toddlers (err see first comment for link) which totally resonated. Wondered if any GERD families on here had wind issues and perhaps tried low FODMAP diet? Or had other tips to share re calming the entire GI tract, top to bottom? Thanks.