Infant Feeding

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.

Special Formulas

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 258 268) 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.

REFERENCES:
Breastfeeding (at Everybody)
Composition of formulas from the Karicare site (no longer available on the website) and Karicare infant formula
Goat formula
Karicare Soy formula, Infasoy formula (Health answers site – website no longer available), Isomil (Ross Paediatric Products)
Neocate
Pepti Junior (Health Answers site – website no longer available)
Karicare AR
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.

  • A Good News Story ... http://www.cryingoverspiltmilk.co.nz/his-gastric-reflux-stopped/

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    Hi Roslyn, Thanks for the updates over the past several months. I am leaving the group as my little boy no longer suffers from gastric reflux and is also no longer dairy intolerant! FYI he was on Neocate from 3 months old and had a combination of formula and my milk until he was 7.5 months. ...

  • Hi. My boy is 6.5 wks. He started screaming at 3 wks. Became unsettled for periods of up to nearly 12hrs without sleep. He's been on formula as my milk never came in. He gets about 100-200 ml breastmilk /dy I pump. He started spilling/vomiting a lot at 4.5wks old.started losec 9 dys ago-frm GP. Saw paediatriciAn 4 dys ago and started amino acid formula to check for CMA. I feel things improved a bit about 4 dys after losec started. Also he seemed great once on th amino acid formula but thn yesterday was his old really bad self - fussed all day 10am-4pm thn really distressed n frantic 4-9pm. He's been ok today.i also started adding karicare thickener 2 dys ago. His first poo day after starting amino acid formula was soft n ok but I thnk he might b constipated with th thickener. He really had to push to get yesterday's out n was very sticky. Anyone else experience this? What do you do? I've heard lactulose and prune juice etc can make reflux/ wind worse. I thought about halving th amt thickener I'm using.also his vomiting better on th new formula I think but still occasional. He vomited Sunday night n mayb brought th losec up- could 1 missed dose like thts make him bad th next day like he was? Any opinions greatly appreciated

  • Please consider joining Gastric Reflux Support Network NZ for Parents of Infants and Children Charitable Trust for access to our Newsletters and Private Local and National Support Networks: http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz-membership-confidentiality-agreement-form/ Membership is free, and this gives you opportunities to discuss gastric reflux related issues with others in a safe and confidential setting. If you have completed a membership form previously, but never received anything further, please message me (Roslyn Ballantyne at https://www.facebook.com/roslyn.ballantyne.rn ) or comment below. The membership sign-up had been a double opt-in with a confirmation email, but as some people have had trouble with this, I've now changed it to a single opt-in. (I do still need to process applications and add you manually to your Local Support Networks though.)

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    Gastric Reflux Support Network NZ for Parents of Infants & Children Charitable Trust Membership & Confidentiality Agreement Form / Newsletter Admin PageFirst NameLast nameEmailStreet AddressCity/TownAreaPostcodeDo you live in NZ?Country and Area if not NZHome Phone (include area code)Partner's NameE…

  • Hi I'm a bit confused. I filled out th membership form on th cryingspiltmilk main page. Do I need to do anything else? I see there's a forum somewhere else - kiwi health or something? Or do I just post n use this Facebook page? I'm thnking you hav th older site but most people jst use this Facebook page now yeah? Ta :) I hav a 6 wks old beautiful boy who has been in so much pain been breaking my heart but I'm jst getting things in motion now to help I thnk. Saw paediatriciAn few dys ago n hav started losec gaviscon mylanta and amino acid formula with karicare thickener

  • Hiya, I'm starting to introduce solids to my almost 6 month old and just wondering if there are any foods that any of you have found to be better than others and which ones to avoid? TIA. :-)

  • Other information here: http://www.lalecheleague.org.nz/news-a-events/lllnz-conference-2014/312-lllnz-50th-anniversary-conference-2014

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  • Anyone want to help? I know you all have plenty to say. ;-)

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    And just in case you missed the post and the opportunity to help others through.........In five words, no more no less, share some inspirational advice to parents that are struggling with a newborn suffering from colic, reflux and inconsolable crying. If there are enough submissions I will post these on my website and perhaps in my book - Prevent and Remedy Colic, Reflux, Lactose and Dairy Overload Naturally - which is off to the proof readers this week!! http://www.naturalwinding.com/book/

  • A new story: http://www.cryingoverspiltmilk.co.nz/ryans-story-of-reflux-and-christinas-story-of-pnd/ Thank you, Christina.

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    I don’t really know where to begin with my story of Ryan and his reflux, and me with Post Natal Depression. I used to feel very sad thinking of all the precious time that was robbed from us. I loved Ryan from the moment I saw him, and he was a dream baby up until two weeks of age. ...

  • Hi my 7 week old, breastfed baby started showing signs of reflux recently so I went to the GP and was prescribed Gaviscon sachets. I'm having trouble giving it to her, but it seems to be working. She usually goes poos after every feed but since starting the Gaviscon (monday) she has only been once. She strains and cries. Not sure what i safe to give her to help as she is so young? Thanks

  • Hi there My 8 week old boy is formula fed and is now trialing gaviscon for his silent reflux, already I feel like it is making a difference but I am worried about the possible constipation the gaviscon may cause...how do you parents relieve constipation in young babies? I know about the cooled boiled water but are there any other remedies that are worth knowing about? Or tricks that can maybe help avoid constipation?

  • Hi, would you say it's a reflux symptom to bring up small vomits between feeds? Like an hour or so after eating? I keep being told that's normal, but it doesn't feel normal? My baby is only 4 weeks old though, so it's hard to me to tell what's normal and what isn't.

  • Hi, my 10 week old is trialling gaviscon to see if it helps with her (potential) reflux. She isnt a miserable baby, but she does scream if I put her down in the daytime, she has a persistent cough, a husky voice (this developed over the last week), and she spills even hours after a feed. Does this sound like reflux? If so, how do I get her to keep the gaviscon down? It says to give it to her after a feed, but she vomits straight after a feed...also is it worth going dairy free to see if this helps? Finding the spilling and coughing and husky voice quite upsetting, it must be horrible for her :(