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.

  • Hi, my 5 month old has started solids and we have been ok'd to feed these before milk as otherwise he spills most of it. He takes losec granules, which was have been giving with pear 30mins before a milk feed. Can we now just give these with his solids with milk following half an hour+ later? Or not due to the higher volume of food in his stomach so it wouldn't be digested by the time he has his milk. Thanks

  • Hi. We've used the karicare thickener in our boys bottles on top of losec and neocate to control his reflux. Now he's 4 months old I was looking at using watties rice cereal to thicken his bottles before moving to solids at 6 months. Looking to find anyone who thickens with rice cereal. Advice? Thank you

  • Argh! I don't know if I'm doing the right thing for my wee girl. We discovered her reflux early 8 days old and has been on goats milk formula for 3 months. Did it help? Hard to say but she was happy enough. We were reffered to the hosp dietician by our plunket nurse and on Thursday started neocate. Its made things worse and she seems in pain.. her poops are slimy green. We gave her a few gaviscon feeds with it to help her tum cos she seems to have a sore tummy a lot. So its Sunday, we've been on it three days but I am continually second guessing myself. Should we have seen a change in her by now. Is it normal to take a few days for the tummy to get used to it? I hate putting her through all this esp if it doesn't end up working... sometimes I just want to throw it in and put her back on goats milk... would love some advice from others on neocate or just any advice/encouragement please and thank you :)

  • Hi mums I have recently taken my daughter off losec on advise from a paed to see how she went. We didn't notice the symptoms coming back and also started solids around same time with it going great. She's had a cough and cold but is over it except this nagging cough which is day and night until she eventually throws up. My question is could the cough actually be the reflux and should I start losec again.

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

    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.)

    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