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 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.

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.

  • http://www.jpeds.com/article/S0022-3476%2813%2901596-5/abstract?elsca1=etoc&elsca2=email&elsca3=0022-3476_201405_164_5&elsca4=pediatrics

    The Journal of Pediatrics, Volume 164, Issue 5, Pages 959-960, May 2014, Authors:William Tarnow-Mordi, BA, MBChB, DCH, FRCPCH; Roger F. Soll, MD

  • Hello - wondering if you can help, my now 5 year old had silent reflux, my 5 month old also has reflux, I saw a specialist in Auckland for my first child but cannot for the life of my remember his name - do you have a list of specialists in Auckland? Many thanks Misty

  • Hi :) just starting my five month old on solids , any foods worse or better for reflux sufferers ? She is quite constipated from losec and gaviscon so also foods that aren't constipating

  • We only have six members in our Hawkes Bay GRSNNZ Local Support Network on Facebook. If you are coping with reflux and living in this area, we would love you to join us. http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz-membership-confidentiality-agreement-form/

    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...

  • A large randomized controlled trial has shown benefits of probiotic treatment in an unselected general population of neonates.

  • hi there, im desperate for help. my wee girl is 5 weeks old and has always been unsettled from birth. At first she was constipated and in pain so paed put her on pepti junior and after no improvement added lactulose syrup for bowels. She has a bowel motion now only every 5-6 days so not ideal. over the passed few days she has got alot worse, fussing at feeds, acidy smelling breath, after finishing bottles she squirms in pain, cramps up like a banana, screams/cries etc. she doesnt spill ever and winds pretty well. Clearly something is still not right but have seen 3 paeds and all havent considered silent reflux?? i feel silly going back again but i know they are missing something, could it be reflux?? thanks Nicole

  • I have been reading your website, thank you, it's helped me a lot. 5 weeks with a very unhappy baby is extremely difficult.

  • Do you live in Northland, New Zealand and have a child with gastric reflux? We would love you to become a member of the Gastric Reflux Support Network NZ and join our latest Private Facebook Group - for the Northland GRSNNZ Local Support Network. We currently have five families who would be grateful to have contact with others in the Northland area and share their experiences. We have Local Support Networks throughout NZ and set up Private Facebook Groups as requested. We already have Yahoo Mailing Lists for each region, but many prefer Facebook. To join complete a membership and confidentiality form: http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz.../ Membership is free, and this gives you opportunities to discuss gastric reflux related issues with others in a safe, private and confidential setting. You will also get access to our newsletters.

    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 there, I was on your website reading that doctors should prescribe the Losec granules instead of the suspension. Does this apply for 2 month old babies as well?

  • I am hijacking this photo. #gastricreflux

  • Hi, I am interested in people's opinion on advice from a dietician re my 13 month son who has reflux and lower GI issues, both currently well managed. I have posted before: he's on a restricted diet - no dairy, soy, gluten as well as a random no tomato/potato (latter done by me without paed knowledge following nasty flare up). He is still bf and not a great solids eater - picky, limited finger foods only, no mush. He is small (prem, lbw) but not at all underweight for size. He is on iron supplement (formerly anaemic) and trying to wean off losec. Dietician wants us a) to go on to neocate advanced and b) to reintroduce gluten. Neither of these sit well with me. I ate non-GF oats and small amount non-GF pasta yesterday - now I have an unsettled boy stretching and groaning after a month of calm. Coincidence?? Re neocate - is it really necessary to give him this or can I find the iron and vitamin boost elsewhere? He hates the taste and doesn't eat porridge/mash/stewed fruit to mix it into. The dietician really p***ed me off for her manner and lack of knowledge of son's history (in spite of having met before) and I don't trust her judgment. Thoughts? Sorry long post. Thank you for reading.

  • https://www.youtube.com/watch?v=qTHhWf_hGJI

    Pyrosis RGO mécanisme