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/cows_milk_allergy.htm

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.

  • The GRSNNZ 0800 number and mobile will not be answered or messages cleared between these dates: 25th to 28th December and then again from 1st January to 11th January. You are welcome to leave a message or text and we will respond as soon as we are able.

  • http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-2284.full.pdf
    Please note, from this article that raising the head of the bed to reduce gastro-oesophageal reflux is NOT recommended and is shown to be ineffective.
    I will edit http://www.cryingoverspiltmilk.co.nz as soon as I am able to.

  • I'm hoping someone here can share their experience with me as I'm at my wits end. My daughter is nearly 11 months old and has had chronic vomiting since she was about 5-6 months old (full feed vomits till there was nothing left, gagging, up to 9 times in 24hrs). After no doctors taking me seriously, and seeing 3 different doctors we finally got a barium swallow test done after taking her to the hospital out of desperation and it showed that she has severe reflux. I have accidentally eliminated gluten which has helped immensely but we still get 2-3 vomits a day. I'm waiting to hear from a paediatric doctor at the hospital for a follow up after the test but I'm just curious if anyone else has experienced this and what eventually helped? Or was it a case of managing it until they grow out of it? She was given liquid omeprazole a week ago but that only made it worse so i stopped giving it to her. Thanks in advance x

  • My sons 3 months, we've been in hospital his whole life but hoping to go home in next couple of days. He has liquad omeprozol via NG, i've heard that you have to pick it up from the pharmacy really reguarly be because once made up it looses it effectiveness quickly. How often do i need to get it made up?

  • This may need adapting a bit for infants and of course remember to think about allergens but some great advice: http://www.drlibby.com/stress/nutrients-herbs-help-children-calm-relaxed/?utm_campaign=December+Newsletter&utm_content=control&utm_medium=email&utm_source=vero&utm_term=Newsletter&vero_conv=365086097

    So often I hear parents exclaim that their children are wired and hyperactive, and it is usually late afternoon when parents are trying to run errands, cook dinner or get home from after-school activities. Quickly, wired children become grizzly and tired. Parents know the difference between when the…

  • can I please be added to the laryngomalacia page

  • My 7 week old has reflux. We went to see the paediatrician yesterday and he gave us Pepti Jr to try. Im dairy free as still partially breast feeding. He also prescribed neocate as a back up. Just wondering on anyone's thoughts about pepti jr as have heard alot of people haven't had any luck on it.

  • Help please. Our 4 month old suffers from silent reflux, he's been on omeprazole for 2 months now. Initially we saw significant improvement (different baby!). Unfortunately, things have really started to plateau (worsen) over the last week. We have had 3 consecutive nights of holding him right throughout the entire night. Any attempt to move him from being held completely upright see's him wake within seconds and start screaming in pain. It's harrowing. We have been advised by our Dr to increase his dose to (20mg) he's currently on (15mg). I'm really concerned as I feel there's going to be nowhere left to go if he doesn't grow out of the reflux soon :( Has anyone switched medicine from omeprazole to something else with good results? Can anyone please recommend a good paediatrician in the Auckland area who specialises in reflux? We're feeling a bit gutted in this household as we thought things were under control but definitely not the case at the moment :(

  • http://faithtap.com/2205/whatsupmoms-blank-space-parody/?v=1
    Just for some fun. We can all relate to parts of this.

    These busy moms take some time out of their schedule and create a parody of Taylor Swift’s "Blank Space" that will have every mom relating to the sleepless nights and the need for caffeine the next day to keep going. All in good fun, these three moms from "WhatsUpMoms" will have you laughing at thei…

  • December 2014 Newsletter - It is on its way out to members.
    If you are on the old Yahoo Mailing List it has been emailed earlier this afternoon, but sometimes gets marked as spam so check your spam/junk folders for it if it hasn't arrived.
    If you are on the new custom emailing list (i.e. not Yahoo), we are sending from a new server...slowly...Currently at 136 of 235. Talking to the webhosts about how we can make this faster next quarter.

    If you should have received one and don't by tomorrow, please contact us.

    If you aren't a member and would like a newsletter, it is easy and free: 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 Page First Name Last name Email Street Address City/Town Area Postcode Do you live in NZ? Country and Area if not NZ Home Phone (include area code) Part…

  • Help please! Miss 7mths was finally diagnosed with reflux 2wks ago. She was pretty god during the day, no spilling anymore, crying occasionally with what I thought was wind but must have been acid, worst was getting her settled at night, took a couple of hours. We started on Gaviscon and it was great the first few days, except neither Dr nor chemist told me of constipation side effect (still not sure if we have her constipation sorted). So last Friday saw the Dr and got omeprazole, at first it helped but have found I still have to give gaviscon at bedtime breastfeed otherwise she won't settle. Now I am concerned as I just saw on the forum a post about omeprazole in suspension not being as effective and this is what we have. Also saw the comment about giving it with milk so it isn't affected by stomach acid. Chemist told me to give it 1/2hr before her first breastfeed of the day, I usually manage to give it 15-30min prior to feed. Finding I still can't give her a breastfeed or water too close to a sleep otherwise she wakes crying (usually wakes and just chats to herself) after about 30-45min, this is worrying me with this Auckland heat and humidity that she isn't having fluids often enough during the day. Maybe this is still happening due to Omeprazole not working properly?
    Now I don't know what to do. I am not looking for medical advice as such but I don't know if I can believe the advice of the Dr and Chemist who don't seem to be very knowledgeable about reflux. Do I still give it suspension or ask for granules? Suspension with a feed or before? My other 3 kids didn't have reflux and I am feeling very lost

  • Has anyone's baby got worse with their reflux after taking Ompremazole?It seems my wee grand daughter is.Any answers would be grateful.Thank you

  • Hi Moms out there! I am in South Africa and my little girl has just turned 2 years last week!
    She was diagnosed with silent reflux about 7 months ago and is currently on Zantac. I am at wits end.. still wakes up three times a night and just can't deal right now. We feel like zombies since the day she was born. We must sound like terrible parents but the lack of sleep is unbearable and the sleepless nights are relentless. She is now eating only gluten free food but there has been no difference
    . Are there any parents out there experiencing the same thing... i am just so heart broken for my little angel! thank you

  • Time for a cuppa chamomile tea and a gingerbread star...whilst I work.
    What are you doing today?

  • Help! How long does omeprazole take to kick in? I thought I saw on here someone say that they had to use gaviscon till it started working but the pharmacist told me it should work straight away. Yesterday was miss 7mths 2nd day of omeprazole and no gaviscon and we had a terrible night last night, she was hard to settle and didn't sleep well. At 2am I gave her gaviscon and she slept about 3-4hrs which was blast nights longest stretch. Just wondering if the omeprazole isn't working at its full potential yet. Thanks heaps

  • Does anyone have a child with laryngeophyrangeal reflux? My son was diagnosed a few months ago and has been on treatment with amazing results (thank goodness). Im just wondering if there is anything else I can do for him, and also if there is an average age they grow out of it. He is 20 months now. Thankyou

  • Gastric Reflux Support Network's page has got much busier and there are more posts to the page.
    Thanks to everyone who keeps on answering. I can't keep up, but it is wonderful to see everyone coming here for support.
    Roslyn, National Coordinator.

  • Has anyone used goats formula on their wee one with a dairy allergy? Am starting my twins on it today as one has dairy allergy and am exhausted from breast feeding so going to do a couple of bottle feeds per day

  • Hello. I read on the website that it recommends the NUK brown rubber teat pacifier. Does anyone know why in particular and where to purchase? Thanks.

  • A question on giving up dairy for relux please...

    Do you need to go 100% dairy free or does cutting back help? I drink ALOT of milk (ill go through nearly 4 litres a week, bit excessive). Can I still have milk in tea/a small amount of cheese etc, or do i need to go 100 % cold turkey?

    My daughter is 2.5 weeks old and is doing alot of regurgitating, back arching/night crying, has acid smelling breath, gets frequent hiccups, coughs and gags alot and cries every time I lay her down. Shall I book a GP visit ASAP? What is usually the first treatment they try?

    Many thanks :)

  • http://www.cryingoverspiltmilk.co.nz/new-baby-on-the-way-taking-probiotics/ - New story from one of our Kiwi Health, Pregnancy and Parenting Forum users. Nice to have positive stories.

    Well I thought I would update you all on our baby. She was born on 24th August, the day before her due date and on my birthday. I was taking 3 x 2 caps of Probiotics per day in the last month of pregnancy which can seem excessive, but as I can’t overdose on them and I only get one chance...

  • Are there any breastfeeding Mums out there? My little girl is about to turn 7mths and has finally been diagnosed with silent reflux (alot of people dismissed me when I suggested it months ago). We have started on Gaviscon sachets nearly 48hrs ago and she is much better especially at settling in the evening. She is usually OK at night so haven't given her the powder when she wakes at night yet. Any tips on how to use at night? I have been mixing it up and syringing it into her mouth. Packet says not to make up in advance but I wondered if I could for nighttime so I don't have to make it up when she wakes. Thanks

  • Anyone else dealing with older children with reflux would love to hear from you my Miss 11 year old seems to be having a relapse . So after nearly 4 years losec free in this household we have it back.

  • There have been some new posts - sorry I haven't had a chance to pop on over and answer. Can anyone share their experiences? Remember, no medical advice. :-)

  • As per my post yesterday, our membership form and newsletter archive for members is now available again.

    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.

    Thanks to one of our amazing webhosts http://www.webmad.co.nz/ for the smooth change-over.

    Gastric Reflux Support Network NZ for Parents of Infants & Children Charitable Trust Membership & Confidentiality Agreement Form / Newsletter Admin Page First Name Last name Email Street Address City/Town Area Postcode Do you live in NZ? Country and Area if not NZ Home Phone (include area code) Part…