Please be aware that Breastfeeding is best for all infants especially those with Gastric Reflux. Artificial milk/formula, AR (thickened) or standard will not cure reflux. If you are considering Artificial Feeding please contact your Midwife, Well Child Provider, Doctor, or Specialist before introduction.
NB: With babies who get pain from reflux as well as vomit, it may be important to control the pain and acid first before considering the use of thickeners or thickened formulas. Studies have shown that although thickeners and thickened formula may reduce the number of episodes they prolong the length of time of the remaining episodes as thickened fluid does not drain as well from the oesophagus. It is these prolonged reflux episodes, when they contain acid that can do the most damage.
However, with the move away from prescribing for GORD by many Health Professionals unless there appears to be significant pain, severe complications, growth issues or difficulties feeding it may be appropriate to discuss thickeners with your Health Professional (doctor, Well Child Provider or dietician).
|Cornflour||Maize or wheat starch. Use maize cornflour for infants under one year of age.||Must be cooked.||One level teaspoon per 100 ml of water. Boil then simmer for two minutes. Cool and prepare formula using thickened water.||Not suitable.||? absorbed||Not recommended for preterm infants.|
|Karicare Aptamil Food Thickener
||Pregelatinised maize starch, maltodextrin, locust bean gum.||-Thickens instantly.-Can be added directly to feeds.||Add to formula feed (1 – 3 teaspoons per 100 ml).||Prepare gel and feed before, during or after feeds (1 – 2 teaspoons per 20 – 30 ml breast milk or water).||3.6||Provides additional calories for babies with poor weight gain.|
|Nutilis||Modified maize starch.||Thickens over a few minutes, but does not continue to thicken. Remains thickened in the stomach but not as thick as when first mixed.||1 – 1.5 scoops per 100 ml.||3.6||Not recommended for children under 3 years.[i]|
|Resource Thicken Up||Pregelatinised waxy maize starch||3.3||Smoother but use in neonates not well documented. NB high sodium content (9.6mmol Na per 100 g).|
|Carobel (Cow and Gate)Not available in New Zealand.||Carob bean flour, calcium lactate.||-Requires several minutes to thicken.-Can be added directly to feeds.||Add to formula feed (0.5% – 1%)||Prepare gel and feed before or during the feed 1 – 1½ scoops (1.8 – 2.7g) per 100 ml water).||May increase stool bulk.|
These thickeners are all currently available here in NZ (as indicated) through your local pharmacy and maybe some supermarkets. Please note though that pharmacies do not always keep such products in stock, and so you may need to ask that they get them in for you (usually takes 2-3 days). There has been some problems with the supply of Karicare Aptamil Food Thickener late 2014. Phone Nutricia if you have problems obtaining this.
Also, you may like to try:
· AR formula – dairy based formula with natural thickener added. Available through most supermarkets. e.g. Karicare Aptamil AR, S26 AR.
· Thickening feeds with rice cereal (baby rice). Please check the ingredients as some brands of rice cereals, contain milk products. You can experiment a bit with the consistency, but usually 1 tsp of rice per 30-50 ml of formula is adequate. Some parents in countries other than New Zealand have been advised to use different cereals such as oatmeal because rice cereal may cause constipation. This is not recommended in NZ as it contains gluten – the early introduction of this may increase the risk of gluten intolerance developing.
· It also pays to remember when using thickened feeds that you may need to use teats with larger holes (medium/fast flow), and it is also best to mix Karicare food thickener and AR formula with cold liquid (heat bottles after mixing).
· For very smooth results, Karicare Aptamil Food Thickener may also be boiled into the water that you make up your formula with. Mix 20 teaspoons of Karicare Aptamil Food Thickener with 1 litre of cold water in a pot on the stove. Bring to the boil, stir frequently. Once boiling point is reached, remove from the heat and allow to cool. When cool re-measure the thickened water and add the appropriate number of scoops of formula powder. An electric mixer is ideal for mixing the formula powder into the thickened water. The amount of Karicare Aptamil Food Thickener in the recipe can be varied to suit, however, do remember that the mixture thickens the most as it cools. (Don’t use an electric mixer for formulas that should be mixed gently e.g. Elecare, Neocate as their amino acids are easily bruised.)
Please consider checking with your doctor, well child provider or dietician before including these in your baby’s diet especially if they are under the age of six months (and check under the comments column for any age restrictions).
Tara Chaplow, Babytimes Dietician
Neonatal and Infant Nutrition Handbook, Second edition.
© Gastric Reflux Association for the Support of Parents/babies (GRASP) and Crying Over Spilt Milk Gastric Reflux Support Network New Zealand for Parents of Infants and Children Charitable Trust (GRSNNZ) 2004. (Some content originally prepared by a Nutricia Dietician). Used and edited by GRSNNZ with permission. Last updated January 2015.
Page may be printed or reproduced for personal use of families, as long as copyright and Crying Over Spilt Milk‘s URL are included. It may not be copied to other websites or publications without permission and acknowledgement. This information (unedited) was also provided (by GRASP) to health professionals in New Zealand to use ” to continue to support and inform families with babies/children with Gastro-oesophageal Reflux.”
Interesting article on dreamfeeds:
Will ‘dream feeds’ work for your baby? Dorothy Waide shares her insights on this late night option.
does a thickener help for Elecare formula? It seems to be so thin and my little granddaughter is spilling a lot with this formula.Would welcome your feedback thanks
Christchurch people - there is a new post from someone needing help finding Karicare Aptamil Food Thickener. If you know where to find it, can you please reply on their post?
Does anyone in CHCH know where to find the formula thickener for Elecare formula?? My wee one has just been put onto Elecare and I am finding it needs to be a bit thicker as she is bringing up a lot just like the breast milk. Not all pharmacies sell it
After some advice, I have a 10 week old with possible silent reflux ( just started gaviscon) we are wanting to progress to help him achieve self settling. Does anyone have any methods that worked? Absolutely no comfort in patting and shushing... Or am I asking too much from my little man that finds a lot of comfort in being rocked to sleep?
Hi all, Just wondering if someone could confirm for me that going dairy free means you can still have non cows milk products like sheep or goat products? I read the spilt milk site and seems to be a cows milk protein issues, not other types of animal products? I just ate sheeps feta then second guessed if it's OK.
My 16 month old just saw an allergist today and he told me it sounded like he had reflux. He had it as an infant but around 9 months he stopped needing meds and was fine, but now this winter he has stayed sick! So I'm really trying hard to wrap my head around this... I feel like my baby has been sick for months (stuffy, sneezing, coughing, wheezing, fever.. the list goes on and on) and it's just reflux! I mean if that's the case I guess I'm relieved because that seems like a simple fix. I just feel like he's really been suffering. His pedi was thinking he had asthma and sinus infections. The allergist did swab his nose to see if anything comes back on it but for now he is just taking nexxium(sp?) and a nasal spray.
Ignore my previous message (If you saw it), http://www.cryingoverspiltmilk.co.nz is back!
For infant and child gastric reflux support in New Zealand: Phone/Text 022 585 5935 Phone 0800 380 517 Contact GRSNNZ via email form Join Gastric Reflux Support Network NZ for Parents of Infants and Children Charitable Trust for access to our Newsletters and Private Local and National Suppor…
I asked for a script for infant gaviscon and was given Acidex. Whats the difference?
Hoping for a bit of help/more advice. My now 8 week old baby has what we believe to be silent reflux, no one has actually diagnosed her with it, but have been given meds to help. She definitely regurgitates milk, and sometimes projectile vomits (she has only started doing this recently). I am getting so lost of what to do next, we have another appointment with the GP on Thursday, but in the mean time would love any advice on what I can do to help her.
We started out on Infant Gaviscon, which didn't help much at all. Then onto Ranitidine, which didn't help either. We got prescribed Losec by my GP to use with gaviscon. Which seemed to help for two weeks, but now she is back to being so unsettled and unhappy. From birth she could only ever drink a small amount before she got really uncomfortable and started screaming, I started expressing to get an idea of what she is really drinking, which turned out to be bugger all, this was why i was feeding her 20 odd ml every 1/2 hr to an hour. I'm doing everything I can to help her, have got the bassinet head raised, burp after what seems to be every mouthful! I wear her in my wrap a fair bit during the day for some of her naps.
I took her to the osteopath last week, and her said she was very sore and had a very tight diaphragm. Two nights later she slept 6 hours! But the next night she was back to a couple of hours at a time. I have another appointment on Thursday.
As I have a 20 1/2 month old toddler and, expressing got too much as I could never find the time to do it, so now have her on Karicare Formula, which i'm not 100% sure if this is upsetting her stomach aswell. She was induced at 38 weeks as they were concerned about her growth, she was 6lb 3 oz at birth.
What would be the best formula to have her on? She is still currently on losec and gaviscon. AND how can I ease the screaming after every feed? I'm really starting to stress alot about it and find myself getting pretty emotional.
Thanks and sorry for the long story!
Hi everyone, my daughter had severe gerd up until about 9 months and was treated with losec and gaviscon and eurthymician (sp). Four about 3 months she was really good, not needing any meds at all so we weened her off them. She has been med free for about 6 months, but the past two months we are back to screaming and crying every hour each night ( was previously a good night sleeper!) very unsettled etc, but no vomit . My question is can reflux suddenly come back ?
Just popping in to clarify our website/forum guidelines.
Please see this page: http://www.cryingoverspiltmilk.co.nz/guidelines/
"As the moderators, GRSNNZ reserves the right to remove or edit any posts:
that recommend another medication as being better or to treat conditions that it is not indicated for
where dosages of medications are being compared (especially in an unsafe manner) as each child is an individual with differing needs
where personal advice is given on choosing a formula (sharing experiences is fine)
where volumes of fluid drunken are counted and compared
with personal attacks against other users including GRSNNZ staff
Medications and prescription foods and formula may not be offered for sale/give away on these forums."
"Please seek assistance from your Doctor, Midwife, Health Professional or Dietician about feeding your baby. "
We are getting a lot of requests for advice regarding choosing formulas over the phone, by email and on the forum. Members can tell you their experiences, but they are only their experiences and do not apply to your baby. Please contact your health professional for advice in the first instance or Nutricia also have qualified dieticians.
GRSNNZ supports the Baby Friendly Initiative and promotes Breastfeeding. GRSNNZ will not give personal advice on formula.
Site Guidelines Most of the information on Crying Over Spilt Milk is copyrighted and may not be reproduced on another site/publication without permission, but some may be printed for the personal use of families (and these pages will be clearly marked at the bottom with instructions.) Some material…
Please help i am desperate! My wee 9 week old is under a paediatrician forbreflux and a maybe dairy allergy. My milk supply is starring to drop and she has been given Elecare but she refuses to drink it. Have tried vanilla essence and mixing it with my breast milk but still no luck. Any help/advice will be greatly appreciated 😊
Hi. I am having real trouble settling my 9 week old baby, especially at night. I would like to wean her off me and have tried both pepti Jr and neocate but no luck. Also on ranitidine for refulx. Am i just best to breast feed or is there other options?
Sharing for your information. Please read the whole article - there are safe options.
A survey of portable cots for sale in New Zealand has uncovered potentially fatal safety defects - including folding mechanisms that could trap a child's neck. - New Zealand Herald
I don't know if this is the right site but my mum is being treated for reflux which has brought on burning mouth syndrome.
All her food tasted awful and was wondering if anyone has any tips if dealing or getting rid of this?
Thank you x
May your heart be warmed by the sweet magic that Christmas brings, and may all your dreams be fulfilled.
Christmas Greetings from the Trustees of the Gastric Reflux Support Network NZ for Parents of Infants and Children Charitable Trust.
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.
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 :(