Thickening Agents

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).

Thickener
Ingredients
Thickening Ability
Formula
Breastfeeds
KCAL/G
Comments
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.  “…to be used under strict medical supervision.”[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.

· 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).

REFERENCES
[i] http://www.nutriciaclinical.co.nz/admin/documentlibrary/nutilisnz.pdf

ACKNOWLEDGEMENTS:
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.”

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    Membership is free. It has been great to see two to three new members every day since I fixed the 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 Auckland Bay of Plenty Canterbury Gisborne Hawkes Bay Marlborough Nelson Otago...

  • I've just discovered our membership form hasn't been working due to some unknown glitch and I've spent the last few hours getting it working again. I suspect this has been like this for a fortnight. So sorry anyone who has been trying to join. Remember membership is free and you can join in confidential chats with those in your local area.
    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 Auckland Bay of Plenty Canterbury Gisborne Hawkes Bay Marlborough Nelson Otago...

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  • National Infant and Child Gastric Reflux Awareness Week logo profile photos - The week finished 6th June. There are still a few people we've noticed with the logo as their profile picture. Can you please remove this now?

    Many thanks, for your support.

  • Thank you everyone who contributed to this. I think it will help others know that they are not alone in what they feel and experience. I also think it might be a great resource for health professionals.

    The following is created from a thread during National Infant and Child Gastric Reflux Awareness Week on our Facebook Page https://www.facebook.com/hashtag/nationalinfantandchildgastricrefluxawarenessweek It included words or short phrases that had something to do with what gastric reflux meant...

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    There was quite a number posted or delivered around NZ so we would love to hear if you spotted one.

    This is the printed A4 glossy poster that has our phone number and website address at the bottom - not the digital graphic. Draft preview here:

  • Gastric Reflux Support Network NZ shared their photo.

    Thank you so much to everyone that supported the Gastric Reflux Support Network NZ and promoted National Infant and Child Gastric Reflux Awareness Week by taking up the Challenge and using the logo as your PROFILE PICTURE on your PERSONAL PAGE.

    It was wonderful to see so many people doing this and I did lots of double-takes when visiting some pages as there were so many orange PROFILE PICTURES.

    I don't know about you, but I'm looking forward to next year and am already making plans. Hopefully, many of you will no longer be dealing with Infant Gastric Reflux, but feel free to come back between 31st May to 6th June and give others some hope that they will get through this difficult time. Put it in your diaries. :-)

    Best wishes for the year ahead,
    Roslyn Ballantyne, National Coordinator, Gastric Reflux Support Network NZ, National Infant and Child Gastric Reflux Awareness Week 2015!

    (Please note the National Infant and Child Gastric Reflux Awareness Week logo is copyright and may only be used with permission from GRSNNZ. It may be shared using the Facebook Share Function.)

    A Challenge to you ALL except we ask that you only do this on your Personal Profiles i.e. NO PAGES or GROUPS. National Infant and Child Gastric Reflux Awareness Week starts tomorrow and continues until 6th June. During this time GRSNNZ would love you to create Awareness by using this logo as your profile picture. Once you have set it as a profile picture please add a comment to the picture on your page and put the link to this Facebook Page and our Website: https://www.facebook.com/cryingoverspiltmilk and www.cryingoverspiltmilk.co.nz so others can find out more. (Please note the National Infant and Child Gastric Reflux Awareness Week logo is copyright and may only be used with permission from GRSNNZ. Permission is granted as above for the use of Personal Profile Pictures only. It may also be shared using the Facebook Share Function.) Example in the comment soon. Many thanks. GRSNNZ Committee.

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  • Gastric Reflux Support Network NZ shared Mum 2 Mum's photo.

    Just sharing this back to our timeline again as this was a perfect way to promote National Infant and Child Gastric Reflux Awareness Week.

    The logo and Awareness Week is not used to sell a product or promote the business.

    It links back to our website and Facebook page so that users can identify that the logo belongs to the Gastric Reflux Support Network NZ ,and seek support and information.

    Top points Mum 2 Mum.

    Today marks the first day of "National Infant and Child Gastric Reflux Awareness Week" - here at Mum 2 Mum we are not strangers to refluxy and spilly babies and we we know how hard it can be as parents some times. If you have any concerns about your infant or child's health or think they may be suffering from Gastric Reflux, please contact a healthcare professional - if you wish to learn more (from symptoms to real experiences), please take a look at the national gastric reflux support website: www.cryingoverspiltmilk.co.nz or check out Gastric Reflux Support Network NZ :)

  • Copyright: The National Infant and Child Gastric Reflux Awareness Week logo/graphic is copyright to Gastric Reflux Support Network New Zealand and may only be used with permission from GRSNNZ.

    During National Infant and Child Gastric Reflux Awareness Week 2015 the logo has been used without permission and in some cases to promote businesses.

    Crying Over Spilt Milk and Gastric Reflux Support Network New Zealand for Parents of Infants and Children Charitable Trust does NOT endorse any product, business, health professional or treatment as there is no one correct way to treat or parent our infants and children with gastric reflux.

  • Gastric Reflux Support Network NZ updated their cover photo.

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    At the time of writing this, she was almost four years. She was almost seven before she had her Nissen Fundoplication surgery so it was not something we rushed into.

    "We have just reduced and stopped her medication to determine if she still really needs it, and she may be referred for a surgical opinion if reflux continues to be a problem. She does seem to still have reflux though, and we wonder how long she will be able to stay off medication.

    Some of the ways she describes what she feels are: "my tummy is hot", "my tummy has sick in it" and "my tummy feels sore", "sick" or "unwell" as well as the obvious sounds of refluxing occurring and sore throats.

    I have never been happy about the thought of surgery to cure her reflux, but over the last few months and with all the research and reading of other's stories (both negative and positive) I at last feel peaceful about this possibility. Whatever happens now we know that reflux is likely to continue be part of her life, but that as she gets older she will be able to tell us more clearly what is happening."

    Written by Roz, Regional Coordinator for © Gastric Reflux Support Network New Zealand 25/01/2004.

    Roslyn Ballantyne, National Coordinator, Gastric Reflux Support Network

  • #NationalInfantandChildGastricRefluxAwarenessWeek
    Please share one piece of advice that has helped you cope (no medical advice).
    Remember national guidelines for sleep are on the back, flat and in their own space.

  • #NationalInfantandChildGastricRefluxAwarenessWeek
    Let's play a game.
    Put in a comment on this post a word or short phrase that has something to do with gastric reflux for you.
    And sign it with your relationship eg mum.
    Please keep it to one description per person as we will potentially have 100s of replies.

  • Gastric Reflux Support Network NZ created an event.

    Come and join us for morning tea to celebrate National Infant and Child Gastric Reflux Awareness Week in Christchurch. If you are not already a @[199074539208:274:Gastric Reflux Support Network NZ] or @[1569415393340472:274:Spilt Milk] member (with a completed membership and confidentiality form), and are attending for support with your infant/child with reflux or who spills or is irritable, you will need to complete one of these forms on the day. Please contact us for your personal invitation.

  • #NationalInfantandChildGastricRefluxAwarenessWeek Story 4

    My first child was a dream, eat sleep play.

    My second baby was a nightmare! Screaming the moment he was born. Sleeping upright on my chest for ten weeks!

    We couldn't find an answer, losing our minds! Five doctors later, high doses of medication for gastro-oesophageal reflux disease and specialised formula we had a baby we could cope with, only just.

    He spilled until one and a half, was on formula and medication until three years and is now a beautiful amazing boy at 8 years.

    It was worth every minute of personal pain and we risked it again by having son number 3 who was a dream like the first.

    Keep your head high, things will be okay, struggle through but never give up!! Your baby will grow into a beautiful human being.

    Melissa, GRSNNZ Member

  • We need 3 more short stories or articles for Awareness Week. Please use the Contact Button App or private message the National Coordinator if you are a member.
    Thank you.

  • I'm not sure if we were clear enough yesterday. :-(

    If you want to promote National Infant and Child Gastric Reflux Awareness Week or if your business or organisation has been asked to do so by someone other than the Gastric Reflux Support Network NZ, please share one of our posts unaltered without any links to any other page, group or business other than the links in the comment below.

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    GRSNNZ has been promoting National Infant and Child Gastric Reflux Awareness Week for a long time and has been given funding to do this. It is linked solely to them with their website, and the Awareness Week Logo/Graphic is owned by GRSNNZ with the trademark baby, organisation name, slogan and colours. Permission must be given or sought before it is used other than by sharing a post unaltered as stated above.