Managing Uncomplicated Reflux

The information provided on Crying Over Spilt Milk is designed to support,not replace,the relationship that exists between a patient/site visitor and his/her existing physician. Please do not change your child’s medical treatment without first consulting their health professionals.

Babies with uncomplicated reflux are often described as “happy chuckers”. These babies vomit or spill frequently, but are otherwise completely happy, sleep well, gain weight and have no other obvious reflux complications.

Happy Chucker

Breastfed Bottle-fed
Try a dairy-free diet for Mum for up to 2 weeks*. Try a non-dairy formula for one week**.
AND
Check latching/feeding, flow of milk and position
Not working? Not working?
Karicare Food Thickener or Baby Rice fed from a spoon before a breastfeed. These thickeners are all safe from birth. Try them one at a time. You will need to give them at each feed for about three days before you should try to decide if they are helping. Try these thickeners/formulas: Karicare Aptamil AR, S-26 AR, Karicare Food Thickener, Baby Rice, Cornflour (cooked).
AND AND

General Management Techniques

Raise the head of baby’s bassinet/cot and changing surface to 30 degrees. Raise the whole cot/bassinet rather than putting something under the mattress. Put feet at the end of the bed or use safe-t-sleep to keep face clear of covers.

Use a front pack, sling etc to keep baby upright when awake.   A Hammock may be useful.

Winding/burping regularly (preferably high on the shoulder with a nice straight body to allow the wind to escape more easily).

Avoid pressure on tummy at all times.

Wrapping for sleep.

Sleep pattern in place.

Avoid “crying it out” as crying worsens gastric reflux and is distressing to family. Bad sleep behaviours do not develop and sleep patterns are easily established once gastric reflux is adequately controlled.

Pacifier/dummy like NUK brown rubber teat (this is only an option if LMC and Parents are comfortable with it). Sucking gives comfort but feeding continuously may exacerbate or encourage more GR episodes so this is where a dummy can be a helpful tool.

Not working?

As a last resort, the medication Gaviscon Infant and/or a motility medication may be prescribed. However, neither of these will consistently reduce/stop the vomiting in every baby tried on them. They may also have unwelcome side effects. Infant Gaviscon may cause constipation; with motility medications stomach cramps, diarrhoea and headache are common. All happy chuckers will outgrow the vomiting/spilling with time. Many parents make a decision just to “ride it out”. There may be long term benefits to these babies for doing this.

 

  • If you have a child who gets both pain from reflux and vomits/spills, you will need to refer to the charts showing treatment options for both “Silent Reflux” and the “Happy Chucker”.
  • However, an important point to note is that with babies who get pain from reflux as well as vomit, it is important to control the pain and acid first before considering the use of thickeners or thickened formulas. When the pain/acid is under control with appropriate acid reducing medications, then try the options on the ‘Happy Chucker’ chart. Babies who get pain due to reflux all have some degree of oesophagitis (inflammation/ulceration of the oesophagus). 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.

*The time frames mentioned for this diet is the length of time that the diet should be trialled for by the breastfeeding mother before deciding that it is not helping and before returning to a normal diet. The dairy free diet needs to be a complete removal of these foods as cheating does matter. A positive response may be seen earlier than the time frame indicated. If the baby has started solids then these also need to be free of dairy. If the diet is successful in resolving symptoms then it needs to be continued or another form of feeding considered. Breastfeeding is nearly always best for the baby with gastric reflux but the mother’s health is also important, so consider this decision carefully with the help of a paediatrician for future feeding options.

**There are three options for non cow’s milk based formulas.

  1. 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.
  2. Goat milk formula is often effective in children with reflux problems due to cow’s milk protein intolerance. (Opinions vary about the suitability of goat’s milk due to the proteins being similar to cow’s milk so this may need to be discussed with your health professional.)
  3. Hypoallergenic formulas are best recommended by a paediatrician as a special authority number is required to receive these subsidised (otherwise they are around $100 per tin).

See our fact sheet on “Infant feeding” for more information. If the baby has started solids then these also need to be free of dairy.

© 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. Used and edited by GRSNNZ with permission.  Last updated August 2013.

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.”

  • 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

  • On 16/02/2014, this page reached 2000 likes. we now have 2059 likes with a total of 23 new likes last week. We hope this page and our website, www.cryingoverspiltmilk.co.nz is helping support your families coping with gastric reflux. If you are in NZ, and want to have support in a confidential setting with other families, please complete our membership form: http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz-membership-confidentiality-agreement-form/ We currently have around 700 members.

    For infant and child gastric reflux support in New Zealand: Phone/Text 022 585 5935 Phone 0800 380 517 Contact GRSNNZ via email form ...parenting reflux babies really is a massive task... I stumbled over your website when I was researching dairy intolerance (which I have). I’m really glad...

  • Has anyone had experience with lactulose ? I have been using on and off but I'm not sure if she's worse on it , seems very farty and uncomfy ! 4 month old 5.5 kg and she's on 2 ml per day , any advice or alternatives appreciated ; she is on losec and gaviscon