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.
|Try a dairy-free diet for Mum for up to 2 weeks*.||Try a non-dairy formula for one week**.|
|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).|
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.
|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 “Managing GORD” 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.
- 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.
- 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.)
- 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 or phone Nutricia on 0800 258 268 to speak to a Dietician. 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.”
Hi. My boy is 6.5 wks. He started screaming at 3 wks. Became unsettled for periods of up to nearly 12hrs without sleep. He's been on formula as my milk never came in. He gets about 100-200 ml breastmilk /dy I pump. He started spilling/vomiting a lot at 4.5wks old.started losec 9 dys ago-frm GP. Saw paediatriciAn 4 dys ago and started amino acid formula to check for CMA. I feel things improved a bit about 4 dys after losec started. Also he seemed great once on th amino acid formula but thn yesterday was his old really bad self - fussed all day 10am-4pm thn really distressed n frantic 4-9pm. He's been ok today.i also started adding karicare thickener 2 dys ago. His first poo day after starting amino acid formula was soft n ok but I thnk he might b constipated with th thickener. He really had to push to get yesterday's out n was very sticky. Anyone else experience this? What do you do? I've heard lactulose and prune juice etc can make reflux/ wind worse. I thought about halving th amt thickener I'm using.also his vomiting better on th new formula I think but still occasional. He vomited Sunday night n mayb brought th losec up- could 1 missed dose like thts make him bad th next day like he was? Any opinions greatly appreciated
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. If you have completed a membership form previously, but never received anything further, please message me (Roslyn Ballantyne at https://www.facebook.com/roslyn.ballantyne.rn ) or comment below. The membership sign-up had been a double opt-in with a confirmation email, but as some people have had trouble with this, I've now changed it to a single opt-in. (I do still need to process applications and add you manually to your Local Support Networks though.)
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 I'm a bit confused. I filled out th membership form on th cryingspiltmilk main page. Do I need to do anything else? I see there's a forum somewhere else - kiwi health or something? Or do I just post n use this Facebook page? I'm thnking you hav th older site but most people jst use this Facebook page now yeah? Ta :) I hav a 6 wks old beautiful boy who has been in so much pain been breaking my heart but I'm jst getting things in motion now to help I thnk. Saw paediatriciAn few dys ago n hav started losec gaviscon mylanta and amino acid formula with karicare thickener
Hiya, I'm starting to introduce solids to my almost 6 month old and just wondering if there are any foods that any of you have found to be better than others and which ones to avoid? TIA. :-)
Other information here: http://www.lalecheleague.org.nz/news-a-events/lllnz-conference-2014/312-lllnz-50th-anniversary-conference-2014
Anyone want to help? I know you all have plenty to say. ;-)
And just in case you missed the post and the opportunity to help others through.........In five words, no more no less, share some inspirational advice to parents that are struggling with a newborn suffering from colic, reflux and inconsolable crying. If there are enough submissions I will post these on my website and perhaps in my book - Prevent and Remedy Colic, Reflux, Lactose and Dairy Overload Naturally - which is off to the proof readers this week!! http://www.naturalwinding.com/book/
A new story: http://www.cryingoverspiltmilk.co.nz/ryans-story-of-reflux-and-christinas-story-of-pnd/ Thank you, Christina.
I don’t really know where to begin with my story of Ryan and his reflux, and me with Post Natal Depression. I used to feel very sad thinking of all the precious time that was robbed from us. I loved Ryan from the moment I saw him, and he was a dream baby up until two weeks of age. ...
Hi my 7 week old, breastfed baby started showing signs of reflux recently so I went to the GP and was prescribed Gaviscon sachets. I'm having trouble giving it to her, but it seems to be working. She usually goes poos after every feed but since starting the Gaviscon (monday) she has only been once. She strains and cries. Not sure what i safe to give her to help as she is so young? Thanks
Hi there My 8 week old boy is formula fed and is now trialing gaviscon for his silent reflux, already I feel like it is making a difference but I am worried about the possible constipation the gaviscon may cause...how do you parents relieve constipation in young babies? I know about the cooled boiled water but are there any other remedies that are worth knowing about? Or tricks that can maybe help avoid constipation?
Hi, would you say it's a reflux symptom to bring up small vomits between feeds? Like an hour or so after eating? I keep being told that's normal, but it doesn't feel normal? My baby is only 4 weeks old though, so it's hard to me to tell what's normal and what isn't.
Hi, my 10 week old is trialling gaviscon to see if it helps with her (potential) reflux. She isnt a miserable baby, but she does scream if I put her down in the daytime, she has a persistent cough, a husky voice (this developed over the last week), and she spills even hours after a feed. Does this sound like reflux? If so, how do I get her to keep the gaviscon down? It says to give it to her after a feed, but she vomits straight after a feed...also is it worth going dairy free to see if this helps? Finding the spilling and coughing and husky voice quite upsetting, it must be horrible for her :(
Here is an amazing article about using probiotics and digestive enzymes to help with reflux. I only found this after I had my second reflux baby and he was 4 months old. Our first son had an endoscopy when he was 12months, which revealed extremely low digestive enzymes in his stomach. So when losec and ranitidine didn't provide much relief for our new baby, we presumed he was the same. We put him onto probiotics and enzymes and have had great results. Worth a read if you are interested. Feel free to message me for any more info (iv been researching it ever since!)
What I found to help! I am not claiming to cure or diagnose anything!
Good on you team for creating an awareness week and getting all of the publicity. So proud of those who have shared their stories. They have all had me in tears, partly because it triggers memories and partly because reading about those who have been without medical support just makes me so sad. Plunket nurses should be required to read about the symptoms of reflux and some real life stories as part of training. So should midwives actually.