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 “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.
- 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. 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.”
Jaime-lee Best, this is where I got a lot of my advise that is safe and works...these Winona babies some have had surgery n all...
Hi ladies. My daughter is now 9 months old and we have finally weaned her from her reflux meds however we are still (even with meds) suffering with insane amounts of spit up. Even after solid meals of finger foods only! I am so overwhelmed trying to always explain why my baby is covered in some sort of spit up and we can not go on play dates bc the other moms freak out. I have had so many days of crying over these dirty carpets and soaked clothes and I am really having a hard time seeing g the light at the end of this tunnel. The doctors just tell me to wait because she's gaining well and not painful anymore but I am just soooo tired of saying/hearing 'it's just just a laundry issue'. What about a sanity issue?? If I see one more baby who has never spit up more than a dribble I am going to freak out!
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Hi Ladies, my 12 week old has silent reflux, was put on neocate with suspected milk intolerance but symptoms never went away untill we suspected reflux was put on gaviscon, helped alot, still wouldnt sleep in the day would wake crying so was put on losec, been on this for three weeks and stil no improvement. And he has started to spill now with every feed. Im wondering if the neocate isn't right for him and considering normal formula. Or would that make things worse?? Any ideas :) Thanks
Did you know that gastro-esophageal reflux disease can present as a behaviour disturbance?
Hi, im after some advice/help. I have a 7 week old son that has been diagnosed with servere reflux and colic.( he also has a upper lip tie and doesnt feed well anyway) We were prescribed infant gavison to help with the reflux but it has blocked him up horrendously. we were told to stop it and have been given a laxative to help clear him out. yesterday the doctor was talking about prescribing him an entensively hydrolysed formula (pepti Junior) and trialing before we can look at the Neocate as she thinks he may have a cows milk allergy. Today she has rung and said there is a new formula out from Karicare. Its called Karicare Plus comfort which is partially hydrolysed. And that i need to pick one and trial it. Im so confused and googling all this info has confused me even more. HELP PLEASE
Hi ladies, is it ok to give a reflux baby infacol wind drops?? Or will it make his reflux worse??? Thanks
The most efficient way to speak to one of the Gastric Reflux Support Network NZ staff is to text a message to 022 585 5935. Include your name, phone numbers or email and a brief explanation of why you are contacting us. We will contact you as soon as possible. Gastric Reflux Support Network NZ for Parents of Infants and Children Charitable Trust (GRSNNZ) appreciates your donations so that we can continue to support families coping with gastric reflux. http://www.givealittle.co.nz/org/GRSNNZ
Can you get samples of Neocate or similar from anywhere?
Does anyone know if there is any kind of parents support page for kids with allergies? Sorry not entirely reflux related but since they often go hand in hand thought id ask here. Thanks :)
The most efficient way to speak to one of the Gastric Reflux Support Network NZ staff is to text a message to 022 585 5935. Include your name, phone numbers or email and a brief explanation of why you are contacting us. We will contact you as soon as possible.
Hi there, I have just today searched for & found your page as I am desperate to find some relief for my 7.5 week old who is in pain & discomfort. My 7 week old was born 4weeks early via c-section & we are seeing a cranio-osteopath for a number of the interventions she needed during & post birth. After the last 2 treatments she has what seems like reflux symptoms, last time (3 weeks ago) was for 6 days, this time we are on day four. She screams for hours after feeds in pain, no holding position really works better than others, we just fluke a good position which may only offer a few minutes relief or she goes into an exhausted pained sleep. She can't sleep on her back in bed during the day (have tried propping it) so I either put her on her tummy (works sometimes) or hold her upright tummy to tummy at varying degrees on me in the ring sling, we need to sleep like that at night sometimes too. She used to wind well & was spilly at times but it didn't seem like an issue. Now she often doesn't burp or spill at all, gets tense & upset instead. Also her saliva gets so thick & it sounds like she's choking & struggling to breathe past it in her throat. I have tried shorter feeds more often but it doesn't really help - and how does this work if she is screaming for 2-3+ hours (more feeding makes it worse) then going to sleep? How will she get enough if every feed is smaller? I don't want to wake her as it all starts again & we both need to recharge too. Any advice much appreciated, I don't know what to do for her & it's so distressing!
http://www.medscape.com/viewarticle/812388?nlid=35583_2047&src=wnl_edit_medn_peds&uac=76049AV&spon=9 :-) - Conclusion is also that it is likely to do no harm either.
Studies vary too widely in products and dosages used to permit definitive conclusions, investigators say.
HAMILTON people - how many of you are out there and reading this post??? I'm just replying to a message regarding our COGS Funding Application for the Hamilton area. As our Trust has just moved from the Hamilton area to the Canterbury area, they want to know how many people we are supporting in Hamilton on a weekly basis. I know how many members we have in Hamilton, but of course we support more via our website and this Facebook page. Please LIKE this post if you are in Hamilton and reading this BUT only if you are in Hamilton. :-) Many thanks for your help. Roslyn National Coordinator Gastric Reflux Support Network NZ for Parents of Infants and Children Charitable Trust
Constipation with infant gaviscon...just wondering if baby's system "gets used to it"?