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.
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).
|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***.|
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.
***Please check the ingredients as some brands of rice cereals, contains milk products.
© 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 2014.
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.”
http://www.treasures.co.nz/Explore-your-stage/Article/?contentId=1784920 These won't work if your child is unwell or in pain, but are otherwise good tips.
Sleeping through the night At this age and stage research by Dr Marc Weissbluth indicates that hunger is no longer why your baby is waking at night if they are a healthy weight and continuing to gain weight we can teach them to sleep from 7pm-7am. Your baby needs to be eating a healthy diet of carbo…
Hi everyone, It has been pointed out that new posts to the page by non-admin don't show up in your newsfeed. I don't want to repost them, but if you want to pop on over and share your experiences there are a few new posts from October.
Please do not advertise on our page. This is for sharing our experiences about Infant Reflux/GOR/GORD. If you would like us to link to your organisation or your page, please message the page. The GRSNNZ Committee will make the decision once you have provided us with information on the Governance of the Organisation, Source of your Information or your relevant NZ Health or Nutrition Qualification etc. Grumble over...
https://www.healthed.govt.nz/system/files/resource-files/HE2309.pdf Cool pictures, lovely mothers. Not saying that women who choose to bottle feed aren't wonderful mothers too, but this is neat promotion.
Hi there. Posting from the UK. Wanted to share our story to gain some more insight. We've had a really tough time. My first baby is 8 + weeks now and we've had no end of issues. She was tongue tied..snipped...but latch still a problem. She is mostly breastfed but using nipple shields. Occasional top up when i can't tolerate feeding her. She feeds or wants to feed constantly. Thought it was hunger but no different after a bottle of formula. Anyway...a friend mentioned she could have silent reflux...symptoms are constant feeding hand sucking...back arching fussing through feeds like she wants it but doesn't too. Struggles to sleep although sooo tired. Falls asleep on boob but wakes immediately after. Hiccups a lot. Sneezes a lot. Crys after feeds...weight has been slow to gain tho. Prescribed infant gaviscon...any experiences of this and is it likely to make her constipated if mostly breastfed?! Worried it feels like trial and error at her expense. She's so unsettled and we are really struggling....opinions welcome :)
The Cards are now available in an app for Android and Apple devices: http://allright.org.nz/our-projects/tiny-adventures/
Our Pack of Tiny Adventures was developed to help parents to enjoy quick, fun and affordable activities with their children. It was developed in partnership with SKIP (Strategies with Kids Information for Parents) gives parents easy ways to connect with their kids - even if they only have a few min…
My 12 week old baby has reflux, currently on 5mg of losec in the morning novelac reflux formula, she also suffers with painful wind, lately she has been choking on her vomit, not sure if I should change to novo lac colic formula instead, we have tried soy and goats to which she spewed up a lot more than the ar formula, please help with suggestions , it is hugely stressful for our family
Cn u get formula made for babies with reflux on script?
I'm getting the September Newsletter ready. Is there anything anyone wants to contribute? Please let me know: https://www.facebook.com/roslyn.ballantyne.rn
Hi there are there any formulas that you can get on prescription or financial assistance? Pretty sure my 8 week old isn't coping with his formula that he's on. He has reflux and on ranitidine but now he has green mucousy poo so im thinking he might need some different formula? But I see specialist formulas are expensive!!
Hi, my 5 month old has started solids and we have been ok'd to feed these before milk as otherwise he spills most of it. He takes losec granules, which was have been giving with pear 30mins before a milk feed. Can we now just give these with his solids with milk following half an hour+ later? Or not due to the higher volume of food in his stomach so it wouldn't be digested by the time he has his milk. Thanks
Hi. We've used the karicare thickener in our boys bottles on top of losec and neocate to control his reflux. Now he's 4 months old I was looking at using watties rice cereal to thicken his bottles before moving to solids at 6 months. Looking to find anyone who thickens with rice cereal. Advice? Thank you
Argh! I don't know if I'm doing the right thing for my wee girl. We discovered her reflux early 8 days old and has been on goats milk formula for 3 months. Did it help? Hard to say but she was happy enough. We were reffered to the hosp dietician by our plunket nurse and on Thursday started neocate. Its made things worse and she seems in pain.. her poops are slimy green. We gave her a few gaviscon feeds with it to help her tum cos she seems to have a sore tummy a lot. So its Sunday, we've been on it three days but I am continually second guessing myself. Should we have seen a change in her by now. Is it normal to take a few days for the tummy to get used to it? I hate putting her through all this esp if it doesn't end up working... sometimes I just want to throw it in and put her back on goats milk... would love some advice from others on neocate or just any advice/encouragement please and thank you :)
Hi mums I have recently taken my daughter off losec on advise from a paed to see how she went. We didn't notice the symptoms coming back and also started solids around same time with it going great. She's had a cough and cold but is over it except this nagging cough which is day and night until she eventually throws up. My question is could the cough actually be the reflux and should I start losec again.