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 an alternative to standard cow’s milk  based formula for one week**.
AND
Check latching/feeding, flow of milk and position
Not working? Not working?
Karicare Aptamil  Food Thickener or Baby Rice***. Try these thickeners/formulas: AR Formula, Karicare Aptamil Food Thickener, Baby Rice***, Cornflour (cooked).
AND AND

General Management Techniques

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 except for during “tummy time”.  (Tummy time is important and newborns should have this at least once a day: http://www.plunket.org.nz/your-child/newborn-to-6-weeks/play-and-learning/)

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? (This is only an option if LMC and Parents are comfortable with it.  Consider latch and milk supply issues.) Sucking gives comfort but feeding continuously may exacerbate or encourage more GOR episodes.  See Dummy or no dummy? by Pinky McKay on Essential Mums for pros and cons.

Not working?

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 “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 may 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.  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).

*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.

**For advice on an alternative to standard cow’s milk  based formula, please discuss which formula to choose with your Health Professional (doctor, Well Child Provider or dietician) 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.

NB:  Raising the head of the bed is no longer recommended and studies have shown that “head elevation may not always be of clinical value“.  http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-2284.full.pdf and http://www.changeforourchildren.co.nz/files/docs/infant%20positioning%20and%20reflux.pdf   Some health professionals still recommend raising the head of the bed and we would advise that you should only do this after discussion with your own health professional.

© 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 March 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.”

  • Gastric Reflux Support Network NZ shared Dance Of The Spirit's photo.

    ;-) does this make you feel any better?

  • Hoping that a few of you can help...any other mums with toddlers with ongoing GERD/Reflux? My son is 16 months old and unfortunately is back on losec 3x a day due to chronic wheezing after eating & ulcers (due to acid) on the throat. Did your toddler just eventually grow out of it? Or was it a physical problem like a hiatus hernia? Any tips on managing it? He's a pretty happy little kid despite everything apart from a pretty low immunity at the moment and choking night episodes that have been going on for 9ish months , they basically present like mini seizures (which they are not) or an extreme night terror where he screams, burps, swallows, passes winds and arches his back for a good 10 minutes they scare the crap out of us. We are on waiting lists to see public/private gastric specialist as reflux specialist can't really do anything more than medicate. He has zero allergies and we still purée his main meals to help with digestion. Just hoping someone has been in similar situation because I feel like I'm going around in circles and feel quite alone in all of this.

  • Gastric Reflux Support Network NZ feeling frustrated.

    Has anyone else had problems getting the membership form to go through recently and giving up? http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz-membership-confidentiality-agreement-form/ Please let me know if you have and I'll switch it back to the old version.

  • http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz-membership-confidentiality-agreement-form/ Our Newsletter is due out tomorrow so please subscribe today or tomorrow morning to find out more. If there are any problems subscribing please let me know. You will be redirected to a welcome page if successful.

  • Gastric Reflux Support Network NZ shared Plunket New Zealand's event.

    https://www.facebook.com/events/490653441123606/ Just sharing this in case any of you have something you want to chat to Plunket about. Check out their event for further information.

  • Newsletter is due out soon so now is a great time to join http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz-membership-confidentiality-agreement-form/ #gastricreflux #gor #gord #infant #baby #gastricrefluxsupportnetworknz #cryingoverspiltmilk #child #family #reflux

  • Gastric Reflux Support Network NZ shared Patient's photo.

    Do you have those days where not much gets done?

  • My 7.5 month old had reflux and whilst he still spilled a little, we took him off Losec a month ago. In the last week or so we (and daycare) have noticed he is spilling a bit more frequently and it is acidic and a little curdled. Any ideas?

  • With all the news items coming up about the dangers of swaddling, here is an article linked from a NZ health website healthinfo.org.NZ on how to swaddle. http://hipdysplasia.org/developmental-dysplasia-of-the-hip/hip-healthy-swaddling/ Remember that any nursery item that puts baby into a position they can't achieve developmentally or restricts their leg movement (abduction) should only be used for short periods (or not at all). Roslyn Ballantyne, RN, National Coordinator, Gastric Reflux Support Network NZ

  • Gastric Reflux Support Network NZ shared a post.

  • Can anyone recommend or know of where I get tongue/lip tie released with LASER in the south island??

  • If you want to join the Gastric Reflux Support Network NZ or update your details, or have had trouble signing up before, I have just updated our membership form so that the process should be easier. http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz-membership-confidentiality-agreement-form/

  • Never posted before but followed this site for a year now. What a roller coaster is has been dealing with a child with reflux. I've learned so much about it yet still feel like I have no answers. For any mommas out there looking for advice from those who have been through it: 1. Get earplugs and a video monitor so you can put them down, walk away, and not listen to the screaming for the millionth hour 2. Push your health care providers! You know what is normal for your baby and what is not! 3. Try everything! Use every tip, trick, medication, bottle, breast, diet, homeopathic remedy, physiotherapy, chiropractor. That way....when nothing is working, you know you've done your best. (In my case....nothing worked. But I got through knowing Id tried it all) 4. When nothing works, tell yourself every day: Your baby loves you Your baby needs you You are the best mother in the world You know what is best for you baby Your baby will one day grow out of this BECAUSE IT'S THE TRUTH!!!! 5. Surround yourself with people who love and support you. And tell the others to $@"& off 😉😘

  • There is a new visitor post about a four month old. Can anyone help out? (Please remember no medical advice or medication recommendations.)

  • I have a 4mo who I suspect has had reflux flare up over the last 10 days. He's waking every 1-2 hours now which is the biggest hassle about it. He's not as bad as a lot of babies but during and after BFing he will come off and cry in pain. I used to think it was wind struggling to come up but the pain would continue even after a good burp. He can fall asleep on me but when I go to lie him down in bed he often wakes straight away, arching his back in pain and kicking his legs around. I could go on but I'm going to docs in the morning. If anyone has any advice for me please share. Also wondering if I should try any homeopathic remedies? I haven't tried the dairy free diet yet, mainly because I'm hoping this is just a phase and he goes back to being a happy baby that would only wake twice a night for a feed!

  • Who has breakfast ideas for a six month old? Someone has posted a question to the page. Can you help out?

  • Mummies of reflux babies, what are or were your go-to solids for breakfast & dinner? Miss 6 months has been on solids for a little while, has veggies (which I make myself) for lunch & then porridge & pears for breakfast & dinner but I think she's a bit over the porridge/will only eat it if distracted by toys... Any suggestions of reflux friendly options so that I can mix it up a bit for her? Thanks x

  • Gastric Reflux Support Network NZ shared Patient's photo.

  • There is a new question to the page. Please look at the visitors posts and see if you can help with ideas for introducing solids.

  • Some info here about screen time for littlies. http://childmind.org/article/media-guidelines-for-kids-of-all-ages/?&utm_medium=email&utm_source=childmind&utm_content=7+-+Media+Guidelines+for+Kids+of+All+Ages&utm_campaign=weekly&source=weekly With our irritable children or siblings that need entertaining whilst we attend to our infants, screens sometimes get used so this information may be useful. I'm not posting it to say not to use them, but as a reminder of safe use. You are in control and can choose when to use them, and choose other activities at other times. E.G screens are for when mummy is feeding baby only. Its time to play outside now. Who has other tips for siblings when feeding baby or putting baby to bed? (Remember it is important to have some special time with siblings after you have attended to baby.) We would love to hear your ideas.

  • Hi I have a 6 month old who was diagnosed with silent reflux at 6 weeks we have struggled through breast feeding as he has quiet a bad feed aversion but I have been trying the last month to get him on to solids and he is just not interested in not sure if it is Age thing and just needs time or feed aversion putting him off a bit any advice?

  • http://www.plunket.org.nz/your-child/facebook-chats/top-tips-from-our-facebook-chats/toddler-sleep-and-settling/

  • Gastric Reflux Support Network NZ shared Inspiring and Positive Quotes's photo.

    We just aren't going to promise a time frame as we know how frustrating that is... When they sit, walk, 6 months, 12 months, 18 months... Enjoy your Sunday everyone.

  • http://www.newshub.co.nz/nznews/8yo-lucky-to-be-alive-after-medicine-dosage-error-2016030617#axzz42GCkEoBP Thank you to Ollie Ritchie our reporter

  • http://www.medscape.com/features/slideshow/safe-sleep-principles?nlid=100491_453&src=WNL_mdplsfeat_160223_mscpedit_peds&uac=76049AV&spon=9&impID=1000340&faf=1#page=7 Click on the link above for a great diagram of why sleeping flat and and on the back is recommended.