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 added 2 new photos — in Canterbury, New Zealand.

    ...At this stage we have three registrations and are surprised we do not have more, and would like to understand why people who fit the criteria in Canterbury haven't registered.... Please respond if you are in Canterbury and fit the criteria. See below. ------------------------------------------------------------------------------------------ The Gastric Reflux Support Network NZ has organised a series of four sessions called "Spilt Milk (Canterbury)" facilitated by the lovely Judy Arnold in Christchurch for those who have a baby under the age of one year who is unsettled or spills, and who would be interested in ideas to look after themselves and manage everyday life in a better way. This does include some practical tips on settling your baby, but the main focus is the parent. This starts next Wednesday morning and runs fortnightly, and is FREE. At this stage we have three registrations and are surprised we do not have more, and would like to understand why people who fit the criteria in Canterbury haven't registered. Was it the short notice, the day and time didn't suit (if so, when would), lack of childcare (please don't let that put you off), no transport (please register and let us know), not a first time parent (it doesn't matter - you still matter!), can't commit to all four sessions, worried about going out with your baby? Something else? Please reply to this post and let us know - or message us. Whichever you feel more comfortable with.

  • So true. Make some time today for you, even if it is just 5 minutes. #happiness #gastricreflux #gor #gord #infant #baby #gastricrefluxsupportnetworknz #cryingoverspiltmilk #child #family #reflux

  • Hi there im only new to all of this! My daughter is 12 weeks old and was put on losec and gaviscon last week, we have had issues with her vomitting up the granules, no matter what we try she just does! My gp has just given us the liquid form to try, my question is do we still give it to her half hr before a feed? Or can we give during? It dosnt say on the bottle

  • Gastric Reflux Support Network NZ shared Spilt Milk's event.

    Is there anyone with a child under the age of one year who is unsettled who would be interested in ideas to look after yourself? This does include some practical tips on settling your baby, but the main focus is you. See the event for details and please register using the registration form. This starts a week tomorrow and we don't have many registrations. Please register asap so we know whether it is worth continuing.

  • Try to relax and enjoy the little things this Sunday. #gastricreflux #gor #gord #infant #baby #gastricrefluxsupportnetworknz #cryingoverspiltmilk #child #family #reflux

  • I have an 18 month old son who had silent reflux. we weaned of gaviscon about four weeks ago. His symptoms for reflux were aconstant runny nose, cough and wheezing. For the last week he has had the above symptoms again. I have had him to the Drs and they have said just to give him his inhaler as he is wheezy. I have always had to fight to get the diagnosis of reflux. I was just wondering if anyone has weaned there child off gaviscon and if so how long would it take to symptoms to possibly reappear?

  • Spilt Milk (Canterbury) February / March 2016

  • Gastric Reflux Support Network NZ shared Spilt Milk's event.

  • We have been weaning off omeprazole and the most recent drop didn't work so we have increased again. How long until she's feeling herself and not in pain again?

  • My 10 week daughter I think is suffering from reflux. She doesn't spill alot however I notice she swallows back quite often. Latley she has been gaging. She has been in a lot of discomfort from about 2 weeks. I've been taking her to a chiropractor which I thought was heping but this last week seems to be back to her old symtoms. I'm just wondering about the medications people use. Do they work? She is gaining good weight. So I'm wondering do I just go another month and hope she grows out of it? or do I try the medications? I'm just worried they might cause trouble Down the track? I don't have a very good GP so no help there. Any suggestions would be great thanks ☺

  • #gastricreflux #gor #gord #infant #baby #gastricrefluxsupportnetworknz #cryingoverspiltmilk #child #family #reflux

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

  • Had you noticed that this page for the Gastric Reflux Support Network NZ is a Verified Page by Facebook confirming that it is an authentic page for the Gastric Reflux Support Network New Zealand for Parents of Infants and Children Charitable Trust? http://www.cryingoverspiltmilk.co.nz

  • Gastric Reflux Support Network NZ shared Above Rubies's photo.

    Thank you to our previous National Coordinator for sharing this one. And in the words of Kelly from SmileDial our children might be a different kind of perfect.

  • Thanks Margot Kristensen for adding me to here we have a silent refulx baby we've been in and outa hospital for help and suport she's 8 weeks old crys frm the moment she wakes till any were frm 11pm or later I've tryed everything she has this day of screaming all day and then she's exausted the next day the pediatrician says there is nothing he can do and she is in pain were Goin to be admitted to mother craft in Hamilton as I can't rock her all day every day I'm exausted 2 any tips or advice pls

  • I have a 4 month old (5 at end of month) he's on omeprazol for silent reflux. He's started spitting his medication and I can't get him to swallow all of it. He gets distressed and this morning he vomited it all back up after gagging on it. He's had a flare up I'm sure cause he's not getting enough. I've asked GP for capsules w. Baby pear, but been denied cause hex too young. Anyone had luck mixing liquid with anything to get him to take it?

  • Hi We were prescribed gaviscon infant and told that it acts Like a plug keeping the acid down, b However I noticed on the crying over spilt milk site that there are two gaviscons used and that it is the other one that acts like a plug. My son is on ranitidine for silent reflux, which has helped but he still wakes up all the time from it and during the day will only sleep for about ten minutes before waking. Can anyone explain the difference between the two gaviscons? Also, is there any reason why my son sleeps better at night? Or is he just exhausted from not sleeping during the day? Thanks in advance for any advice

  • Please check the posts to the page and help out on a recent question if you have ideas for helping keep a young baby upright.

  • Hi there, I have a little 3 week old baby girl who we have just been told has reflux. It causes her a lot of pain and because of the reflux her windpipe gets closed off for an extended period of time with the milk/acid going up and down causing her to go bluey or purple which is very scary. She needs to be held 99% of the time because when lying her down it causes a lot of pain and also causes her to be sick out her nose and mouth. She has been started on gaviscon at every feed which seems to be helping with the "choking" episodes but I still need to hold her all the time. I am wondering if anyone has had any good slings or has any ideas that may help to keep her upright and comfortable to sleep etc. for both me and her. :)

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

    #understanding #havebeenthere

  • Our daughter has had reflux since about 5 weeks & she is now 7 and a half months old. She will sleep 12 hours and wake to have 30 mls. She has small amounts often throughout the day and cannot handle anymore than 80 mls which is few and far between. She also has solids 2 - 3 times a day. She is also still on newborn teats and we try all the time to go up but she cannot handle the flow and wont drink at all. She is now a good size and looks healthy but only because I am constantly feeding her and also have a 4 year old who has gone backwards in her behaviour and toileting because Miss 7 1/2 months is so time consuming. She is under a pediatrician, on Ranitidine 3 x a day and is booked in for a barium swallow on the 18th of this month. Has anyone else had/have this issue?

  • #gastricreflux #gor #gord #infant #baby #gastricrefluxsupportnetworknz #cryingoverspiltmilk #child #family #reflux

  • Our seven week old baby can sleep for hours vertically in our arms, but wakes when in his back. When he is sleeping on his back he often makes a sound which sounds like someone clearing their throat, it goes on and on and eventually he wakes up. He doesn't spit up, but often has white on his tongue. He also grimaces a lot in his sleep. Does this sound like silent reflux? I'm especially keen to know if anyone has experienced the same type of noises in their baby. We have a doctors appointment on Tuesday.

  • There is a post to the page about settling babies with Gastric Reflux to sleep.

  • #gastricreflux #gor #gord #infant #baby #gastricrefluxsupportnetworknz #cryingoverspiltmilk #child #family #reflux