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.”

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  • Hi there, my daughter has been on omeprozole granules (5mg, twice daily) since 6 weeks old. I've talked to our GP about how and when to wean, his advice was to go cold turkey "whenever we felt like it"..!

    I'm looking for some advice from other families on how they went about weaning - Would like to take a gentle path.
    Are there signs of readiness?
    What age did you start?
    Did you drop one dose and see if there was any effect before fully weaning?
    Or is cold turkey the right thing to do, after all?

    Thanks.

  • Hi all,
    Does anyone know if its okay to mix kiwiherb stuff with losec to mask the taste if you stick to the correct dosages? Eg .5ml each of kids calm, echinature, and chest syrup mixed with 3.8ml of losec?

  • 10 day old baby showing signs of reflux already. Similar to his brother (who is now 22months).
    He has the "breath that smells like stomach acid", looks like he's got a bad taste in his mouth, the "cottage cheese" spit up at times and obviously a very sore tummy after feeds.
    I am babywearing to keep him upright which is helping.

    I suppose what I'm asking is at what point do I go to gp and ask for a paed referral? My husband says don't go looking for trouble until it becomes a much more obvious issue.

  • Can anyone in the Wellington area recommend a good doctor with an understanding of allergies/ intolerances? I'm convinced our doctor doesn't get it! My poor bubba needs a formula top up and is intolerant to diary protein and soy. The doctor wants to start solids but he is only 4 months, I want to leave it until 6 as there is a family history of food intolerances.

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

    Join our PlunketLine Nurse Carla, PlunketLine Advisor Elaine & National SKIP Advisor Regan to chat about Baby Sleep (12 months and under). Post any questions you have below or private message us and we'll be sure to answer these during our chat.

  • New Membership Form for the Gastric Reflux Support Network NZ - but same address and similar details required: http://www.reflux.cryingoverspiltmilk.co.nz/grsnnz-membership-confidentiality-agreement-form/

    Please let me know if there are any problems, but I have tested it - and besides the WordPress Plugin insisting on US format for DOB...it was all good. :-)

    Gastric Reflux Support Network NZ for Parents of Infants & Children Charitable Trust Membership & Confidentiality Agreement Form First Name: Last Name: Email Address: Street Address: City/Town: Area: Auckland Canterbury Gisborne Hawkes Bay Marlborough Nelson Northland Otago Southland Taranaki...

  • I've just taken the Membership form offline for a moment whilst I switch it over to a more stable one - I hope. It should be back up within half an hour. I'll let you know!

  • I have a 11 month old who will be 1 in a weeks times who has silent reflux. Gaviscon seems to work for him at them moment however I am looking at reducing the number of bottles he has a day. I was therefore wondering if anyone had any ideas on how to get the gaviscon in to as he current has four doses a day?

  • I have an 18 month old with silent reflux. It seems to flare up dramatically when she is teething. She can wake up to 10 times in a night! I am still breastfeeding and although this is good for her as it helps to comfort her I get very little sleep. I co-sleep so I at least can doze while she's latched. When the reflux is at its worst she gets very angry and lashes out, often banging her head on the ground. It's heartbreaking to watch and when she is in that state she doesn't want to be cuddled. I'm finding it so emotionally challenging as she is generally a happy, giggly, cheeky little girl in between times.
    She was so bad last week I was in full meltdown mode.
    She has had this since birth, I've always had a dairy free diet and from about 6 weeks old I took out dairy,soy, added probiotics and started her at the osteopath also. This helped heaps and at one point she was sleeping 6 hour stints at night. Then at 12weeks old it came back and has never left and I would say the last couple of months is the worst it's ever been. I've upped the probiotics and added other probiotic foods and am taking out acidic foods as much as possible. She has been a little better the last 3 days so hoping she'll keep improving.
    Has anyone had good results with osteo or similar at this age? I'm wondering if it's worth trying that again.
    I also want to know if people have had success with medications because I read forums online and it seems like only approximately(total estimation)
    2/10 people will write that it really helped them so I don't want to pump her full of things if there's not a good chance of it even working. What are your experiences?
    Help! And thanks in advance 😊

  • There are two new posts to the page if anyone would like to help by sharing their experiences.

  • Hi There I am looking for support for a toddler with reflux. She had terrible silent reflux as a baby and then we thought she had grown out of it by 1ish. Then she has been rediagnosed with it age 2 years one month - after countless ENT problems (She has grommets and has had her tonsils and adenoids removed) and constant constipation. The medication is starting to kick in but she is so upset and so angry all the time (also partly because she is a toddler). Any tips people have to soothe her and help her not be afraid of sleeping/ lying down much appreciated, We are also considering reintroducing her dummy as it worked so well last time, but are conflicted about wether it is a terrible idea or not.Thanks

  • For those dealing with a silent refluxer, what are the symptoms you've noticed? We've been treating my 9 month old for this but never had much success which makes me second guess if that's what the problem is :/ she wakes within an hour of going down at night (if we get her down!), won't settle until around midnight, sleep during the day is never guaranteed and now since starting solids she wakes very frequently dumb the night with what looks like either sore tummy or wind pain. Sound like anyone else's baby?

  • Gastric Reflux Support Network NZ shared their note.

    A reminder please when you are replying to messages.

    Please do not give advice on dosages, advise families to give medications in two dosages when they were told to give them once daily by the prescriber or vice versa, or give direct advice on medications, formulas etc.

    It is perfectly fine to share your experiences as long as you do not discuss dosages of medications or mention health professionals etc.

    We love you chatting and supporting each other so please continue to do this, but keep it safe and non-medical.

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  • Hi Team. My now 3month old has been on Losec for quite sometime now and we had a different chemist make up the liquid and it looked different to out usual dose. Well he now seems like he is back to that child he was before we started on it. I have been back to the old chemist to get it better batch...how long will it take to kick back in,if it has gone out of his system? Cheers. Very exhausted mum

  • Emma has asked a question.

  • Can anyone help us? We have an almost 8 month old she's on Pepti jr, omeprazole and gaviscon. The last 2 weeks have been not very fun for us. She goes off to sleep nicely at 6.30-7 then ban at 9.30-10 inconsolable crying. Her reflux through the day is also much worse. We give losec in the morning and gaviscon with her bottle before bed but not at other feeds because it made her constipated. She's not interested in crawling and rolling anymore because she gets a lot of acid coming up and just wants to stand all the time. She is on a variety of solids is there anything I shouldn't give her because it makes reflux worse? We thought about taking out citrus peaches and apricots?? Too make everything so much more fun she is teething just got her first tooth yesterday ... Any advice much appreciated we would just like some sleep :-(

  • We have a question from Sara now too.

  • Hi there! Im just wondering if anyone has gone down the line of bubs having to have an endoscopy and pH probe study because of reflux lasting too long? My bubs is 15 months and still on high doses of reflux meds and she gets so bad when we try to wean them down. Her Paediatrician has referred us for an Endoscopy +/- pH probe. Has anyone had this? If so, what was the outcome and did it even change their management? Thanks!

  • Hi everyone, Brylee has asked a question. Have a look at the posts to the page. Thanks for sharing your experiences in advance.

  • i keep getting an error message when trying to register?

  • Has anyone else had a major setback with reflux after their little one starts moving? I am feeling so emotionally drained and thought it was supposed to get better, he's now nearly one and we are back to square one

  • I've just hit SEND on the newsletter so if you are a member, you should receive it over the next 24 hours. I'm using MailChimp for the first time, so it will look a little different.
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