Food and 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 seek assistance from your Doctor, Midwife, Well Child Provider, Health Professional or Dietician about feeding your baby.

Food and reflux pain

The foods that can make reflux pain worse for a baby/child are:

  • Fruit and fruit juice, especially oranges, apples and bananas. Pears are the least acidic and an ideal first fruit for reflux babies.
  • Tomatoes and tomato sauce
  • Chocolate
  • Tea and coffee
  • Spicy Foods
  • Fizzy drinks (especially coke)
  • Fatty foods (i.e. fish and chips!!)

It is important to note however, that these foods will not worsen vomiting, and so it is not necessary to avoid them in a ‘happy chucker’.

Well tolerated first solids include baby rice (please check the ingredients as some brands of rice cereals, contain milk products), kumara and pumpkin. Here is a Feeding Guideline that provides a sensible plan for introducing solids to a baby with reflux if the foods listed on this page that are likely to cause problems are introduced later and with caution:  Starting Solids from heathed.govt.nz

Breastfeeding and the mother’s diet

Citrus fruit, tomatoes, caffeine containing drinks (tea, coffee, coke) and chocolate may also need to be avoided by the breast-feeding mother of a reflux baby. Of course alcohol should also be avoided by the breast-feeding mother.[i] Some asthma medication (e.g. Theophylline) taken by the breast-feeding mother may also make the baby worse. Remember that all babies are different and different babies react to different foods – the list above is a guideline only.

Volume and variety

The introduction of solids is known to either help reflux or make it worse when introduced.

Some babies progress well onto solids, but are reluctant to take mixed (lumpy) textures. Aim to start your baby on mixed (lumpy) textured solids by seven to nine months of age. Delaying introduction of mixed textures until beyond nine months is associated with fussier feeding during pre-school years. Make eating a fun experience and allow your child opportunities to feed themselves and experience new textures in their own way. Be prepared for lots of mess! Research shows it is the frequency of tasting solids rather than the amount your child eats that helps them progress onto new tastes and textures. Therefore, try offering your seven to nine month baby very small amounts of mixed texture food at least twice daily until your child indicates he/she is keen to eat more.

Food allergy or intolerance

Studies have shown that about one third of infants with gastric reflux disease will have a cow’s milk protein allergy or intolerance. Skin prick or blood tests may not diagnose an allergy as gastrointestinal delayed reactions are often intolerances.

If you suspect that this is a problem for your baby and you are bottle-feeding, you may need to try 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 you are breast-feeding, you can go on a “dairy-free” diet. This means avoiding all milk and foods that have dairy products in them (e.g. cheese, yoghurt, bread, biscuits, cakes etc.) for up to two or three weeks to see if there is any improvement in your baby. Any solids that your baby is eating will need to be dairy free also.

For information on preventing food allergy please speak to your health professional.  You may also find useful information at http://www.allergy.org.nz/  

Some parents have found that unproven forms of testing such as Kinesiology have helped them to remove offending foods. GRSNNZ doesn’t endorse these and would recommend that limited diets also be supervised by a dietician, that a medically qualified health professional (paediatrician, allergist, immunologist etc.) be involved and if appropriate the foods be challenged after a suitable time lapse.

Cow’s milk protein allergy should not be confused with lactose intolerance. Breast milk always contains lactose even if the mother is on a strict dairy free, lactose free diet so a baby who responds to a change in their mother’s diet, does not have a lactose intolerance.


References:
[i] https://www.health.govt.nz/your-health/healthy-living/babies-and-toddlers/breastfeeding/getting-ready-breastfeed/what-avoid-while-breastfeeding/avoiding-alcohol-while-breastfeeding
[ii]Gastroesophageal reflux and cow’s milk allergy in infants: A prospective study.
[iii] Northstone, Emmett, Nethersole & The ALSPAC Study Team (2001). The effect of age of introduction to lumpy solids on foods eaten and reported feeding difficulties at 6 and 15 months. Journal of Human Nutrition & Dietetics, 14, 43-54.

© 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, edited and added to by Roslyn Ballantyne (RN), National Coordinator GRSNNZ and Fiona Kenworthy, Speech-Language Therapist with permission. Last updated by Roslyn Ballantyne, 13/11/2019.

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.”