Babies with Reflux
Introducing Solid Foods to a Baby with Reflux
Reflux is when the stomach contents come back up into the oesophagus – this causes discomfort, often accompanied by pain.
Infant reflux is believed to affect 50% of babies to some degree. Sadly, it is often miss-diagnosed as colic – when an accurate diagnosis would mean that medication, or some simple tips and adjustments to feeding, could relieve symptoms early on.
There is another infant reflux condition – known as GERD (gastroesophageal reflux disease) – which can have rather more serious symptoms.
Happily, for most babies with these reflux conditions, they will grow out of them by the time they are 1 to 2 years of age – though this is not always the case, and the condition could persist.
If your baby has infant reflux,he or she may:
- Show symptoms similar to colic
- Cry frequently – sometimes suddenly, or for long periods of time
- Spit up or vomit food
- Arch her back or neck when being fed, or just afterwards
- Be generally irritable
- Be unable to sleep for long periods
- Have frequent ear infections
GERD symptoms may include:
- Eating very little or refusing food – even when hungry
- An aversion to food and to anything being put in the mouth
- Swallowing difficulties, or gagging when eating
- Arching of the back or neck when being fed, or just afterwards
- Excessive drooling
- Runny nose
- Frequent or persistent sinus or ear infections
- Persistent sore throat or hoarse-sounding voice
- Unpleasant breath odour
- Baby gagging himself with his fingers
- Poor weight gain – or weight loss
- Wheezing, asthma or other respiratory difficulty
- Apnoea (stopping breathing for at least 20seconds – awake or asleep)
Things that you can do to ease your baby’s reflux problems.
One of the first things to do is to discuss the problem with your baby’s doctor.
Doctors often suggest thickening formula or expressed breast milk with cereal before the age of 6 months for a baby with reflux, to help the milk stay down.
And rather than immediately prescribing medication, many doctors recommend starting to introduce solid foods earlier than is usual (in fact, many parents notice improvements to symptoms when solid foods are introduced). If your doctor suggests this, here are a few guidelines:
The 4 Day Rule…
- If your baby has reflux, it is important that when you introduce any new food, you always use The 4 Day Rule, so that you can quickly identify any food that triggers a flare-up or other reaction.
- Your doctor may recommend introducing foods with a fairly thick consistency, as these usually stay down better and will provide your baby with more calories.
- Make sure that the food is really smooth so that your baby will not gag on lumps, which will make the reflux worse.
- Some parents whose babies are very unwilling to eat have more success with thinly pureed foods. Experiment a little -under your doctor’s supervision – to find what works best for your baby.
- If your baby is only taking small amounts, then it is best that the foods that you offer provide plenty of calories. Ask your baby’s doctor about:
Cooked egg yolk - for thickening purees, soups, etc.
Wheat germ - for sprinkling over cereal, or pureed fruit or vegetables.
Avocado - high in calories – serve mashed on its own or, for an older child, as a dip.
Cheese - grated and mixed into mashed potatoes, pureed vegetables, or pasta, or cream cheese spread on soft bread or served as a dip for an older child.
Unfortunately, every baby with reflux differs in the foods that aggravate their problems – so there can be no list of ‘recommended foods’ to help you with your own baby.
In babies without reflux, solid foods are usually introduced from about 6 months, starting with cereal, and then moving on to vegetables and fruits. Rice cereal is normally used, but this is known to cause flare ups in some babies with reflux, or other digestive problems like constipation or excess wind (gas).
If rice cereal disagrees with your baby, your doctor may suggest you try oatmeal instead of rice cereal – or even vegetables or fruit as baby’s first solid foods.
Many parents find that some fruits and juices make the pains worse – oranges, apples, bananas and rhubarb, and tomatoes are the most common offenders. Less acidic fruits such as pears would be best to try at first.
Don’t give your baby foods that cause him to ‘burp’ a lot as this can aggravate reflux discomfort, so avoid:
- Brussels sprouts
Foods that can be given to older children – but are well known for prompting reflux symptoms include:
- Whole milk, flavoured milk, or foods prepared using whole milk
- High fat foods – fatty meat, chicken skin
- Bacon and sausages
- Creamy soups and creamed vegetables
- Carbonated drinks
More ideas for helping your baby with reflux:
- Try giving small amounts of food – but more often – rather than bigger “main” meals.
- Avoid feeding your baby less than two hours before bedtime to help avoid an uncomfortable night.
- Don’t bathe your baby or change her nappy (diaper) just before you feed her – or for at least two hours after feeding.
- It is best to keep your baby upright for at least 20 minutes after feeding – hold him against your shoulder, or put him on a raised bed.
- After feeding, don’t put your baby in an infant seat – this will cause baby to slouch and could worsen reflux.
- When you change a nappy, keep your baby’s head raised with a pillow.
- Don’t have the nappy too tight around your baby’s middle, and avoid putting him in tight clothing.
- Prop your baby’s bed up at an angle of around 30 degrees – do this is securely by placing the legs of the bed on blocks. Or raise the mattress itself using special wedges that are available for this purpose. However, make sure that the mattress stays flat – if it bends it could make your baby bend at the middle, causing discomfort.
- Equipment that is designed to keep a baby upright before he can stand (door bouncers, baby walkers, etc.) often press on the abdomen – avoid these if your baby has reflux.
- Infant massage may aid digestion and ease reflux symptoms.
- A dummy (pacifier) will encourage sucking, increasing the amount of saliva your baby produces – saliva is alkaline, so it can neutralize acid coming up and reduce your baby’s discomfort.
This information presented to you acts as a guide which contains general information only and is not intended to replace advice from a qualified health professional.
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