Tips to Feeding an Infant with Acid Reflux
Nourishing your child with severe acid reflux or acid reflux disease can prove challenging. It is beyond confusing to negotiate the messages sent about what is best for these often sensitive babies. If you check out the formula isle it can confuse the issue even further. Remember they are selling a product first not diagnosing your child's condition. Here is the low down, from a mom whose been there, on how to negotiate all of these decisions for your reflux baby!
Breastfeeding is generally best for infants with acid reflux. This is because breast milk is the most easily digested food. If you are breastfeeding and find that you continue to have problems it can sometimes be helpful to limit trigger foods from the mother's diet. Many pediatricians will suggest removing dairy as a first step. If this does not help there are more strict elimination diets that can help determine if something the mother is ingesting is aggravating the child's reflux. Dr Sear's website has some wonderful tips on how to do the elimination diet correctly.
Most formula fed reflux babies will start out on a basic milk based formula. When that causes trouble many parents will try a formula with comfort proteins like Gentle Ease or perhaps one that is soy based instead. In many instances that simple change can help a lot of infants. Especially those having trouble digesting cow's milk. If you have tried all of those things and your baby is still having problems then it might be time to try a higher level formula. Of course, there is more than one choice and the "formula food chain" can be really confusing!
One trend in reflux formulas is thickening. Enfamil AR is an example of one of the formulas on the market that claims to limit spit up episodes by thickening. It contains special thickeners that slightly thicken the feeding when it hits your babies stomach. Similac Sensitive for spit ups contains rice starch to aid in thickening. For babies with especially sensitive stomachs or ones whose main issue is pain not spit ups the thickening may not be enough.
They next line of formulas on the market are generally referred to as "hypoallergenic" or elemental. These include formulas like Pregestimil, Alimentum and Nutramigen. These formulas are called extensively hydrolysed formulas (EHF) because they have more broken down proteins that are easier to digest. Most also do not have lactose or sucrose which can also be hard to digest for some little ones. These can be great in children who have reflux symptoms that are severe or are complicated by food allergy.
If your child has even more serious issues with food allergies or absorption and has failed a trial run of one or more of the EHF's it might be time to look into whether an amino acid based formula can help. Two of the most well recognized are Elecare and Neocate. Two years ago Nutramigen AA was also added to the list. These formulas have proteins that are broken down into the most basic of component, the amino acid. This prevents most reactions and is easier on the digestive tract because most of the "work" of breaking down the formula has already been done.
If you are up late with a screaming reflux baby you might be wondering why you wouldn't just start with the amino acid based formula. Truthfully, because most babies won't ever need one. While these amino acid based formulas are lifesaving for infants with severe GERD, shortened GI tracts or issues like Eosinophillic Esophagitis for most they are just an unneeded expense.
If you are having such severe issues with your child's digestive tract that you require an amino acid based formula then you are most likely plugged in with a pediatric GI and/or allergist. If not, then you may want to consider fully addressing your child's issues before "sampling" formulas. You will want a clear picture of the problem before you start the process of adding solids to your child's repertoire.
I hope this blog has helped make sense of some of the feeding confusions. Check back for tips on adding solids into your reflux babies diet.