One of the questions that I have gotten frequently in my years working with acid reflux babies and their parents is how to add solids. Most parents have been told that once their baby starts solids the reflux will improve. This is true for most kids with mild reflux because baby's gastrointestinal tract has had time to mature and the solids help to weigh down the stomach contents which helps to prevent splash back. Unfortunately, there are some sensitive kids whose reflux actually gets worse when they start solids. There are no cut-and-dry answers but there are some tips and tricks to make it a little easier to determine what works for your little reflux baby.
When to start solids
The first thing that you need to determine is when to start solids. Most pediatricians will discuss this with you at your Well Child visit. If your child has any history of allergy, asthma, eczema or you have a family history of these things your pediatrician may offer additional suggestions to these basic tips.
The age range for starting solids has long been recognized as 4-6 months old but a recent study noted that 40 percent of moms actually start solids before 4 months of age. If you have a baby with reflux it is important to wait at least until 4 months old because it allows your baby's system time to mature and handle the new feedings with less discomfort. Starting solids too soon was also linked with obesity, diabetes, eczema and celiac.
Once your child hits the "magic age" of 4 months it does not necessarily mean they are ready for solids. Your baby should be able to manipulate food from the tongue into the mouth, should be able to sit up on their own, should be double their birth weight, and will likely be showing signs of hunger. If you have any questions about your child's readiness to start solids, your baby chokes every time you try solids, or you see signs of an allergic reaction you should discontinue solids until your pediatrician can evaluate the situation.
Which solids to start with
Most baby books will tell you to start with a single grain cereal, like rice or oatmeal. You do not have to start with those foods as long as you start with single foods. Each single food should be introduced one at a time. After a few days if you see no sign of reaction then you can add a new food. Adding foods slowly can be a pain but it is key in helping you determine if your baby has an allergy, intolerance or if a food irritates your baby's reflux.
Don't worry if your baby doesn't like a food the first time- try, try again It can take multiple times of tasting a food for your baby to decide if they really like it or not.
Triggers you may want to avoid
Many people like to add juice to baby's diet around the time they add solids. If you have a baby with reflux the added sugar and acidity of a lot of juices can often do more harm than good. There is no nutritional reason for your child to need juice if you are feeding them fruits and veggies! So, don't worry if you find juice just doesn't work for your baby.
Other known triggers for acid reflux: citrus fruits (and juices), tomato and tomato based products, spicy foods, onion, garlic and high-fat foods can all be triggers in children with reflux too. I would suggest trying these foods only once reflux is under control and one at a time to determine if it is a trigger for your child.
Following these simple tips can help you add solids in the healthiest way for your acid reflux baby!
_**Jennifer has a bachelor's degree in dietetics as well as graduate work in public health and nutrition. She has worked with families dealing with digestive disease, asthma and food allergies for the past 12 years. Jennifer also serves the Board of Directors for Pediatric Adolescent Gastroesophageal Reflux Association (PAGER).