Best formula for reflux?

[Emthejem]

Hello, I am new to Mumsnet and am wondering if anyone has any advice on a good formula to try with my 10 week old daughter who has reflux. She is refusing to breastfeed as she associates it with discomfort, I think. I'm expressing & thickening as many feeds as poss with Carobel, but with a 2 year old to look after as well, it's not always practical. I don't really want to use formula but I think I'm going to have to. If anyone has any experience of this, I'd love to hear from you. Thanks.

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bumping for you as no personla experience...i know my sister had a baby with reflux and was prescribed a thicker formula milk ....

sorry to not be more help...

My ds has SMA Gold with Gaviscon added. However, I believe a lot of people swear by Cow & Gate Omneo Comfort. With my dd1 (who I also had to ffeed) I used Dr. Browns' bottles which are great for reflux - but are a real faff to wash up - poor ds gets Avent! I have ds at 6 mo plus dd1 in reception and dd2 who is two and a half and I have massive symapthy for you. If you can afford it, buy the milk in cartons - so much easier.

Good luck!

omneo comfort by cow and gate, sma staydown or enfamil AR - can be got on prescription or they are only a couple of pound more expensive to buy in the pharmacy - they can order it in form you if you want to try them before going for a prescription. It can take a couple of feed to see an effect.

DOnt want to encourage you to not BF but you seem to see this as a solution for you - and you need to go with what you want.

My DS got to 16weeks of constant sickness until the HV saw him vom on my for the 3rd time in ten minutes at a baby group and sent me to the GP! The change was amasing - I didn't need to take spare clothes for me everywhere as well as for the baby!

Go to gp and ask about enfamil AR [anti reflux] My dd was put on it after gaviscon and carobel stopped working and it worked wonders. It is a formula so you dont have to add anything and available on prescription.

Thank you all very much for your help. It's great to know that I may be able to get something on prescription. She's on omeprazole, domperinone and carobel and is definitely better but still very unsetlled and will only take a full feed if I put it a bottle. Am now having to face the prospect of getting up at 4am and expressing for her usual 5 am feed! So the formula option is looking better all the time. Am just so tired and I think it will give me a break and also she may feel more settled on it. We'll see. Thanks again.

I know bfeeding is wonderful but as someone who has extended bfed one baby and had to ffeed two others, there really isn't a lot of difference as far as they are concerned. You need a break so you can get back to being a happy mummy and baby. Good luck!

Has anyone discussed the possible cause of the reflux with you? Its quite possible that it is linked with a milk protein or lactose intolerance and therefore if breastfeeding it might be worth you trying a dairy free diet for a week or 2 and see if there is any improvement?

Alot of formula fed babies end up on hypoallergenic /elemental feeds like Nutramigen or Neocate because they can't cope with normal dairy based formula. Just depends on the cause... So i would maybe try the dairy free diet as a first port of call ?

alice

Hi Alice
Thanks for this. I'll talk to the consultant when we're next at the hospital. They have explained it as a purely mechanical problem where the muscle at the top of the tummy isn't closing properly. She doesn't actually vomit that much. She has what they call silent reflux where the acid comes up the gullet but tends to just sit there which is what's causing all the pain she has, and is why she swallows so heavily and cries as she does it poor love. I will definitely investiage the lactose issue though. I'll give anything a try! Thank you.

Emma

Emma
Hi again - it may well be that it is mechanical but in a significant number of cases it isnt (its more likely to be a milk protein issue than a lactose one).

You might find this interesting - he's one of the leading paed gastros in the country - and he suggests its an allergy/intolerance issue in up to 40% cases(we saw him and dd has been on a hypoallergenic milk ever since). Just food for thought anyway...it might just be worth changing your diet just for a short while to see if it makes any difference at all, before you give up breastfeeding . Is she at all windy/colicky?

www.paediatricgastroenterologist.co.uk/development.htm

You might also find this board helpful (not as busy as this one but pure reflux)

boards.babycentre.co.uk/n/pfx/forum.aspx?_requestid=1149110&webtag=bcUKBabyReflux

hth
alice

hi other good links are:

PAGER which is the US based organisation for paediatric and adolescent reflux
pollywogbaby.com
and infantrefluxdisease.com
infantreflux.org doesn't have so much useful stuff on the main site but the forums are very active and people give really helpful suggestions.

I know what it's like trying to deal with a refluxing baby and a 2 year old as my ds1 was just over 2y when ds2 was born. There are some good web resources for breastfeeding refluxers, and I also got a very good response from the La Leche League. I carried on bf ds2 (despite feeling absolutely at my wits end many many times) as ds1 had a cow's milk and soya intolerance so there was a high probability that ds2 would also react to most normal formulas. Plus breastmilk is digested faster than formula so is better for refluxers as it spends a shorter time in their stomach, so lessening the risk of it coming back up.

I can understand why you're thinking of introducing formula but would advise you talk to your paediatrician or possibly ask to see a dietitian, before you make that change. If you are going on to formula it should really be Nutramigen or Neocate - because of the probability of a food sensitivity as mentioned by jasperc163 - but they can talk you through this better.

The whole area of food sensitivities is very close to my heart. I worked out that ds1 was intolerant to cow's milk protein by eliminating it from my diet for about 2 weeks. I know the medical professionals tend to be very wary of people going on elimination diets, but my feeling was that it was worth trying to see if it made a difference. If it didn't make a difference, I reckoned it wouldn't have damaged my health or his because 2 weeks is hardly a long time to avoid certain items. In the end it made such a huge difference to his colic I decided it was worth carrying on. And whenever I reintroduced milk into his diet, he started screaming again about 8 hours later. Although you can't test for intolerances in the same way as you can for allergies, the correlation was pretty clear to me and all my family.

With ds2 I joined a great yahoo group health.groups.yahoo.com/group/breastfeedingreflux/ and the group members have lots of experience in identifying foods in their diet that affect their babies' symptoms.

apologies that this has turned into a long post but I hope there's something useful for you amongst it all!

ps another thing that I feel strongly about is that the medics don't really understand what it is like to live with and care for a refluxing baby. so if you are getting desperate, call them and ask for a new prescription or another appt - otherwise they might send you away for the next 3 months and in the meantime she will get worse and worse. There's loads of info on those sites about how fast babies grow out of the reflux meds - whether or not they are putting on weight. You can probably read me being more vociferous about this on older posts.

thinking of you

Nothing new to add, but also wanted to urge you to try giving up dairy yourself before you try switching to formula. My dd has both silent reflux and milk protein intolerance, and she became like a different baby once I gave up dairy. We're still breastfeeding now and she is 9.5 months.

Thank you very much for all this information and for taking the time to write. I'll give the dairy free a shot. It would be worth it if I could continue to breastfeed. She seems to tolerate my milk well if it's expressed and thickened, but is never totally symptom free so I'll try changing my diet and see what happens.

My sister is a consultant paediatrician and has been a great help on the medical front. But, as has been alluded to, living and dealing with reflux on an every day basis is very complicated and emotive, and can't usually be dealt with using prescription medication alone. For example, I was advised to make up a paste of Carobel and get my 4 week old daughter to lick the whole lot off my hand at every feed. Each dose was 20mls worth and tasted like cold wallpaper paste. No surprise that she did not take it, and was not practical to do at every feed anyway, My sister is also very adamant that I must not give up breastfeeding. No one would feel sadder than I would if that's what I had to do, but she isn't the one getting up at 4am to express milk! I managed to express nearly all her feeds today but that's because I stayed in and my poor DS aged 2 was left to his own devices.

I'll investiage all those websites - thank you.

It's been so lovey to read all this advice. I'm finding it quite a lonely business looking after a refluxing baby, although she is a sweetheart and gives me lots of smiles when she's not crying

"she is a sweetheart and gives me lots of smiles when she's not crying"
that's just what ds2 was like, emthejem. And he's a joy to be with now he's past the refluxing (apart from his 'difficult toddler' phases )

I know I've given you loads of links, but if you only try one, go to the yahoo group, they are a great bunch of people and very supportive, and will certainly help you through avoiding cow's milk for a couple of weeks. And do use 'contact another talker' to e-mail me if you want to moan about things to someone who has been through it all. As someone said on another thread fairly recently, people often think they know what you're talking about when you say your child has reflux, and just dismiss it as a baby possetting a bit more than usual

20mls of paste is a huge amount for a 4 week old baby

If you are going dairy free then you could try this site. We found it very useful when my daughter had a dairy intolerence. She also had reflux. It particularly helps identify hidden dairy ingredients in food.

www.milkfree.org.uk

none of the staydown formulas worked for ds only C&G organic with omeprazole and domperidone. ranitidine and gaviscon also had no effect.