Reflux and Milk
Reflux and milk is slightly controversial but I want to share my thoughts and feelings around the topic of how milk and baby’s diet relates to reflux. There is so much that you can do to help your baby’s reflux and I want this post to help you in discussing your baby’s reflux symptoms with your paediatrician or doctor.
Changing diet is not the first thing you should do
If you think your baby has colic or reflux there is so much you can do before changing diet. Thinking about air intake, having a lactation consultant checking your baby’s latch – whether you are breast or bottle feeding I would look at latch and positioning and do as much as you can on a holistic level that air intake is not the main root cause to reflux or colic. If it is, moving to a different milk is not necessarily going to make much difference and it could make it worse, in some instances.
If you’re convinced that it is the milk they’re on then you can look at different formulas and breast diet too.
How do I know if it’s air intake or diet?
Sometimes there isn’t an obvious answer and it can be a combination of factors. We are looking for signs of tummy ache as well as reflux, also you can have a look if their poo is mucus-y or green (which can be related in itself to taking in lots of air when feeding). There are some markers that are more obvious such as antibiotics exposure or after their vaccine they can be more unsettled. I would always suggest you look at everything: don’t just assume it’s diet. Look at:
- ait intake
- high palatte
- tongue ie
- lip position
Once you’ve looked at all of these things, then look at milk. Of course: if it is a full on allergic reaction to milk then you would have gone to your doctor anyway, and you must take these seriously. For babies who are struggling a little bit and it’s not clear cut, these are the ones that often struggle more for longer because so many health professionals don’t take it seriously. You may be told they wouldn’t be gaining weight etc, but the reality is you can have a very happy baby who is still struggling with their tummy. Be confident, try and sort it and, if needs be, I hope this information will be helpful if you do have to go down that route.
If you are formula feeding your baby then the most common will be the Number 1 formula. If we give baby a standard number 1 milk but we think baby is uncomfortable – where do we go from there?
I have seen some babies become more comfortable when they move over to an Organic formula, such as Hipp Organic. That can be more gentle on their tummies so you might find that has a big enough impact on your little one’s tummy.
With any change to milk, unless there’s an allergic reaction, you often need to give it at least 4-5 days to see how it goes, rather than chopping and changing. You won’t be able to monitor symptoms in any less than that.
If you’ve moved to an Organic version of the route and baby is still struggling, you may wish to try an anti-reflux milk (most brands do these). An anti-reflux milk is made to be thicker, which means the milk sits heavier in the stomach and so, if there is an regurgitation going on, that it doesn’t come up so easily and, therefore, baby is more comfortable. I have seen clients use this milk and they have worked really well for some babies. However, the issue with anti-reflux milk is that if it’s the contents of the milk that’s the issue (i.e. dairy) then all you’re doing is stopping the body being able to expel that milk and you’re not dealing with the route cause. If it’s their tummy that’s the issue, it will still be a struggle for them – so they may vomit less but their sleep is still broken or their stools are very constipated. These milks contain Maltodextrin and carob bean gum ( thickeners) – they help the heaviness but a baby with a sensitive gut will react to these in a negative way and they can cause other side effects.
What do we do if we feel formula is causing the problems?
Your first call is to try comfort milk. This is basically a main-brand milk that is partially hydrolysed. If your baby is struggling with dairy itself – the lactose or the protein – then comfort milk will be easier for your baby digest because it has less of those things.
If there is a dairy issue, a baby on comfort milk can really thrive. Again, it’s slightly thicker but does have similar thickening ingredients which can affect their guts. It’s not necessarily the magic answer but it could definitely be helpful for some babies.
If comfort milk helps to a certain extent but there are some reflux issues, then I’d say it does look like a dietary issue and you may wish to look into a fully hydrolysed milk. The first place to get this is your GP or doctor. It can be difficult to get hold of (you can buy online) – but do speak to your GP in the first instance.
These milks still contain dairy but the protein is really broken down into tiny pieces. If dairy is the issue, these milks could be the best for your little one but please remember that changing to one of these milks will not help if air intake or positioning is the issue so please, please, always start with looking at these things before altering your little one’s milk.
Amino Acid Based Milk
There is no dairy in this type of milk, you would get it on prescription from a doctor. This is a last result if the fully hydrolysed milks are not working and baby’s sleep is still affected. These milks are very expensive and difficult to get hold of but I want you to know that they are an option for you, with support of a GP or a Paediatrician. This milk is brilliant for allergy babies.
If you are breastfeeding your little one who has reflux, I cannot stress how important it is that you go through the latch and air intake support first before you look at giving up food groups.
The problem with a breastfeeding diet is it affects both you and your baby so, if you do go down the path of cutting our a food group, I would really recommend that you consult a doctor or nutritionist to ensure that both you and your baby are still getting the full range of vitamins that you need to be healthy.
The research on breastfeeding diets is mixed and I think that’s why it can sometimes feel like you’re not supported or finding the answers you want. I know there is not enough research on how Mum’s diet affects baby – the reason being because it is so difficult to analyse when each Mum has a different metabolism. This means that we can’t know for sure that something you have eaten will or will not affect a baby within a 4- 24 hour period, as every Mum and baby digests food at different rates. Therefore, it is really difficult to measure. We do, however, know that certain proteins (such as dairy) are passed from a Mother’s milk to baby – lots of proteins could potentially cause a negative response for baby. The main proteins that can make a baby have reflux through a Mum’s milk are dairy and soy.
If you decide to cut out a protein from your diet, I would really suggest that you have a discussion with a health professional.
I have seen babies transform over 3-4 days and some takes up to 6 weeks. Whatever it is, you must do it exclusively and be really aware of everything that you are taking in.
You must ensure that, if you cut out a food group, you must ensure that you keep your calorie intake up because breastfeeding takes a lot of energy.
For some children with very sensitive guts, there are many things that can affect their tummies. So many will grow out of this but my advice is always to push for a referral if their behaviour, ability to be settled and their sleep are affected by their milk intake. Keep a diary of symptoms and know that you can get to the bottom of what is causing the disruption, with the right support.
For more information, please click here for my Colic & Reflux Course for babies of 0-6 months old.