Weaning
a Baby With Reflux
Not much is written about reflux and weaning but that’s
probably because a paediatric osteopath and child psychological therapist have
never gotten together to sift through the research.
What
is Reflux and Silent Reflux?
Most babies suffering from reflux are diagnosed within
the first few weeks of life. The symptoms of reflux vary but the most common
one is discomfort when feeding. Your baby may arch their back, scream, refuse
the breast or bottle and turn away.
When your baby drinks milk it travels down their oesophagus
and in to their stomach where the acid gets released to start breaking it down.
The diaphragm in your baby should contract and close the gateway between the
stomach and oesophagus, preventing regurgitation of the contents.
If the gate doesn’t close then the milk, now mixed with
acid, bubbles up and burns the oesophagus causing pain and possibly vomiting.
If your baby has the pain but doesn’t vomit they may be diagnosed with “silent
reflux”.
The taste of the acid isn’t nice so your baby probably
wants to feed again to wash it away – a comfort feed. But since the stomach is
probably full already this has a negative effect and causes more vomiting as they
have overeaten. You can probably see now
why weight gain / loss is never a good indicator of reflux since some
babies avoid eating to avoid pain and others overeat to get rid of the acidic
taste.
Jen’s
Story: Jen
came to see us with her 9 month old, Charlie, who was showing signs of fussy
eating. She was at her wits-end and has been following the “controlled crying”
method, allowing Charlie to “self-soothe”. From the case history it was clear
Charlie was likely to be suffering from reflux. Osteopathic examination showed
his diaphragm was restricted and unable to contract to fully close the stomach
and following referral to a paediatrician an endoscopy was performed and the
oesophagus was found to be ulcerated from the repeated acid burns.
Weaning
a reflux baby early
Many parents choose to introduce their baby with reflux
to solids a little earlier than other children. The reason being is gravity
holds heavier food down more easily. If you picture the stomach as a drawstring
bag and you drop a heavy tin inside then the bottom of the bag gets pulled down
and the top comes together, closing the gateway.
Many people will tell you this goes against the ethos of
baby-led-weaning since you should wait for your baby to show the signs they are
ready before introducing solids.
But, introducing solid food early is baby-led
weaning since you are following your individual baby’s needs. If your baby has
reflux and you feel they will benefit and your GP or health visitor sees no
issue with weaning early then you go ahead and follow your parental instinct.
Never introduce solid food
before 17 weeks, unless instructed to by a health professional
Serving
food to a reflux baby
We have always said purees have their place and this is
the same with a reflux baby. Serving up a variety of textures can be helpful so
a combination of purees and chunky solid foods but still allowing your baby to
self-feed. You may find yourself having to pre-load a spoon of puree and allow
them to guide it in to their own mouth or they may be happy to slap their
fingers in the puree and pop it in their mouth. Allowing your little one to
play with the food, dip their fingers in mush and pick up a stick of something
and pop it in their mouth is still possible with a reflux baby.
Here’s some general guidelines:
- Relax. Remember
that you and your child are attuned so any stress from you will
automatically be picked up by your child. When your own child cries it
resonates with you in a way different to any other person, that is the
attunement, so any stress from you will be picked up by your little one
- We always
suggest sitting and eating with your baby for safety reasons as well as
for ensuring your baby grows to see mealtimes as a pleasurable time where
he gets to engage with mummy rather than being left whilst mummy washes
up! However, with a reflux baby you need to be even more alert t spotting
a particular food which might be causing pain so sit with your baby and
enjoy mealtimes together
- Forget about
offering a “balanced diet” since nutrition to 9 months comes from milk
feeds. From 9-12 months they will have got the hang of feeding and
nutrition will begin to play a bigger role as the milk feeds reduce as
more solids go down.
- Reflux babies
will gag in the same way as any other baby – read more on gagging here.
- Babies with
reflux tend to vomit more easily when they gag and so try to avoid serving
a milk feed too close to the solid foods.
Solids
before milk
When weaning, many people suggest serving a milk feed
before a solid food so your baby doesn’t get fractious and hungry whilst tying
to eat the solid food. With a reflux baby it can be best to reverse this and
serve solid food before milk feed. The reason being is if we think again of the
diaphragm as a bag, having the solid food in it to weigh the bag down before
offering milk feed can actually help
reduce the reflux. On average, leaving an hour between a solid feed and a milk
feed can be helpful
What
foods should I serve a reflux baby?
A combination of purees and finger foods are ideal so
they get the opportunity to choose, self-feed and try a combination of
textures. Some examples include our Broccoli Bonananza and Cucumber Platter which all have sloppy foods and firm foods to keep it
interesting and cater for different degrees of reflux.
What
foods should I avoid with a reflux baby?
There are some “risky reflux foods” which are renowned
for aggravating reflux. However, just because these foods are common reflux
triggers doesn’t mean they are going to be a trigger in your baby. Try introducing one “risky reflux food” at a
time and see how they get on before deciding whether or not it is in your baby.
Risky reflux foods include:
- Acidic
Foods: such as apple, tomato, peppers, onions, berries,
oranges, kiwi, grapefruit
- Tomatoes:
some babies can tolerate cooked and some can
tolerate raw and some can tolerate none at all so you might need to
experiment
- Fruit
Juices: Such as prune, pear and apple which are
high in sorbitol
We like to
set our little ones a good example and encourage sharing. We don't mind
you using any of the information, recipes and tips from our website, all
we ask is that you credit us hard-working mummies here at Yummy
Discoveries.
Thank you x
