How do I wean a baby with reflux?

How to introduce solids to a baby with reflux, when to start, best ways to wean and what foods to avoid

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As if coping with reflux wasn’t tough enough, now your baby is ready for the new challenge of solid food. So if your baby finds it difficult to keep down milk, how will she cope with solids?

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The good news is that some mums find weaning their babies on to solids can actually reduce reflux. However, others find it doesn’t make a difference, it’s just becomes a different challenge.

With expert advice, we’ve put together some useful info to help you and your baby with weaning…

Talk to your doctor or health visitor about when to start weaning

Because weaning may help to improve reflux for some (but not all) babies, you may be keen to start weaning early – ie, before the official guideline of 6 months. It’s thought that the improvement may come because food is thicker than milk and is more likely to stay in your baby’s stomach, however there’s no clear evidence for this.

“Some babies with reflux will improve once weaning has started and so doctors may advise early weaning for babies with reflux (though no earlier than 17 weeks),” says GP Dr Philippa Kaye.

If you do want to start early, it’s vital that your baby is showing the 7 signs of readiness for weaning and that you talk to your GP or health visitor first.

If you’re starting solids at 4 or 5 months, you will need to begin with purees, as your baby won’t be ready for baby led weaning. Once your baby is 6 months, baby led weaning or purees can be used.

Remember, you should never give your baby solids before 4 months (17 weeks).

How to give your baby solid food

  • Start weaning slowly and take your lead from your baby as to how much she needs as she will still be getting the majority of her nutrition from milk
  • Don’t rush each meal. Let the food settle in her stomach
  • Start with food that is as smooth as possible. Some babies with reflux can be sensitive to different textures, so it may help to introduce new textures slowly. Your baby may want to stay on purees for a little longer than a baby without reflux. You can slowly make purees thicker and slightly lumpier – aim to introduce more lumps between 7-9 months
  • Although she has reflux, your baby does not need more solid foods than milk, and if she has stopped gaining weight or is losing weight then see your doctor
  • Feed your baby in an upright position. Look for a highchair that offers a lot of support so even a young baby is sitting upright as possible
  • Some mums find that giving solids after a milk feed helps their babies to keep the milk in their stomachs
  • Keep a daily food diary. This will help you identify which food types your baby reacts more or less to
  • Introduce new foods every three days, rather than every day. Your baby may not react immediately to a new food type, so you need a little time to see the effects

Best foods for a reflux baby

Each baby is unique and will have different reactions to foods. The best approach is to talk to your GP or dietician for individual advice. However, the current thinking is that good foods to give when starting weaning are:

  • Purees of root vegetables, such as potatoes, carrots, pumpkin, swede, parsnips and sweet potato
  • Non-acidic fruit

Foods you may want to avoid

These foods may exacerbate reflux or make it more painful:

  • citric fruit, such as oranges, apples and grapes
  • tomatoes, peppers, courgettes, cucumber and aubergines
  • foods containing cows’ milk proteins
  • spicy foods

Is feeding a reflux baby more difficult?

In a nutshell, yes, it can be. This is because of the problems and pain caused by reflux, so many babies with this condition do at some point find feeding upsetting. If this happens to your baby, you’ll need lots of patience and persuasion.

If your baby starts to get very upset during feeding, it may help to let her out of the highchair and play for a period, and then try her again with the food 30 minutes later.

Does reflux made weaning harder? What mums say…

The results from our forum mums seemed to be a mixed bag: some hailed it a miracle for reflux problems, while others said it actually made things worse.

“We early weaned at 17.5 weeks for reflux – and there was absolutely no improvement. If anything it was worse because she then had more smelly stuff to bring up!! Her reflux didn’t really clear up until she was about 9 or 10 months old, sometimes it just takes time.

“I’ve hated weaning and wish we’d held off for longer, it’s a lot of extra hassle and heartache if your baby isn’t a good eater.

“Sorry to put a downer on it but it’s only fair you get both sides of the story!! Good luck with it, take it slowly and protect your floors!!” says Colligreen.

“We weaned Freya, who has silent reflux, at 22 weeks (we started 10 days ago!). I had really wanted to wait until 6 months, but she has needed to be held upright for about 2 – 3 hours after her bed time feed each night for about the last two months, and she is currently waking about 2-4 times a night. I couldn’t cope with either and so we decided to see if solids would help,” shares mum Alison E.

“She shows real interest in food, and weaning has been surprisingly easy so far (after a blip in the first few days, when I tried her on pure apple and carrot, but she was happier when it was mixed with baby rice and milk). I think it has started to help her reflux.

“She is on two meals a day and although she isn’t sleeping better, for the last two nights we have been able to put her down an hour after she has eaten, which feels amazing!

“Just a hint – I hadn’t realised but some solids can make refulx worse – namely acidic things like apple and pear (apparently banana also makes it worse – which sounded odd but she was a bit refluxy after she had banana for the first time).

“We are still giving her those things, but only in the morning and mixed with lots of milk and rice. In the evening it is solid easy stuff like carrot and sweet potato. THis has made things better – she was really refluxy the first time we gave her pear because I didn’t know it could make it worse and it was at bedtime.”

Posy took things slowly and had a positive result, sharing: “We weaned early at 4.5 months mainly due to reflux issues and not getting enough milk down my LO.”

“It was slow going with baby rice/cereal, and baby rice mixed with veggies/fruit to start with for the first 6 wks, but things did turn a corner and at nearly 10 months now she is loving her food and it has def helped with the reflux.

“The only thing I would say is that she still has fairly small portions to help with food not refluxing back up again. She is still on Omeprazole however, but should be coming off it in the next month under consultant’s instructions, yippee!”

And Peeptoe1 added: “I started weaning Hugo (24 weeks) on the weekend and so far it seems to have made things worse.

“He is on IG for reflux but that doesn’t seem to be dealing with his acid as effectively now that we’ve introduced solids. He is back to looking really uncomfortable, arching, pulling his legs up, squealing and screeching and grunting, as well as being in a constant bad mood (as you would be if you were in pain!)

“He’s also got the wet hiccups again, farting, burping and possetting a lot more (milk only, not food).

“So far I have only been giving him fruit (banana/apple/pear) mixed with a teaspoon of baby rice around mid morning and he is otherwise exclusively breastfed. It’s really disrupting his sleep as well – nighttime and daytime.”

What medicines can you give?

The first recommended medication is normally a paediatric version of Gaviscon. Never give your baby the adult over-the-counter version. The medication comes in powder form and is mixed with either breast milk, formula or water and thickens the milk as well as keeping the stomach contents in your baby’s tummy to prevent reflux.

Other medication such as antacids and anti-vomiting medicines may also be used but always speak to your GP or health visitor before using any medicine.

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