Formula, reflux, and colic

Rebecca - posted on 01/13/2010 ( 2 moms have responded )

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I know that many moms in this group have chosen to use formula (and some have to do so for medical reasons), so I wanted to share some useful information from the American Academy of Family Physicians. This is a summary of the different types of formula and their uses, based on clinical research and NOT the advertising schemes of formula companies. Your doctor has access to this information, but may not provide it to you, even though it could make a big difference to you and your family if you are experiencing issues with reflux or colic. I have heard so many stories of moms trying 10 different formulas, ready to pull her hair out, when really...all infant formulas are pretty much the same, and changing formulas is usually not the answer (and may cause more problems than it solves for your baby). Here are some key excerpts:



Reflux:

"Gastroesophageal reflux is common in infants partly because of a decreased resting tone of the lower esophageal sphincter. Reflux may be considered physiologic and does not require treatment unless it is accompanied by poor weight gain or significant infant discomfort.



Colic:

Parents often change formulas in response to infant colic. Soy and lactose-free formulas are heavily marketed for colic without a formal diagnosis of lactose intolerance. Most colic improves spontaneously between four and six months of age; new formulas tried during this time may be credited with the improvement, perpetuating the popular belief that colic is exacerbated by certain formulas.



Because evidence for soy formula in the treatment of colic is limited and based on poor-quality trials, the AAP concluded that there is no proven role for soy in the management or prevention of colic. There is no evidence to support lactose-free formula either, but a short trial may be reasonable in infants with colic who also have gastrointestinal symptoms. Two systematic reviews have found some benefit with hypoallergenic formula; this potential benefit must be weighed against substantially greater cost. Physicians may recommend a one- to two-week trial of hypoallergenic formula for refractory cases. Counseling parents about infant crying appears to reduce symptoms of colic more than any change in formula."





The article also mentions DHA and ARA, and says that there is NO good evidence for its inclusion in formula. These synthetic ingredients are NOT absorbed by the baby's body in the same way as the DHA and ARA found in breastmilk, and doctors are beginning to report that some babies have negative reactions to those ingredients (which disappear when the baby is changed to the same brand/type of formula, without those additives). Yet the formula companies market them as being better for your baby, and charge more for products that contain them.



Here's the link: http://www.aafp.org/afp/2009/0401/p565.h...

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Rebecca - posted on 01/13/2010

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Oh goodness Doreen...it sounds like you and your precious baby have been through the wringer! First of all, try not to beat yourself up about not breastfeeding longer. I really do understand how you feel about wanting to nurse for a year -- I am a huge advocate of breastfeeding, and I'm still nursing my 11 month old son -- but 2 months of breastfeeding is better than none, and it's more than a lot of babies ever get! And you really went the extra mile, trying to change your diet and everything. Who knows... maybe your baby could have continued nursing, with your modified diet, just by treating the GERD, but how could you know? The doctor said to quit nursing and use soy formula, and you trusted him to know what he was talking about. Personally, I think the doctor should have known that babies who are allergic to cow's milk are usually allergic to soy, also! But we trust our doctors to know what they are talking about. Unfortunately I think a lot of them don't keep up with the latest research and instead listen to the reps from formula companies.



As for the thing about you eating dairy during pregnancy, I don't know. I did hear about that in my Bradley class when we were discussing nutrition. I guess it's possible, because some proteins do cross the placenta. But MILLIONS of women eat dairy during pregnancy; it's highly encouraged in fact, because milk, cheese, etc. are relatively cheap sources of fat, protein, vitamins, etc. I'm not saying there's no ill effects from this -- maybe that's why so many babies have colic and other issues? -- but you were trying to take care of yourself and your growing unborn baby. Again, try not to beat yourself up over this.



I know it must be hard to be using formula after you wanted to breastfeed so badly, but rest assured that Nutramigen will help your son gain weight and probably won't make him more likely to have allergies when he's older, like other formulas can. A lot of babies with these GI issues end up on Nutramigen (or the other one like it, can't remember the name), and it usually solves the problems, but man, is it expensive! Are you able to get help with it from your insurance company at least? You can also help your son by waiting until he's at least 6 months old to start solids, and be very careful about potential allergens -- wait until 12 months to introduce eggs, wheat, and dairy.



Maybe a way to make a positive out of a bad situation...you can use what you've learned for any future babies you might have -- try to limit your dairy intake in any future pregnancies, cut out dairy entirely around 36 weeks, and make sure that those babies don't get ANYTHING other than your milk after birth. If problems still arise, you can move forward with medications, but try to avoid switching to formula.



I'm glad you found my post helpful...hang in there, mama! You're doing a great job for your little guy. If you ever need encouragement, send me a message. Keep me updated on how your son is doing!

Doreen - posted on 01/13/2010

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Thank you so much for this information. My son has been diagnosed with GERD. He is also seeing a ped GI doc. I tried to breastfeed him and only did so his first 2 months of his life, bc the doctors told me he has a severe Milk Protein Allergy. I needed to put him on soy, well needless to say it was crap!!! I had the GI doc change it because he wasnt getting better he was getting worse. He is now on Nutrigen formula. I feel like a bad mother cause I could not breasfeed him my goal was to breastfeed his first year. I even changed my diet completely, I read all the labels of what I was eating and never got anything that had milk in it or I was unsure of. This helped me lose weight but did not help my son. My son had an ultrasound looking for an obstruction, but friday he is getting an upper GI done. Im so worried, and often think that maybe I did something wrong while I was pregnant. I even heard from a doctor that he had the allergy because I drank too much milk while I was pregnant, which was heartrenching to think I did this to him. He is now on 2 prescriptions prevacid once in the morning and pepcid at night. If you have any more advice I would love to hear it. seems like you have done lots of investigating, so have I. Thank you again for this awesome information.

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