Finding the right formula is one of the most important steps in managing a gerdling. Your baby very likely has an intolerance. Learn more about the differences between allergies and intolerances click here and click here.
Standard Formulas – Used for Routine Feeding
- Cow’s milk protein
- Examples of Typical Brands: Enfamil Newborn, Enfamil Infant, Similac Advance, Earth’s Best Infant Formula with Iron, Baby’s Only Dairy (note that all Baby’s Only formulas are listed as toddler formulas but are safe for babies, as they are trying to promote breastfeeding for the first year).
- Even though soy-based artificial baby milks may be less allergenic for some babies, between 30 and 50 percent of infants who are allergic to cow’s milk are also allergic to soy.
- On the other hand, this formula may be a lifesaver. Many swear by it, especially the Baby’s Only brand.
- Slightly more expensive than routine formula.
- Examples of Typical Brands: Enfamil Prosobee, Similac Soy Isomil, Gerber Goodstart Soy, Earth’s Best Soy Infant Formula, Baby’s Only Soy
Corn Free/Corn Light Formulas
- Quite a few babies seem to have a corn intolerance. While milk and soy intolerance is more common, consider corn if your baby is not responding to the more advanced formulas discussed below.
- What is This About Corn in Formula? (Post)
- Note: No formula is corn free, but they can be “corn light.” There will be hidden corn in them, to which baby may or may not react.
- Example of corn light brands: Alimentum Ready to Feed and Baby’s Only brand formulas
Lactose Intolerant Formula
- This is a rare condition when the body is unable to digest milk sugar. It is usually seen and diagnosed in school age children and up. it is highly unlikely your baby has lactose intolerance.
- Lactose Free Formula Rant (post)
- Example of Typical Brands: Baby’s Only LactoRelief
- These formulas have added rice starch in them and are thicker. The concept is that if the formula is thicker, it won’t be able to come up as easily.
- A lot of babies become constipated on these formulas from the rice starch.
- It does not treat the pain.
- Thickening is now controversial in the treatment of reflux. Other options for thickening include cereals (which can take the place of needed calories from formula and babies can react to) and gel thickeners like Gelmix.
- If your baby needs extra calories, you should be working closely with your doctor and possibly a nutritionist for the best way to accomplish this.
- If your baby is aspirating liquid, a Swallow Study should be performed. Afterwards, you will work with a speech language pathologist (SLP) who will help prescribe the right consistency for your baby.
- If your baby is choking, gagging, or gulping, a SLP can check for dysphagia. You should also have a tongue and lip tie ruled out by a preferred provider.
- When is it Time to see a Feeding Specialist?
- Tongue Ties and Lip Ties
- Articles explaining why thickening is not necessarily recommended:
Lack of Efficacy of Thickened Feeding as Treatment for Gastroesophageal Reflux
The Effect of Thickened-Feed Interventions on Gastroesophageal Reflux in Infants: Systematic Review and Meta-analysis of Randomized, Controlled Trials
A Systematic Review of Nonpharmacological and Nonsurgical Therapies for Gastroesophageal Reflux in Infants
- Example of Typical Brands: Enfamil AR, Similac for Spit Up
Partially Hyrdolyzed Formulas
- Contains partially broken down milk proteins that are supposed to be easier to digest.
- Are not hypoallergenic.
- Examples of Typical Brands: Gerber Goodstart Gentle, Gerber Goodstart Soothe, Enfamil Gentlease, Similac Sensitive, Similac Total Comfort, Earth’s Best Sensitivity
- Milk protein is broken down very small so that the body does not recognize it.
- Has a bad taste and smell. May have to do a gradual change if your baby refuses to drink it due to the taste.
- Some babies still react to the broken down milk proteins and will need an elemental formula.
- Very expensive. Can run between $300-$400 a month.
- Can take up to two weeks to see full results.
- Examples of Typical Brands: Alimentum Ready to Feed (corn free), Alimentum powder (not corn free), Nutrimagen Ready to Feed and Powder (neither are corn free), Gerber Extensive HA (not corn free).
- Abbott/Alimentum will try to help you find financial assistance with this site: http://pathwayreimbursement.com/
- Amino acid based formula, no milk protein at all.
- Contains corn syrup solids which some babies will react to if they have a corn intolerance.
- Has a bad taste and smell. Many babies need to change to this formula gradually and mix in previous formula.
- Very expensive. Can run between $500-600 a month.
- Can take 4 weeks or more to see full results.
- Examples of Typical Brands: Neocate, Elecare, Puramino.
- Read here about How Neocate and Elecare Work (explains hypoallergenic formulas, too!)
- Abbot/Elecare will try to help you find financial assistance with this site: http://pathwayreimbursement.com/
- Neocate will try to help find financial assistance with this site: http://www.neocate.com/reimbursement/
Bottle Aversion/Baby not Interested in Feeding
What if your baby is refusing to eat/is difficult to feed? Make sure her/his pain is addressed by proper medication: dose, form, and administration. Is it ‘mechanically’ difficult for your baby to eat? Have your baby checked for a tongue tie and a lip tie, as this can affect eating. You can also get your baby’s mechanics of sucking/swallowing checked out by a Speech Language Pathologist (SLP) who can conduct a Swallow Study which also checks for aspiration. Something else to consider is Delayed Gastric Emptying (DGE), also known as gastroparesis. This is when the stomach doesn’t empty as it should, so your baby may be feeling full when it’s time to eat. There is a test for this called a Gastric Emptying Scan. If your baby is choking, gagging, gulping and refusing to feed, a SLP can check for dysphagia. If you are desperate, ask your doctor about Sulcralfate (Carafate): it helps protect and coat the lining of the esophagus, stomach and upper small intestine by shielding their exposure to stomach acid, so that healing can occur.