Nutritional questions/concerns

[Anonymous]

Hi! I’m new to posting on this site, hopefully this will work! Here is a little background and my question…

I have a 5 month old boy diagnosed with reflux at about 1 month. Since then we have tried Prevacid, Zantac, and Axid all making him very fussy and not really helping the reflux. Archaic as it may be, my ped had me add rice cereal to thicken his feeds and… “voila!” different baby! I know many of you guys are cringing, but we are now able to control his reflux successfully with rice cereal added to his formula and no meds. We are very happy about that since none of the meds seemed to help anyway. Unfortunately, in order to regulate the reflux with the cereal we must thicken the formula with 1 TB cereal to 1 oz. formula. It really does work great for this baby. (Zantac alone worked for his older brother.)

Well…3 months later we are taking only 17oz. of formula per day. My understanding is that babies his age are to have about 28-40 oz of formula each day. Now, my problem is not that my child isn’t gaining enough weight, rather, it is the exact opposite. He is about 27 inches and 18 pounds. That puts him in the 90th percentile. (His brother was almost just as big even w/out rice added.) It’s not that he’s a big baby that I’m worried about…it is that he’s only getting the nutrition of half of the recommended formula amount per day. Of course, calorie-wise with the cereal added, it just about equals out.

I suppose I say all of that to ask this…should I be concerned that 1/2 of his daily calories are coming from rice cereal?I know that everyone usually says that if they’re healthy and they’re gaining weight, why worry? Well, I’m a Mom….I worry!! I try not to…but I do! I would just like to do what is best for my child so that he is both healthy (nutrition-wise) and comfy (reflux-wise). Any ideas or advice would be greatly appreciated!

Tam

[Anonymous]

Addy was always a good gainer even when her intake dropped very low…I agree…just because they are gaining and aren’t FTT, doesn’t mean there isn’t a problem. I would be concerned with that intake too since half of the calories are coming from the cereal. Like adults, just bc we are getting the right amount of calories, doesn’t mean we are eating the most nutritional foods…we’ll still gain weight or maintain but we may be lacking vitamins, minerals, etc.

[Anonymous]

you may need to talk with your ped about a possible multivitamin to help make up the difference in the nutrients. Or if you are willing to give it a try, you may want to cut back the amount of cereal you are putting in the bottle and see if since the baby is older if less will work. The reason they aren’t taking as much formula is b/c the cereal is filling them up, so possibly by cutting back the cereal even if it is to 3/4 tbsp per oz of formula you may be able to get more formula in them. Just a suggestion.

[Anonymous]

Well, he is on tri-vi-fluor already. I’ve also tried to cut back on the rice cereal thing last week and we had massive spit-up issues. The ped suggested that we go ahead and introduce solid foods since he’ll be more likely to hold them down. The only problem is that if we introduce the foods 1/week due to family allergies it will be months before we can even begin to think about a balanced diet solid food-wise.

In the meantime I’m thinking about putting him back on the Prevacid and removing the cereal from the bottle and seeing if the med will control the spit-up/reflux thing. Beth, I see that your child is on Prevacid…does it control the spit-up?

[Anonymous]

Tam, we also thickened Seth’s feeds with 1 tablespoon of rice per 1 ounce of formula and he would drink about 15-20 oz. a day at that age too. This was per the GI’s instructions (we were told not to give him over 5 oz. at a time). He thrived and grew with this regimen and to be honest, I never even thought about him missing nutrients. Most of the cereals are fortified.

[Anonymous]

Tiffany, that is SO good to know! I haven’t spoken to anyone who has used the same proportions before. It is also good to know that the GI gave you this regimen. That eases my mind considerably. Thanks! Tanderson2007-6-18 13:8:34

[Anonymous]

Several moms on this site have gone as high as 1tbsp per ounce. I wouldn’t really worry about it, but if you’re concerned then I’d ask the ped if he thinks it’s okay.

[Anonymous]

Awesome! Thanks for the vote of confidence ya’ll!

Another question:

The ped suggested several months ago that when we started solids we would cut back more on the formula because of his reflux. He gave me a feeding chart for regular babies on 28-40oz of formula…no help to me in this situation. Since his formula amount is already so low I kind of don’t know what to do. Does anyone have any ideas of about how much solid food I should introduce per day and how much formula I should then cut back? I figure he’ll self regulate, but I don’t want to overfeed.

[Anonymous]

If I remember correctly, we started with 1 small jar at the lunch feeding and then added at other mealtimes from there. Once we were offering at all mealtimes, we increased the amount. We actually offered the solids after the bottle since Seth was taking smaller amounts of formula, I wanted to be sure he got it in first. I don’t think there is any right or wrong way though!!

[Anonymous]

Wanted to add that we never did cereal on the side since he was getting so much in the bottles.

[Anonymous]

if you are worried about nutrients etc, the last thing i would do is start solids right now. solids have no nutritional value in the first year of life, babies need bm or formula for their nutritional requirements. reflux babies tend to be more sensitive, and they often experience gi distress if started on solids too early. i held off unitl 9 months, and i know many people that went even longer. this is just my opinion though. i have found our ped to be mistaken in regards to everything related to reflux thus far.

[Anonymous]

The prevacid does not prevent Cooper from spitting up, just makes it so it doesn’t hurt him any when he does spit, so now he is what they would call a “happy spitter”. The prevacid only help with the acid production doesn’t prevent the spitting, Cooper’s spitting is less lately, but I attribute that to the fact that he is on his tummy more now that he rolls over and that he likes to sit up more and gravity can hold things down so to speak.

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