Introducing solid foods to a baby with reflux can feel daunting, especially if you feel you’ve just started to get your baby’s flare-ups under control. The following suggestions can help minimise any difficulties related to introducing your baby to solid foods.
What is Infant Reflux?
Reflux, also known as posseting or spitting up, is an event which is all too familiar for new parents. You’ve just put on a brand new top - but your baby’s dinner has reappeared on your shoulder! Reflux, for which the medical term is gastro-oesophageal reflux disorder (GORD), happens when the milk that your baby has swallowed comes back up their oesophagus almost immediately.
Reflux happens when the muscles that separate your baby’s food pipe (oesophagus) and stomach don’t work properly, as they are still developing. The problem should go away once your baby reaches around 4-6 months, and their digestive system begins to mature. Reflux can be uncomfortable for babies, as milk and acid can come back up together, which causes an uncomfortable burning sensation.
Symptoms of Infant Reflux
- colic-like symptoms
- frequent crying – sometimes persistent, sometimes sudden
- vomiting or spitting up
- irritability
- arching of back/neck during or after feeds
- frequent hiccups
- frequent waking – seeming inability to sleep for long periods
- frequent ear infections
Which foods should I try first?
Although getting a list of foods that are well tolerated by babies with reflux would be great, the fact is that every baby is different and so are their reactions to various foods. The introduction of solid foods to babies without reflux normally consists of cereal–veggies–fruits, beginning at 6 months of age (see baby’s first foods for more detailed guidelines).
However, in an effort to "keep the milk down," some physicians consider using cereal to thicken the formula or expressed breastmilk of a baby with reflux before the age of 6 months. Whilst there is not a huge amount of evidence that this really helps, doctors often prefer parents to try it before prescribing any kind of medication.
Alternatively, many doctors will recommend that babies with reflux start solid foods earlier than is considered necessary for their “non-reflux” peers. Though rice cereal is widely recommended as a first meal, it doesn’t have to be the first meal you give your baby - while it can be tolerated well by one baby with reflux, it could cause a flare up in another.
Rice cereal may also lead to excess gas / wind and constipation which isn’t ideal! Instead, you could first try vegetables or fruits with the permission of your child's doctor (see our pureed baby food recipes for some ideas) or you could try oatmeal instead of rice cereal.
When introducing solid foods to a baby with reflux, many parents find that some fruits and juices – particularly oranges, apples, rhubarb and bananas – can cause more discomfort. Tomatoes and tomato juice are also commonly responsible for flare-ups. Pears are the least acidic fruit and may be the best fruit to try first.
Other foods which may worsen reflux symptoms…
- onion
- garlic
- broccoli
- cucumber
- brussel sprouts
- cabbage
- cauliflower
- corn
The following foods (which may not all be suitable for very young babies) are also notorious for triggering reflux flare ups:
- pineapple
- whole milk, flavoured milk or foods prepared with whole milk
- high fat foods, including fatty meat and chicken skin
- bacon
- sausages
- creamy soups
- creamed vegetables
- carbonated drinks
When introducing solid foods to a baby with reflux, it is very important that you obey the four day rule, so that you can easily recognise which foods cause a flare-up in your baby. Doctors generally recommend introducing foods with a reasonably thick consistency, since it is thought that they "stay down" better and provide more calories. But some parents of babies with extreme oral aversion (unwillingness to eat) find that they have more success with thinly pureed foods.
It seems that the key is to experiment a little, under your doctor’s supervision, to see what works best for your child and to ensure that the food you give is smooth. Gagging on lumps often worsens reflux.
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