Infant Formulas for Babies with Reflux

If you are a parent of a reflux baby who is bottle fed, you will no doubt have had many well-intentioned suggestions from family and friends. Changing to a different formula is often one of these suggestions. But with so many formulas to choose from, how do you know you are changing to the right formula?

We only recommend you change your baby’s formula if advised by your doctor, public health nurse or another medical practitioner. There should also be a valid reason for the change, not just a “let’s try this formula” approach. In this article we will give you a broad outline of the different baby formulas available for babies with reflux, describing why they work.

The first question to ask is what is causing your baby’s reflux. We firmly believe that this must be the first step in treating baby reflux. So, for example, if your baby has a milk allergy and this is the main cause of their reflux, a change to an extensively hydrolysed formula or a dairy free formula will make a big difference. If your baby has a tongue tie, and this is the main cause of their reflux, a change in formula is not required.

A Comfort Formula

This is a formula primarily for babies with colic and constipation. It is often recommended for babies who are a little windy and who have mild positional reflux. The reason it works is because it is slightly thicker than the standard formula, the milk proteins are partially broken down, they contain a reduced level of milk sugar, and they contain a special fat blend to allow for softer stools. This aids digestion, reduced wind, and helps keep the milk in baby’s tummy.

You will notice your baby’s stools can be quite loose and green on a comfort formula; this is totally normal. And you should never add a thickener like Gaviscon to a comfort formula. You may also need to adjust the teat size if your baby finds the thicker formula more difficult to drink.

An Anti-Reflux Formula

These formulas are generally recommended for babies with reflux that is causing them distress. When a baby is continually bringing up their stomach contents, the acid in the regurgitated milk will burn the oesophagus (feeding tube) and cause pain for baby. Using an AR Formula will help keep the milk in baby’s stomach, thereby preventing the burn of the acid in the feeding tube.

An AR formula is useful while you are seeking treatment for the cause of your baby’s reflux. They are also helpful if reflux symptoms persist after the cause/causes are treated.

AR formulas are not suitable for babies with a diagnosed milk allergy.

Extensively Hydrolysed Formulas

Nutramigen and Aptimil Pepti are examples of extensively hydrolysed formulas in which the milk proteins have been extensively broken down to make them more digestible and less allergenic. They are suitable for babies diagnosed with a mild or moderate non-IgE milk allergy.

These formulas are not thickened, and you may need to add a thickener to them if your baby still has reflux symptoms. Some EHFs do not contain milk sugar and can taste quite bitter.

Dairy Free Formulas

These formulas are recommended for babies with an IgE milk allergy and babies who has trialed an extensively hydrolysed formula without any improvement. They are generally prescribed by your GP or a Paediatrician. If your baby requires a dairy free formula, you should also be referred to a paediatric dietitian to discuss future weaning and supervised reintroduction of dairy.

Again, a thickener may be required if your baby still has regurgitation that is caused them distress. You should speak to your GP or Paediatrician about this.

When you change your baby to a new formula, you should stay on it for at least 2 weeks to determine if it is helping your baby. Too many formula changes is discouraged as your baby’s digestive system is already under pressure due to reflux and too many formula changes can  adversely affect it.

If you are changing your baby’s formula we would recommend doing it slowly. We have 2 free downloads available on our website to help parents make the change. See the link below for more information.