Re: Reflux and rice cereal

[Guest guest]

Be sure to check for a tongue tie since they often accompany reflux.MargaretSent from my iPhone

Hi all,

I have a client whose 3-mo old baby was hospitalized last week due to failure to thrive and severe reflux. For the past week her baby has been on expressed breastmilk and/or formula, in a bottle, with rice cereal used as a thickener to help her keep her food down. Mom is petrified to breastfeed because she thinks the rice cereal is the only thing that is helping her baby digest her food.

I am meeting with mom and baby for the first time today.

Has anyone had experience with a similar situation? Does this baby truly need to be on rice cereal at such a young age? My 'food intolerance' red flag went off, which is something I want to explore with mom today. Any thoughts?

Thank you!!!

Robin Kaplan, M.Ed., IBCLC, RLC

San Diego Breastfeeding Center, LLC

www.sdbfc.com

[Guest guest]

I thought rice cereal in a bottle was not recommended anymore. Sent from my, selling Jon's plasma to pay for my iPhone, iPhone.

Hi all,

I have a client whose 3-mo old baby was hospitalized last week due to failure to thrive and severe reflux. For the past week her baby has been on expressed breastmilk and/or formula, in a bottle, with rice cereal used as a thickener to help her keep her food down. Mom is petrified to breastfeed because she thinks the rice cereal is the only thing that is helping her baby digest her food.

I am meeting with mom and baby for the first time today.

Has anyone had experience with a similar situation? Does this baby truly need to be on rice cereal at such a young age? My 'food intolerance' red flag went off, which is something I want to explore with mom today. Any thoughts?

Thank you!!!

Robin Kaplan, M.Ed., IBCLC, RLC

San Diego Breastfeeding Center, LLC

www.sdbfc.com

[Guest guest]

I thought the same thing.  I remember seeing something either an article or research that said baby's can aspirate too easily on the thickened solution. But can't put my fingers on it.Not a good practice.Shari

I would look for tongue tie as Margaret suggested.  Anytime you find reflux, sleep apnea, chronic sinus congestion look under the tongue.Shari

 

I thought rice cereal in a bottle was not recommended anymore.  Sent from my, selling Jon's plasma to pay for my iPhone,  iPhone.  

 

Hi all,

I have a client whose 3-mo old baby was hospitalized last week due to failure to thrive and severe reflux. For the past week her baby has been on expressed breastmilk and/or formula, in a bottle, with rice cereal used as a thickener to help her keep her food down. Mom is petrified to breastfeed because she thinks the rice cereal is the only thing that is helping her baby digest her food.

I am meeting with mom and baby for the first time today.

Has anyone had experience with a similar situation? Does this baby truly need to be on rice cereal at such a young age? My 'food intolerance' red flag went off, which is something I want to explore with mom today. Any thoughts?

Thank you!!!

Robin Kaplan, M.Ed., IBCLC, RLC

San Diego Breastfeeding Center, LLC

www.sdbfc.com

-- ~~~~~~~~~~ Shari Silady ~~~~~~~~~~~~~ " Mothers have as powerful an influence over the welfare of future generations as all other earthly causes combined. "

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

[Guest guest]

Also, did anyone look into the mother’s milk ejection reflex ? Sometimes, when mom’s MER is powerful babies suffer from reflux. Tweaking the position and keeping the infant vertical after a feed, for at least 30 minutes, tends to help. The Biological Nurturing position may be a good position to explore with this dyad (www.biologicalnurturing.com). I encourage you to read Dr. Vartabedian’s excellent pocket book on reflux. It is titled “Colic Solved” but has nothing to do with colics... J Ghislaine Reid, BA (Translation 1981), LLL (1990), IBCLC(2002)Montreal, Quebec, Canada De : [mailto: ] De la part de RobinEnvoyé : 8 avril 2011 12:52À : Objet : reflux and rice cereal Hi all,I have a client whose 3-mo old baby was hospitalized last week due to failure to thrive and severe reflux. For the past week her baby has been on expressed breastmilk and/or formula, in a bottle, with rice cereal used as a thickener to help her keep her food down. Mom is petrified to breastfeed because she thinks the rice cereal is the only thing that is helping her baby digest her food.I am meeting with mom and baby for the first time today. Has anyone had experience with a similar situation? Does this baby truly need to be on rice cereal at such a young age? My 'food intolerance' red flag went off, which is something I want to explore with mom today. Any thoughts? Thank you!!!Robin Kaplan, M.Ed., IBCLC, RLCSan Diego Breastfeeding Center, LLCwww.sdbfc.com

[Guest guest]

Hi all

This can be a really big deal.....can't imagine that baby is being given rice cereal via bottle - thickening feeds just isn't appropriate as a measure to stop reflux - adults have reflux and we eat solids! This baby needs lots of care on many levels if already at FTT level. Baby likely refusing food due to pain or on that path. Bottle can be put into mouth to ensure some calories are taken but this will, of course, causes further feeding trauma. If baby will go to breast then careful positioning (prone or quite upright) along with at breast supplementer might be a good start along with meds and other comfort measures (upright sling very close to mom's body is a good place to start........). Mom can be pumping her own milk and supplementing with that or using other fortifier to ensure that the small meals that baby might be ok with are calorie dense if normal - small frequent - feeds aren't going to cut it (mom might have to be open to lots of 'snacking' at breast but that is an education thing that you can do with her). If Dr.s, mom and OT are all in agreement about amt of calories/wt gain needed and flexible about vehicle of delivery (breast vs: bottle) then this can work. Hopefully baby will accept at breast supplementer. Mom can easily wean from this as things progress. Maybe a scale at home might empower mom?? Have seen some crazy situations develop from what could have been a fairly easy fix but got waaaay out of control - i.e. OMER/OS as mentioned by Ghislaine, toooo many invasive treatments and procedures that weren't done respectfully, untreated reflux..... all these have ended up in feeding refusal. In one extreme case I know of a 12 yr old who in spite of being an otherwise normal, actually very high achieving, kid gets all nutrients via PEG tube.

beth LLLC leader & IBCLC

ottawa

RE: reflux and rice cereal

Also, did anyone look into the mother’s milk ejection reflex ? Sometimes, when mom’s MER is powerful babies suffer from reflux. Tweaking the position and keeping the infant vertical after a feed, for at least 30 minutes, tends to help.

The Biological Nurturing position may be a good position to explore with this dyad (www.biologicalnurturing.com).

I encourage you to read Dr. Vartabedian’s excellent pocket book on reflux. It is titled “Colic Solved” but has nothing to do with colics... J

Ghislaine Reid, BA (Translation 1981), LLL (1990), IBCLC(2002)

Montreal, Quebec, Canada

De : [mailto: ] De la part de RobinEnvoyé : 8 avril 2011 12:52À : Objet : reflux and rice cereal

Hi all,I have a client whose 3-mo old baby was hospitalized last week due to failure to thrive and severe reflux. For the past week her baby has been on expressed breastmilk and/or formula, in a bottle, with rice cereal used as a thickener to help her keep her food down. Mom is petrified to breastfeed because she thinks the rice cereal is the only thing that is helping her baby digest her food.I am meeting with mom and baby for the first time today. Has anyone had experience with a similar situation? Does this baby truly need to be on rice cereal at such a young age? My 'food intolerance' red flag went off, which is something I want to explore with mom today. Any thoughts? Thank you!!!Robin Kaplan, M.Ed., IBCLC, RLCSan Diego Breastfeeding Center, LLCwww.sdbfc.com

[Guest guest]

Unfortunately, the research has been out for a number of years to NOT use rice cereal for reflux but many doctors just can't seem to break the habit. They think this is THE first fix for the problem and if/when it doesn't work then they go onto finding other ways to remedy. In fact, sometimes it does work in the short term but a few days or so later the baby starts refluxing the cereal, then there is a real aspiration fear. So, yes, many or most of us have had experience with this quite often.

Check for things as suggested by others and find out how often mom has been feeding baby and positioning. If mom has been waiting too long between feedings then she will have a more powerful let-down, baby will drink too much because he is so hungry and then his tummy won't hold all of the milk. Maybe mom was trying to schedule and doesn't let him have smaller meals or eat as soon as he needs after spitting up because it is not time. Seems like a mean way to parent, but you never know until asking.

Cheryl n, IBCLC, RLC

Subject: reflux and rice cerealTo: Date: Friday, April 8, 2011, 12:51 PM

Hi all,I have a client whose 3-mo old baby was hospitalized last week due to failure to thrive and severe reflux. For the past week her baby has been on expressed breastmilk and/or formula, in a bottle, with rice cereal used as a thickener to help her keep her food down. Mom is petrified to breastfeed because she thinks the rice cereal is the only thing that is helping her baby digest her food.I am meeting with mom and baby for the first time today. Has anyone had experience with a similar situation? Does this baby truly need to be on rice cereal at such a young age? My 'food intolerance' red flag went off, which is something I want to explore with mom today. Any thoughts? Thank you!!!Robin Kaplan, M.Ed., IBCLC, RLCSan Diego Breastfeeding Center, LLCwww.sdbfc.com

[Guest guest]

I'm a bit late in this response, but my first thought was pyloric stenosis -

which would explain the failure to thrive. Has that been looked into? If so,

cereal would make no difference at all since not enough of anything would be

getting into the stomach.

Anne-Marie Rohrberg BS, IBCLC

Stow, MA

>

> Hi all,

>

> I have a client whose 3-mo old baby was hospitalized last week due to failure

to thrive and severe reflux. For the past week her baby has been on expressed

breastmilk and/or formula, in a bottle, with rice cereal used as a thickener to

help her keep her food down. Mom is petrified to breastfeed because she thinks

the rice cereal is the only thing that is helping her baby digest her food.

>

> I am meeting with mom and baby for the first time today.

>

> Has anyone had experience with a similar situation? Does this baby truly need

to be on rice cereal at such a young age? My 'food intolerance' red flag went

off, which is something I want to explore with mom today. Any thoughts?

>

> Thank you!!!

>

> Robin Kaplan, M.Ed., IBCLC, RLC

> San Diego Breastfeeding Center, LLC

> www.sdbfc.com

>

[Guest guest]

Robin,

What did you find with this babe? My first thoughts, of course, would include

some things mentioned by others--TT, food allergies and structural restrictions.

Tow, IBCLC, France

> >

> > Hi all,

> >

> > I have a client whose 3-mo old baby was hospitalized last week due to

failure to thrive and severe reflux. For the past week her baby has been on

expressed breastmilk and/or formula, in a bottle, with rice cereal used as a

thickener to help her keep her food down. Mom is petrified to breastfeed

because she thinks the rice cereal is the only thing that is helping her baby

digest her food.

> >

> > I am meeting with mom and baby for the first time today.

> >

> > Has anyone had experience with a similar situation? Does this baby truly

need to be on rice cereal at such a young age? My 'food intolerance' red flag

went off, which is something I want to explore with mom today. Any thoughts?

> >

> > Thank you!!!

> >

> > Robin Kaplan, M.Ed., IBCLC, RLC

> > San Diego Breastfeeding Center, LLC

> > www.sdbfc.com

> >

>

[Guest guest]

just heard an OT talk (from the hospital) where wolf and glass work--interesting presentation on using simply think with breastfeeding. a little mixed with milk spoon fed to baby in the middle of the feed. I think if it were my baby I'd rather use this method first before I tried a med. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/Facebook:

www.facebook.com/thesecond9months--- Subject: Reflux and rice cerealTo: Date: Thursday, April 28, 2011, 9:52 AM

Wolf & Glass use "Simply Thick" to thicken liquids...Thickening feeds is old information with diagnosis of reflux... other reflux meds indicated as first line of treatment, then further testing if needed...lee Hulburt, IBCLC, RLC Lactation Consultants of San Diego www.BreastfeedingSanDiego.com

[Guest guest]

And at yesterday's Beyond the Hospital Stay conference, it was mentioned that

this product is now available OTC at Costco pharmacies.

Fay Bosman, IBCLC

>

> Wolf & Glass use " Simply Thick " to thicken liquids...Thickening feeds is old

information with diagnosis of reflux... other reflux meds indicated as first

line of treatment, then further testing if needed...

>

> lee Hulburt, IBCLC, RLC Lactation Consultants of San Diego

www.BreastfeedingSanDiego.com

>

[Guest guest]

Fay I was there! I didn't realize you were in seattle!!! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/Facebook: www.facebook.com/thesecond9months--- From: Fay

Subject: Re: Reflux and rice cerealTo: Date: Saturday, April 30, 2011, 9:34 AM

And at yesterday's Beyond the Hospital Stay conference, it was mentioned that this product is now available OTC at Costco pharmacies.

Fay Bosman, IBCLC

>

> Wolf & Glass use "Simply Thick" to thicken liquids...Thickening feeds is old information with diagnosis of reflux... other reflux meds indicated as first line of treatment, then further testing if needed...

>

> lee Hulburt, IBCLC, RLC Lactation Consultants of San Diego www.BreastfeedingSanDiego.com

>

[Guest guest]

Oh I am sorry to have missed you! I came up with my boss and 4 colleagues, all

from WIC, from Vancouver, WA, where I am located.

It was a great day!

Fay

>

> Fay I was there!  I didn't realize you were in seattle!!!

>

> Beebe, M.Ed., IBCLC

[Guest guest]

I was pretending to be a hygeia rep so was an exhibitor. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/Facebook: www.facebook.com/thesecond9months--- Subject:

Re: Reflux and rice cerealTo: Date: Saturday, April 30, 2011, 10:34 AM

Oh I am sorry to have missed you! I came up with my boss and 4 colleagues, all from WIC, from Vancouver, WA, where I am located.

It was a great day!

Fay

>

> Fay I was there! Â I didn't realize you were in seattle!!!

>

> Beebe, M.Ed., IBCLC

[Guest guest]

I'm still confused. So are they recommending moms thicken Breastmilk when baby has reflux. If so do They say that moms need to offer a spoon fullOf cereal half way during a feeding. Or am I Reading this wrong? what do you do for babies with Reflux? I'm sure there is not just one thing That you recommend for reflux. Sorry I'm having a hard time trying to wrap My brain around this. WarmlyElaine Taking Ibclc exam 2011Sent from my, very fine line between "hobby" and "mental illness", iPhone.

I do not know why anyone would use this product when all they need to do, if they want to thicken milk is to add the xanthan gum alone. Why us a product that contains a preservative associated with mitochondrial damage, and has been shown to be carcinogenic when combined with vitamin C. Furthermore, as citric acid is derived from corn, and corn is such a common allergen, why expose infants at such an early age?

Tow, IBCLC, France

>

> Wolf & Glass use "Simply Thick" to thicken liquids...Thickening feeds is old information with diagnosis of reflux... other reflux meds indicated as first line of treatment, then further testing if needed...

>

> lee Hulburt, IBCLC, RLC Lactation Consultants of San Diego www.BreastfeedingSanDiego.com

>

[Guest guest]

the OT's at the conference were talking about simply thick or xanthum gum, mixed with a little milk spoon fed to baby in middle of feeding (this is for a breastfed baby) a bottle fed baby can have it in the bottle... they said this does help some babies... Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/Facebook: www.facebook.com/thesecond9months--- On Sat,

4/30/11, Elaine Rose wrote:Subject: Re: Re: Reflux and rice cerealTo: " " < >Date: Saturday, April 30, 2011, 7:55 PM

I'm still confused. So are they recommending moms thicken Breastmilk when baby has reflux. If so do They say that moms need to offer a spoon fullOf cereal half way during a feeding. Or am I Reading this wrong? what do you do for babies with Reflux? I'm sure there is not just one thing That you recommend for reflux. Sorry I'm having a hard time trying to wrap My brain around this. WarmlyElaine Taking Ibclc exam 2011Sent from my, very fine line between "hobby" and "mental illness", iPhone.

I do not know why anyone would use this product when all they need to do, if they want to thicken milk is to add the xanthan gum alone. Why us a product that contains a preservative associated with mitochondrial damage, and has been shown to be carcinogenic when combined with vitamin C. Furthermore, as citric acid is derived from corn, and corn is such a common allergen, why expose infants at such an early age?

Tow, IBCLC, France

>

> Wolf & Glass use "Simply Thick" to thicken liquids...Thickening feeds is old information with diagnosis of reflux... other reflux meds indicated as first line of treatment, then further testing if needed...

>

> lee Hulburt, IBCLC, RLC Lactation Consultants of San Diego www.BreastfeedingSanDiego.com

>

[Guest guest]

The last research I read says it is not recommended.  It is actually dangerous for baby.  If milk was suppose to be thick our bodies would make it thicker.  Can't put my finger on the research but am looking.Shari

 

the OT's at the conference were talking about simply thick or xanthum gum, mixed with a little milk spoon fed to baby in middle of feeding (this is for a breastfed baby)  a bottle fed baby can have it in the bottle...  they said this does help some babies...

Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.com

Breastfeeding Between the Lines:  http://second9months.wordpress.com/Facebook:  www.facebook.com/thesecond9months

 

I do not know why anyone would use this product when all they need to do, if they want to thicken milk is to add the xanthan gum alone. Why us a product that contains a preservative associated with mitochondrial damage, and has been shown to be carcinogenic when combined with vitamin C. Furthermore, as citric acid is derived from corn, and corn is such a common allergen, why expose infants at such an early age?

Tow, IBCLC, France

>

> Wolf & Glass use " Simply Thick " to thicken liquids...Thickening feeds is old information with diagnosis of reflux... other reflux meds indicated as first line of treatment, then further testing if needed...

>

> lee Hulburt, IBCLC, RLC Lactation Consultants of San Diego www.BreastfeedingSanDiego.com

>

-- ~~~~~~~~~~ Shari Silady ~~~~~~~~~~~~~ " Mothers have as powerful an influence over the welfare of future generations as all other earthly causes combined. "

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

[Guest guest]

Did the speaker's have citations for this claim?

>

> the OT's at the conference were talking about simply thick or xanthum gum,

mixed with a little milk spoon fed to baby in middle of feeding (this is for a

breastfed baby)  a bottle fed baby can have it in the bottle...  they said

this does help some babies...

>

> Beebe, M.Ed., IBCLC

> Lactation Consultant/Postpartum Doula

>

> www.second9months.comBreastfeeding Between the Lines:

 http://second9months.wordpress.com/Facebook:

 www.facebook.com/thesecond9months

[Guest guest]

I haven't looked over their hand out. They were talking about the spectrum of services/positioning devices and all kinds of strategies including the pollywog pillow and sleeping wedges. The thickener was one small part of the talk and they discussed all the different ways that this is done. they were saying that they have had good results with various approaches but it was very individual as we all know! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/Facebook: www.facebook.com/thesecond9months--- Subject: Re: Reflux and rice cerealTo: Date: Saturday, April 30, 2011, 8:39 PM

Did the speaker's have citations for this claim?

>

> the OT's at the conference were talking about simply thick or xanthum gum, mixed with a little milk spoon fed to baby in middle of feeding (this is for a breastfed baby) Â a bottle fed baby can have it in the bottle... Â they said this does help some babies...

>

> Beebe, M.Ed., IBCLC

> Lactation Consultant/Postpartum Doula

>

> www.second9months.comBreastfeeding Between the Lines: Â http://second9months.wordpress.com/Facebook: Â www.facebook.com/thesecond9months

[Guest guest]

They had video of VSS, showing less aspiration  with the thickened feeds.  It was of a bottle fed baby.  They said with spoon feeding thickener half way through, the thickened milk mixes with the thin milk in the stomach and results in less reflux.  I am still skeptical.  I was trying to recall the same research Shari is talking about.  I thought it was something about how aspirating breastmilk was less dangerous than aspirating the thickened milk.

They also said rice cereal doesn't work to thicken breastmilk.

They mentioned Bob's Red Mill xanthan gum, but they don't use it because it can mold within 48 hours after being mixed with liquid.  I don't know why that would be a problem if you mix it and use it immediately...

Healy

Seattle, WA

[Guest guest]

I once had an experienced breastfeeding mom come to see me with her second baby

and all was going well except for the reflux. It took awhile for her to be

convinced by her friend that she even needed help or that an LC could do

anything for her. The baby had a posterior TT and tight maxillary frenum and

food allergies. Once the TT was revised, the baby had bodywork and we got her

off the allergens, all was well. Until then, the baby was on meds and mom was

doing her best to manage through positioning.

No, there really isn't one solution for reflux, but what I do know is that it

isn't a zantac deficiency. While tracking down and eliminating allergens,

healing the gut (mom and baby), finding the right structural work or addressing

oral function may not be as easy as medicating the baby, they do solve the

underlying cause, which is what healing really is all about.

Tow, IBCLC, France

> > >

> > > Wolf & Glass use " Simply Thick " to thicken liquids...Thickening feeds is

old information with diagnosis of reflux... other reflux meds indicated as first

line of treatment, then further testing if needed...

> > >

> > > lee Hulburt, IBCLC, RLC Lactation Consultants of San Diego

www.BreastfeedingSanDiego.com

> > >

> >

> >

>