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Q&A with Australian Health Practitioners
Why is my newborns reflux causing excessive vomiting?
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My newborn (11 weeks) has been diagnosed with reflux (at 4 weeks, we have been taking Losec daily and it seems to have helped settle him.
He has always produced large vomits during, between, before and after feeds.
But recently he has become very unsettled, and vomits in his sleep, waking him up. He is only achieving 20 minute naps and the occasional 2 hour sleep.
I always keep him upright after a feed (for at least 15-20 minutes) and burp when necessary. Is it possible that there is more to his vomiting than typical reflux?
The volume of milk coming up is quite large. He can produce volumes that would cover an A5 piece of paper in one vomit, and sometimes he will do this 3-4 times after/between feeds.
It can occur immediately after a feed, 1 hour, 2 hours or 3 hours after a feed.
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Joy Anderson
Dietitian, Nutritionist
Joy is an Accredited Practising Dietitian and Accredited Nutritionist, as well as an International Board Certified Lactation Consultant (IBCLC). She has a special interest in … View Profile
It is hard to give a complete answer to this question without knowing more details, such as how baby is fed (breastfed or formula-fed), weight gains, other symptoms (such as rashes), what bowel motions are like, etc. If baby is otherwise reasonably content and thriving, the vomiting may be excess milk and it is a breastfeeding management issue. A call to the Australian Breastfeeding Association Helpline on 1800 686 268 could help clarify that.
True reflux in babies can be a symptom of food allergy or food intolerance. The most common food causing this is cows'-milk protein. Dietary investigation can be useful to resolve the reflux and avoid mediations or weaning (in the case of a breastfed baby). The simplest step to check this is to try a dairy-free diet. If the mother is breastfeeding that means she goes dairy-free, strictly, including label-reading for ingredients in foods that are from dairy, not just avoiding milk, yoghurt and cheese. If effective, improvement may be seen within days or it might take up to about 3 weeks.
While dairy-free, the mother may need to take a calcium supplement once a day to make sure she is getting enough calcium. If she decides to remain dairy-free, it is still worth testing out the baby's tolerance every few months, as babies usually grow out of this problem.
If the baby is formula-fed, that means switching to an extensively-hydrolysed or elemental formula. Soy formula is generally not recommended for babies younger than 6 months, partly due to concerns over phyto-oestrogens in soy products and partly as individuals who react to cows'-milk protein often develop sensitivity to soy protein as well.
If a breastfeeding mother finds that avoiding only dairy is not effective, she might like to consult an Accredited Practising Dietitian with an interest in babies as well as food allergy/intolerance for help to further investigate her diet as a cause of the symptoms.Report this post
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Hi
Thankyou for taking the time to answer my post. My baby is breastfed. He has anywhere between 1 and 4 bowel movements a day, and they are quite runny. There are no ‘bits’ in them. I also witnessed a poo when his nappy was off and it was frothy and airy. …..quite explosive too. He has minimal rashes, but I have noticed patches of dry red skin around his ears and some on his back and chest. My daughter (now 3) is dairy and soy intolerant. Do you think this could be the same? Would that cause the excess vomitting?
Thank you.Report this post
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Joy Anderson
Dietitian, Nutritionist
Joy is an Accredited Practising Dietitian and Accredited Nutritionist, as well as an International Board Certified Lactation Consultant (IBCLC). She has a special interest in … View Profile
Thanks for the extra information. The fact that your older child is sensitive to dairy and soy lends support to the notion that that this baby may have also inherited this tendency, in addition to the characteristics of the bowel motions and skin. And, yes, this can show up as reflux in a baby.
The only way to find out is to try an elimination diet, probably avoiding both dairy and soy, for 2-3 weeks. If this is effective, then you need to challenge each of these foods separately to see if the symptoms return.
It may still be a good idea to see a dietitian to help you carry out the process and make sure your diet is adequate for you and your baby, both while you do the elimination diet and afterwards.Report this post
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