Adding cereal to bottle for reflux

Hi,
This question is for a friend of mine with a 3 mo old boy who has had a terrible time with reflux and food allergies. She's had to quit breast feeding (even after eliminating all dairy and soy!) and he's now on some sort of special formula and now they are recommending she add 1/2 teaspoon of rice cereal to it. The question is what kind of nipple do you all use who have had to do this - Level 1,2,3 or 4 or that "Y-shaped" one? She uses Dr. Brown's bottles.

I told her I'd ask all the wise women of my forum!

TIA!

 

If she is only adding a 1/2 teaspoon of cereal period, then she can probably get away with a level 2 or maybe a 3. But I would be she needs to add at least 1/2 teaspoon per ounce of formula or maybe more to really help with the reflux. If she adds more, she may need to to do the Y cut. We used Dr. Browns and I was adding 2 tsp. per ounce of formula to make it pretty thick.

 

oooppss. Sorry, she is adding 1/2 teas per oz of formula to start out with. She may need to increase it depending on how he does with this. She used a level 4 nipple this afternoon and thinks he drained the bottle too fast giving him a tummy ache..... maybe go down to a level 3 then? Does the Y-shaped nipple flow really fast - faster or slower than a level 4?

Thanks so much!!

 

Our boys have reflux too and I briefly tried thickening their formula with rice cereal, but couldn't get the consistency right. So then we switched to Enfamil AR formula which is made with rice starch. That formula (and the Target AR brand) was pretty thick and did a great job at reducing their spit up. They went from spitting up a few times a day to spitting up once every few days. However, it severely constipated them! So then I switched to Enfamil Premium and tried thickening it with oatmeal instead, 1 tsp per ounce. Ugg, what a pain. Dr. Brown's level 3 were too slow and the Y-cut ones were too fast. Plus we pre-mix our bottles and after a few hours in the fridge the oatmeal would settle on the bottom of the bottle like a very thick sediment. I couldn't deal with that. So I did yet more googling and read about commercial thickeners like SimplyThick and ThickenUp. SimplyThick is a gel-based thickener, and I think ThickenUp is a corn-based thickener. Anyway, both are VERY expensive. However, I found a simple recipe online to make your own version of SimplyThick. All it takes is xanthan gum and water! So for 3+ weeks now this is how we have thickened Enfamil Premium formula.

A batch of the thickener consists of:

3 tsp xanthan gum (can find at any health food store)
8 oz water
The recipe I found online said you could just shake the mixture to mix....but that did NOT work for us. However, we have a Cuisinart hand mixer that mixes it up no problem. I highly recommend a mixer of some sort.

Our formula batches have always consisted of 15 scoops of formula mixed with 30 oz of water, which makes about 32 oz of formula mixed. And to thicken a 32 oz batch like that we add 4.5 tablespoons of the thickener to it (again, we mix in the thickener with the hand mixer). We played around a lot with the amount of thickener to use. The online recipe called for 1 tablespoon per 4 oz...but that was TOO thick! 4.5 tbl seems to be just right for that amount of formula, and makes it egg nog consistency. We also moved up from Dr. Browns level 2 nipples (which our boys used with regular formula) to level 3 nipples because otherwise with the level 2 they had to suck too hard and got frustrated.

I hope this helps! And please PM if you/your friend have any questions about this thickener!

ETA: The formula thickened with the xanthan gum thickener works just as good at reducing spit up as the AR formula. They rarely ever spit up, which is great.

 

I used 2.5tsp of rice cereal per oz, and used a size 3 Dr. Brown's. I suggest she uses Beechnut cereal, as it dissolves a little better than Gerber, with less clogs.

 

I would go down a nipple size for sure and see if that doesnt clog. As for the Y, it's flow is dependent on the baby I believe. The harder they suck, the more they get.

 

We used the Y shaped ones but for Advent and Playtex. They worked much better than the holes. I'll second what Becky said about Beechnut vs Gerber though!

 

WE had a very difficult time with this---tried everyting. Finally, we started actually grinding the formula once we mixed it up. This really helped--you wouldn't think since the rice is so fine to begin with, but doc recommended it and definitely helped us witht he nipple thing--we sitll had to use a level 3--and we were probably adding about 1/2 tsp also per ounce. the y was just way too fast for us. She could try grinding it in food processor--just pour it in after you have mixed it up some, then a 3 may work.

 

i saw the p.a. today for abbey about reflux...i asked about giving abbey cereal and she said i could once a day..she mentioned putting in a bottle, but i never do that...i have always, with all the kids, when they start cereal to do it in the high chair with a spoon...i've never had success with giving a baby cereal in a bottle...in order for the hole to be big enough to allow the cereal to come out, the liquid comes out too fast...have you tried putting them in a high chair and feeding with a spoon?

 

i also use dr. brown's bottles and my twin boys have HORRIBLE reflux. they get 1tsp of rice cereal per ounce of formula. the Y cut nipples and by far too fast of a flow and you end up with a LOT of spit up and drool and go through burp rags like crazy. i have found that the level 4 nipple, while still fast, is better. we still go through a lof of burp rags and they spit up a lot (drool rather) but it works much faster and they don't get tired of sucking. we tried the level 3 nipples on them which worked great at keeping the drool to a minimum but after 3 ounces the boys would get tired of sucking and want to give up, not to mention the feedings were taking 30-45minutes per baby.

i would recommend, since she's only adding 1/2tsp, to try out the level 3 nipples first. maybe even the level 2 since i'm not sure if she's adding 1/2tsp per ounce or total to her formula.

also, for reflux, we have noticed that it helps a lot to burp very frequently, elevate the crib (if you can) to an angle or prop the baby in an upright position for thirty minutes after the feeding (which is not always possible in the middle of the night) and make sure that if they start to pull back, gag or choke to stop feeding them and burp them immediately very gently to avoid any projectile vomit.

if the reflux is bad enough she might need to put her baby on medication. our boys are on prevacid solutabs 7.5mg in the morning and zantac at night. the GI specialist said that the type of formula (soy, milk, hypoallergenic) doesn't really matter since the reflux is going to be an issue regardless. you just have to find the formula that works best for you. we like similac but we still get projectiles at least once a day from each baby.

good luck!

 

Thanks for all of the advice ladies. I passed on the info, and she'll just have to play around with it to see what works for him!