Solid food and digestive issues

My boys are a week away from being 4 months old (13 weeks, adjusted). The pedi says we should for SURE start the bigger one on solids at that point (as of last week when we were in for RSV shots), but we haven't talked about it for the other one yet.

The bigger guy has reflux pretty bad. He's on Prevacid, 7.5 mg per day, not sure it's really doing the trick for him. The pedi really thinks that solids will help him. He's been taking Enfamil A.R since he was 6 weeks old, so he's already been getting rice that way. He eats a lot, he's approaching triple his birth weight, lost his tongue-thrust reflex, has good head control, etc, so she says he's ready.

He's also got bad gas pains and trouble pooping. I know the rice is constipating, so we'll likely be moving on from rice to oatmeal pretty quickly. Will the solids help with this, or just make it worse? If it will HELP, we're contemplating starting introducing him to the spoon this weekend instead of waiting the extra week - we're desperate around here for the screaming to stop, so the sooner the better (if it will help). That's the only thing keeping him from STTN too, the gas pains. (Mylicon didn't work, we've tried.)

The little guy .. he's really little, still. We're on 24 cal formula, and it's really hurting him. Breaks my heart, and kills my ears. He just has so much trouble digesting it, and the pedi is very against changing it. (We'll be having that discussion again next week.) Now, I know cereal isn't as caloric and so he'll likely take a hit on the weight-gain front ... but will it help his digestion at all? I know how to help adult digestion, but I don't know much about an immature system. I've just got to do SOMETHING to help him, and if a little bit of cereal might soften the blow of the dense formula ...

Thoughts? I want to do something to help them, they're both so miserable.

 

QUOTE
but will it help his digestion at all?


I would think not...

QUOTE
If solids are started before a baby's system is ready to handle them, they are poorly digested and may cause unpleasant reactions (digestive upset, gas, constipation, etc.). Protein digestion is incomplete in infancy. Gastric acid and pepsin are secreted at birth and increase toward adult values over the following 3 to 4 months. The pancreatic enzyme amylase does not reach adequate levels for digestion of starches until around 6 months, and carbohydrate enzymes such as maltase, isomaltase, and sucrase do not reach adult levels until around 7 months. Young infants also have low levels of lipase and bile salts, so fat digestion does not reach adult levels until 6-9 months.


source

 

There have been several threads here on solids and reflux and/or solids and digestion. I don't remember anyone saying that solids helped. In fact, I've seen a lot of people report digestive problems starting when they started solids. Solids are harder to break down (as the PP said) than formula, so I can't see why your Ped would say they'd help.

I had a couple of other thoughts for you:

If Prevacid isn't working, your son could be switched to a different reflux medicine. Prilosec is the only one that worked for my daughter.

Is it possible that your sons have milk protein intolerance? The symptoms sound right... gassiness, fussiness, constipation, problems with digestion. You should discuss with your Ped, but a trial of Nutramigen or Alimentum formula might be helpful. For my daughter, all the reflux medicines and gas drops in the world did nothing until we started her on Nutramigen. Then within 24 hours her screaming and pain was gone.

Also, you can mix up 24 calorie Nutramigen (or other formulas) by using 5 scoops instead of 4. Again, check with your Ped, but I was told there was no reason to stay with the actual 24 calorie formula if we thought the milk proteins were causing problems. We switched and life got immediately better. I hope something similar will work for you.

Good luck!

 

I don't know why on Earth pedi's say starting solids help reflux. About 99% of moms I've asked reported that it made it worse, or stayed the same. My DS is in the "worse" category. It is more difficult to digest. In fact, since starting solids, DS refuses the bottle even more because the solids are sitting in his stomach longer so it's been really difficult. He is getting full quickly/digesting slower and is puking even more because of it. His reflux is so bad, he gags a lot on most solids, especially the thicker ones. He is already 10 months and is still suffering The reflux has really taken a toll on his oral/motor development and now has a texture aversion, which I heard is typical for refluxers. DS is just slow to overcome it.

 

Starting solids greatly helped us. Mine both have terrible reflux and they do so well with solids. They rarely puke the solids and never cry while I feed them solids, but formula is still an awful thing around here.

We are on Prevacid 7.5 2x daily as well as 4 ml of Mylanta before every formula feeding.

We did start solids early as our PED felt early introduction of solids would help. It did!

We started cereal in the formula at 2 weeks so feeding it off a spoon was not a major change. Once they got that, we moved to oatmeal and it solved so much for us. They pooped 5x daily instead of 1x every other day, they stopped crying all the time and most importantly they became happy.

I do not think this is what everyone should do, but for us.........it worked!

And remember all the professional guidelines are a suggested age and each child is an individual. Our PED fully agrees with the AAP with full term, healthy infants.

 

Whoa, whoa, whoa!! 13 weeks adjusted?? That sounds awfully early to start solids...even if you want to start moving away from adjusted age, it doesn't makes sense to me to push new things on babies who are already having a terrible time (hurting!).

Maybe I'm overreacting, but that just jumped out at me. Are the babies showing any signs of being ready for solids? Able to hold their heads up on their own reliably? Tongue-thrust reflex gone? Able to turn their heads or otherwise indicate they don't' want more?

 

Glad to hear it did help SOMEONE.

Our bigger guy IS showing all signs of being ready for solids - holding his head up, sitting really well, no tongue thrust reflex, consistently tells us when he's had enough. He is, according to everyone (PT, nutrionist, pediatrician) "not a preemie" so there's no need to adjust his age - as it is, he's ahead on milestones for an un-adjusted age. The pedi thought he might have been ready at 3 months, but suggested holding off the extra month.

We've tried him on the hypoallergenic formula, with no change, except that he would spit 3/4 of it back up at us. The pedi (and nutrionist) have been saying it would help because if it's not the milk it's likely the rice in his formula causing his problems now, so getting oatmeal in him instead (in addition? They haven't been clear as to if we'll change his formula again) will help. I mean, he's getting rice one way or another, and he seems ready to try with a spoon.

The little guy .. he doesn't have quite the head control, but he's getting there (another couple of weeks and he'll BE there, I think). No tongue thrust, very clear when he's had enough to eat. His pedi (and nutrionist) are giving us a really hard time about changing his formula to see if it's the milk proteins or not. We're hesistent to do it on our own because of how careful they were in the first place to thoroughly check out his formula intake vs. his weight vs. some blood work - he's gone a couple of not yet diagnosed potential problems (how's that for vague? but that is our life) - so without them we wouldn't know if we needed to supplement. So I'm just trying to come up with ANYTHING that might help him - the nutritionist goes back and forth on if it might help to add cereal, and the pedi won't yet weigh in on the issue. With him, we're not looking to go full-fledged solids yet (he needs the formula intake too much), just wondering if a couple spoonfuls of cereal a day (even if he drinks it from a bottle) might help him out.

I guess we'll see what the pedi says next week. Something's gotta change for him.

 

Hmmm. :umm:

I wonder why the ped is so reluctant to try different formulas if they are having such a hard time on the milk-based? Can the Nutramigen/Alimentum also be mixed to 24 calories? If it can, I would almost go ahead and do that. I would also add rice cereal to their bottles if they are spitting up a ton. I did a little over 2 tsp per oz, and it was thick!

If constipation is a problem on the Nutramigen/rice cereal, I would add oatmeal to just one bottle a day to start out with. I tried it, and it made my babies REALLLLLY gassy, so I just added a little bit, and not everyday. Nutramigen tends to make their stools looser, since it is so broken down, so you might not need to do that.

As far as the solids go, I would give the formula change a try for now, and see how they do. By that time they will be a little bit older, and more ready for solids. All of my kids started on solids at 4 months. I can't really say that adding the solids made the reflux any better, since they were all on bottles with rice cereal before solids were started. It did not make it any worse, just more colorful!

All of my babies had milk intolerances and reflux. The twins were by far the worst. So, of course I am no ped, but with my experience in this, that is what I would recommend! If something is not working for your babies, you are the momma, and sometimes, despite what the ped says, you know best!

:hug99:

 

QUOTE
just wondering if a couple spoonfuls of cereal a day (even if he drinks it from a bottle) might help him out.


Even if it's only a couple spoonfuls, it's still a couple spoonfuls of something his body is incapable of digesting. If he's having so much trouble, I'd be really hesitant to throw that into the mix.

That seems really weird that they're reluctant to have you try Nutramigen. Milk protein sensitivities are so common in babies - why on earth don't they want to at least try ruling that out??? :huh:

 

I am in the minority here as well. Solids did help my Maia with her reflux.
She was projectile puking, puking out her nose, super fussy and my pedi has me start rice about a week before their 4mo bday and it greatly helped! I only did rice for about a week before switching to oatmeal because she was constipated. She also take 15mg of prevacid daily. We do solids in the morning and evening, only very small amounts (a couple teaspoons between the two of them) but it definitely has helped.

 

QUOTE(cat419 @ Apr 2 2008, 11:04 AM) [snapback]700803[/snapback]
My boys are a week away from being 4 months old (13 weeks, adjusted). The pedi says we should for SURE start the bigger one on solids at that point (as of last week when we were in for RSV shots), but we haven't talked about it for the other one yet.

The bigger guy has reflux pretty bad. He's on Prevacid, 7.5 mg per day, not sure it's really doing the trick for him. The pedi really thinks that solids will help him. He's been taking Enfamil A.R since he was 6 weeks old, so he's already been getting rice that way. He eats a lot, he's approaching triple his birth weight, lost his tongue-thrust reflex, has good head control, etc, so she says he's ready.

He's also got bad gas pains and trouble pooping. I know the rice is constipating, so we'll likely be moving on from rice to oatmeal pretty quickly. Will the solids help with this, or just make it worse? If it will HELP, we're contemplating starting introducing him to the spoon this weekend instead of waiting the extra week - we're desperate around here for the screaming to stop, so the sooner the better (if it will help). That's the only thing keeping him from STTN too, the gas pains. (Mylicon didn't work, we've tried.)

The little guy .. he's really little, still. We're on 24 cal formula, and it's really hurting him. Breaks my heart, and kills my ears. He just has so much trouble digesting it, and the pedi is very against changing it. (We'll be having that discussion again next week.) Now, I know cereal isn't as caloric and so he'll likely take a hit on the weight-gain front ... but will it help his digestion at all? I know how to help adult digestion, but I don't know much about an immature system. I've just got to do SOMETHING to help him, and if a little bit of cereal might soften the blow of the dense formula ...

Thoughts? I want to do something to help them, they're both so miserable.

 

Our boys will be 4 months next week as well & both are on zantac (.6cc)for GERD problems. The older boy has gassy problems BAD because of the GERD & the younger one has BAD projectile vomiting cause of the GERD. We tried every single kind of formula they make - including the Enfamil AR for spitting up & the ONLY kind that works, is the Enfamil Nutramigen. It's super expensive ($800/month for both kids) but it's the only thing that helps them & they STILL had their same problems to point that our older boy had colic for a month due to GERD.

Our pedi sent us to a pediatric gastroentologist/specialist when the boys were 2 &1/2 months, who said to stay on the nutramigen formula (got our insurance to cover most of the cost for us) & then she suggested adding a little stage 1 rice cereal to their bottles to see if that will help. She explained that the Enfamil AR will probably not work as well because it's not as "broken down" as nutramigen is & when they have GERD or any acid problems, their bellies need easy to digest formulas & nutramigen is usually a sure bet. I asked her about solids & she said not to push it until our pedi said to go for it (about 4 months) & they may still have problems with the spitting up & GERD issues, but GERD problems usually peak @ 4 months & even with a more gentle formula (nutramigen) they will still have issues until they just outgrow it (about a year - give or take).

We tried the rice cereal with the nutramigen - our older boy gained weigh REAL quick & it didn't help the younger one who was spitting most of his meals up so we quit mixing it & are just waiting for the "OK" to try cereals when they go for their 2nd set of shots next week. Our specialist did say that rice cereal will probably help them a little better than oatmeal just because it is easier for their bellies. But specialist said all babies are different, so it may or may not help them when they start solids - only one way to find out...

Good Luck!!

~ Mom of Zackary 9lbs 11oz & Ethan 8lbs
Born 10 days early on Dec 6th 07'
Biggest twins ever born at our hospital!