Reflux: Introducing solids to a baby with reflux

Gastro-oesophageal reflux is when the content of the stomach comes flowing back up the feeding pipe. This is mostly due to a weak sphincter muscle between feeding pipe and stomach. Reflux is very common in babies and between 50 - 70% of babies at the age of 3 months show symptoms.

Symptoms can range from regurgitation of various amounts of food over arching back at feeds and excessive crying to feeding aversion and failure to gain weight. The good news is that most babies grow out of it, a large number of babies as soon as the age of 6 months.

Feeding situations can be particularly stressful for parents and baby, as both have negative associations with the experience. Parents are advised to introduce solids early, and this can add extra stress to the situation. The idea behind an early introduction of solids is that the thicker texture might help to keep the food in the stomach. There is some evidence that feed thickeners can reduce the amount of reflux episodes per day and, therefore, the theory could be right, although there aren’t any studies around this topic. The most important advice around this topic is to make sure your baby shows all the signs of readiness for solids and that you feel comfortable enough to give it a go.

Here are 5 tips, which will help with the introduction of solids to your baby:

1. Have your little one sit upright and make sure head and neck can be held steadily. This makes it more difficult for the food to come back up.
2. Take your time: Introducing solids to a baby with reflux can take longer, as there might be some degree of food aversion. This is perfectly fine and your little one will learn the pleasure of eating eventually. Some babies with reflux remain fussy around food for longer, so give yourself time to try different methods.
3. Expose them to small amounts of food without any pressure. Let them play with the food and choose their own pace of eating. Stop the meal when they signal you that they are done. Remember: Your baby’s main energy supply still comes from milk feeds, so it is ok if they don’t eat a large amount of solids from the beginning.
4. Make sure the food actually has a thicker texture than milk. A lot of pouches and jars are watered down, so will not necessarily make your little one’s symptoms better. Try thicker purees or finger foods.
5. Food choices: There is no evidence that some foods are better than others when introducing solids to a baby with reflux. It is best to start with small amounts of dark-green vegetables to get your little one used to the flavour and texture from early on. If your little one is very fussy around bitter tastes, try some sweeter tasting veg, such as carrots or peas, or even some fruit, such as banana. Don’t give up on the bitter tastes, though, and keep offering them. It can take up to 15 trials until a baby accepts a new flavour.

Make sure you find a way, which works for both you and your baby. The first months with a reflux baby are stressful enough and introducing solids should be a positive experience for both of you. If you feel that introducing solids has not helped with your little one’s symptoms, talk to your GP about it. It might be worth waiting a little longer until you try again or to discuss other treatment options.

Author

Dr Sophie Niedermaier MD