The Magic Formula for Acid Reflux

The Magic Formula for Acid Reflux - Baby formulas that can actually help http://incredibleinfant.com There are two types of parents desperately searching the Internet right now, looking for a formula for acid reflux.

Parents whose baby has been diagnosed with either silent or acid reflux.

and…
Parents whose baby has NOT been diagnosed, but the constant spitting-up is kinda freaking them out.

If you’re one of those two, allow me to sprinkle you with happy sun-beams of encouragement.

Encouragements that I will whisk into the giant cauldron I keep in the basement for emergencies:

Double, double, toil and trouble;
Fire burn, and caldron bubble.
Fillet of a fenny snake,
In the caldron boil and bake;*

*Fifty “cool parent points” if you can name this source!

The magic formulas presented here are specifically centered on helping your baby keep his meal down.  If your baby spits up more than five times every day, these formulas may be your saving grace.

If you suspect a milk allergy or intolerance (fussy, gassy, cramping, etc.) is making your infant miserable, you need to use my formula allergy checklist first.

If you suspect colic, (your infant screams for hours for no reason) let me introduce your new hero.

First…What Defines Reflux?

There are four main kinds of reflux that affect infants.  Here’s what I call them (along with their proper fancy-pants medical term.)

Regular Reflux

Impress the Doctor Term:  Gastro Esophageal Reflux, (reflux or GER)

GER is very common in babies, basically it means the baby spits up once in a while.

It’s not that serious so start with allergy-sensitive formulas first.  Give it a a week to see if things improve.

The Crappy Reflux

Impress the Doctor Term:  Gastroesophageal Reflux Disease (GERD)

This type of acid reflux is not as common (1 in 300 babies) but is much more serious.

These babies will struggle to grow, hate to eat, seem to have constant colds, and may wheeze or show other breathing problems.

Talk your doctor if you suspect this.  Your little suffering infant will mostly likely need medication.

I would also discuss switching to one of the formulas below, as they have been shown to help with GERD.

The Sneaky Reflux

Impress the Doctor Term:  Silent GERD or GER

This type of reflux is by far the crappiest because it’s silent.  Your sad-faced little guy re-swallows the spit-up so you never see it.

This causes twice the damage, since the bile burns on the way up and on the way down.  Poor baby!

Silent reflux is hard to diagnose.  Look for him to be Mr. Cranky Pants, hate the sight of a bottle, and cry more after meals than at other times during the day.

Call your doctor for an analysis and see if using one of these formulas for reflux can help.

What Can Help a Baby with Reflux?

The reason babies struggle so much with reflux is because their tiny little esophagus isn’t 100% fully formed.  This means that the flap of skin (to use a technical term…) that keeps foods down in the stomach isn’t quite ready to play Bouncer and keep breakfast’s milk from trying to join the party going on in the mouth again.

There are two things that tend to help babies with acid reflux (other than medications, but that’s between you and your doctor).

infant reflux bean bag Sleeping on an incline.  Gravity can help keep supper down where it belongs.  (This baby bean bag may be helpful in this. Don’t use in the crib, though.  This is best for non-squirming newborns under mom’s watchful eye.)

Thicker formulas.  A thicker formula is heavier, which makes it easier to keep down.

The Non-Magic Formula for Acid Reflux:
Trying to Thicken It At Home

Here’s what most parents do to thicken infant formula:

  1. Throw a tablespoon of rice cereal into a warm bottle of formula.
  2. Shake vigorously.

What’s the magical result? 

Nada.

No spark…no twinkle…not even a glimmer.

Why isn’t it working?  I give you three reasons…

Younger Infants Can Struggle Digesting Rice Cereal

The younger your infant, the less “magical” the result of adding rice cereal by hand is going to be.

Newborns in particular can have a difficult time digesting the rice cereal.  The smaller particles of rice starch works better for them than rice cereal.

Shaking = A Bubble Frenzy in the Tummy

No matter how hard you try, mixing in cereal by hand is going to create bubbles.  (That or raw chunks.  Yum!)

Those bubbles travel down into your infant’s tummy.  So instead of having an infant screaming because of reflux, you have an infant screaming because of gas.  Huzzah!

The Nipple Nightmare: It’s Stuck and Won’t Come Out

Now that you’ve thickened the formula by hand, you have to make sure your baby can actually drink it…without using the hollow-cheeks method of sucking that leaves her really torked off and sore.

So to avoid that, you have to try an endless assortment of nipples to get the right flow. (Or try to improvise with a scissors, making a mess and a new choking hazard.)

You can do better, my friend.

Use one of these magic formulas below and eliminate all sorts of curses.  Each of these acid reflux formulas will work just fine with the standard nipples.

A Note About Poopies:  Some parents have complained that using an acid reflux formula like one of these can cause constipation.   If your baby’s poops are thicker than peanut butter (always a better indicator than frequency), use these anti-constipation suggestions to keep the pipes clean and movin’.

The Formula for Acid Reflux You’ve Been Waiting For

There are only three thickened formulas on the market (as of this writing).  Talk to your doctor on which one to start with.

Not only will Doc have some great insight, he may just have a freebie or two to throw your way.

These aren’t cheap! Grovel if you have to.

If he’s plumb-out of free samples, and hysterical weeping isn’t scoring any discount coupons, purchase the standard size first.

Then, if it works, you can save cash by going with I call The Big Kahuna bulk options.

Enfamil A. R.

formula for acid reflux ar Enfamil A.R. uses rice carbohydrates instead of cereal, so it flows easily through the nipple, yet settles solidly in your baby’s tummy.

It’s a fully-fortified formula for acid reflux, including DHA & ARA and immunity boosters.  You can purchase it in powder form or in premixed containers and nipple-ready bottles.

  • The standard size is 23.2 oz.
  • The big kahuna 4-pack is 88 oz. (Saves you $2.56 per 8-oz bottle)

Similac Sensitive for Spit Up

types of baby formula sensitive spitup Similac Sensitive for Spit Up uses the same “Early Shield” formulations as the normal Similac formulas.

Lutein, DHA, ARA, nucelotides for immunity, prebiotics, and an exclusive palm olein-oil blend for growing bones are all bubbled together with rice starch to create a formula for acid reflux your baby can keep down.

After mixing, let it sit for 10-15 minutes to thicken up evenly.  Yes, it will look a little grainy.  (That’s normal.)

Pregestimil

Pregestimil is a hypoallergenic and lactose-free formula that’s usually used for colicky symptoms, but may be a good back up plan as a formula for acid reflux.

baby colic formula pregestimil55% of it’s fat content comes from a special blend of fats (called MCT), designed to help babies who struggle digesting fats.

It comes in powder form or in Nursette bottles.  These special bottles have the colic formula premixed, so all you have to do is attach a standard nipple.

Hype? or Holy-Cow?

Call me nosey, but I’d love to hear whether or not a formula for acid reflux like these helped your infant.

How quickly could you tell a difference?

Comments

  1. This was an amazing article… Is there any difference between similac sensative for spit up powder versus ready to feed? You only mention the powder mix…

    • Thanks Christina! I’m so glad you found it helpful. Really the only differences between a powder or RTF mix is cost and convenience. I talk about the difference between the different types of formulas (powdered, RTF, concentrated) in my article, How to Choose the Best Baby Formula for Your Superbaby. I hope it helps!

      • Mackenzie Robinson says:

        Hello I have a question. My 5 month old has chronic reflux. He is on two different medications and we have switched his formula from gerber gentle to soy, nutrimegan, elecare, and similac for spit up. He has threw up with every formula after every feeding. Is there any difference between Enfamil A.R and similac for spit up? I am running out of options. We also add rice cereal to his milk.

        • Mackenzie, I’m so sorry to hear of all this! Poor little baby! The main difference between them is that one is Enfamil and one is Similac. Theoretically you could say there is no difference, since the basic components are the same, but I’ve found that with some babies brand does actually matter. Hope you can find the right formula soon. Keep hanging in there, you’re doing a great job, brainstorming and problem solving to find answers. He’s lucky to have you. :)

      • My daughter is 5 months old and has had reflux issues since 4 weeks old. It was Silent reflux, she didn’t spit up but had really wet burps, hiccups all the time, fussy after feedings, cluster feed, and slept best in swing. She was on Enfamil Newborn formula and they suggested we switch to Gerber Gentle Soothe. We do the ready made b/c powdered seem to irritate more. Formula alone didn’t really help so they put her on Zantac that didn’t help. Started Prilosec compound saw little to no improvement and started adding rice cereal to bottles which seemed to help for 3 weeks but then old symptoms reappeared. We tried a couple bottles without rice cereal but she screams after her feeding with pain so have continued to add rice to bottle which eliminates the screaming immediately after feeding. But she still spits up(not alwAys consistently spitting up but does in spurts) she gets fussy and irratiable about 45 minutes after feedings, always putting hands in mouth and drooling all the time creating rash on neck and chest, sometimes wants to eat within an hour of last feeding maybe to sooth pain, will only nap during the day if held but will sleep all night in bed fine(that I don’t understand?) so anyways we have an appointment with GI in a few days. But saw your article and now wonder should I try just switching the formula? Don’t know why my pediatrician hasn’t sugested that? What is best recommendation?

        • Candice, two things I think could help your situation… 1. I would talk with your GI specialist about switching to a hypoallergenic formula. These acid reflux formulas are helpful for some babies and are less expensive, but for other babies, research has shown that they do better on a hypoallergenic formula. So ask Dr. GI about that option and see what he says.

          2. Recent research has also shown that giving your baby probiotics like these on Amazon may also help in fighting acid reflux. I would see what he thinks about that as well.

          I hope this can help Candice! Please let me know if I can do anything else to help. You’ve been doing a GREAT job, searching for answers and being your little princesses advocate. I know things are really tough right now, but you really are being the best mom to this little baby. There are many things we can’t control as parents (like medical stuff), but we CAN control asking questions and seeking answers! And it sounds like you’ve been doing exactly that. Well done. :-)

        • My 10 weeks old has the exact symptoms as your baby. She screams after feeding, wet burp, hiccups a lot. She will take about 1 hour nap time after feeding if I hold her in my arm, she will immediately wake up if I put her down on bed, but she will sleep through the night. Sometimes 6 hours until her next feeding. We went to the doctor and they have given her the Prilosec and it have not seen any improvement yet. She is still spitting up, still arching her back after feeding, still fuss and cry, more like screaming after being fed, I stop feeding her powder formula and switched to ready to fed formula (no bubbles) that seems to help a bit more. It just a bit more costly.

          • Caycee, what did you end up doing that solved your issue. Our baby girl LITERALLY has the same exact symptoms and she sounds wheezy after crying.

      • My dd has been diagnosed with silent reflux but she also has a milkallergy,so she is on alimentum,there are no hypoallergenic formulas for babies with milk allergy that also have reflux. :(

        • Andrea, you’re correct there’s no pre-thickened formula for reflux babies. However, new studies have shown that hypoallergenic formulas can also be really helpful with reflux – so you may already be in a good spot! Another recent development in reflux treatment is giving babies probiotics like these. May be worth talking over with your doctor!

    • reflux.momma says:

      Silent refluxers (in my experience) can also greatly benefit from Similac Alimentum formula. That formula in combo with Prevacid, has worked wonders for my son. Silent reflux is the devil and I’ve had two sons with severe cases….a lot of these doctors are not up to speed on this subject from what I’ve seen and read. Articles like yours are truly a lifesaver for some of us parents. :-)

      • Thanks so much for adding this comment! It’s good for other parents to see they have more than just two options, and I have heard that some of the hypoallergenic formulas, like Alimentum, can be really effective. Thanks for sharing your experience, I’m sure it will be encouraging to others. :-)

  2. Ok…please help!!!

    My 9 week old daughter has been on Nutramigen for 3 weeks now. She’s been wheezing since she was born..I call her “zombie baby” because of all those weird grunting/wheezing/choking noises she’s always made.

    She also chokes sometimes and cries inconsolably allllll of the time! She’s always wanted to eat constantly, but only very small amounts at a time!

    Well, all three visits to her ped resulted in “shes fine”

    I honestly went with it because I’m formula feeding for the first time ever (breast surgery…tried to bf and didn’t have milk) and figured it was the formula!

    Now..after more research…I KNOW she has silent reflux!

    My question is this….should I switch formulas again?

    Before the nurtamigen, she was on enfamil infant ready made. It worked for about two weeks!! She wasn’t as fussy and wasn’t at all constipated like then Gentle EAse and Prosobee made her!

    But now…she’s sooooo fussy..with normal and sometimes explosive poops! She is literally crying the whole time she’s awake.

    I have an appt with her ped. (Again!) tomorrow because I called and told them that I’m sure it’s the silent reflux…but I don’t dare get their advise on formula or anything anymore!

    So….should I try the AR??? Perhaps that will help a bit? Or would switching yet again make things worse? I’ve already tried her on 6 formulas including the one we are on now.

    Thank you!

    Sarah

    • Sarah,

      First of all, if you’ve been to the same pediatrician three times and you don’t feel he/she is being helpful, I would seek a 2nd opinion from a new pediatrician. Just in case. You can always go back to the first, but it never hurts to have another doctor look at her.

      Secondly, if you’re confident she has silent reflux, I would go ahead and switch to the AR and see if that helps. Have you seen these tips to make the formula switch easier? Then set up another appointment with a new doctor and go from there.

      You are her only advocate, and you’re doing great! Keep looking for answers and experimenting with solutions. Yes, some things we just have to endure as parents, but you can endure WHILE finding answers. :-)

      Heather

    • Vanessa Milliman says:

      Yeah my doc says my son is fine too, he’s 2 mons old and he spits up every time u burp and is very hard to burp. We have him on Enfamil AR and add gas drops every bottle and no change sometimes its worse. Also tried soy, and plain simulac sensitive no change…. I give up!

      • When my son was 2months old after tryin gentle and soy and they put him on nutramigin and generic zantac. he is four months now and i add as much rice cereal as i do milk and he still spits up bad..he HAS to wesr a bib at all times. i think I’m going to try AR. and i get his nutramigin through WIC but that’s with a prescription friend from pediatrician. i tried oatmeal and he kept it dwn but couldn’t go to the bathroom and that’s with a litte Karo in every bottle. after three day he still didn’t poop and started using rice again and he went to tge bathroom but still spits up soo much

        • Ashley, I do recommend giving AR a try – you may find that helps a lot. Another option is to alternate the rice and the oatmeal in his bottle. Also, try using two teaspoons of prune juice instead of the Karo. It’s less sugar, and has more fiber. If you add that to the oatmeal bottles, it’s possible that will fix the constipation issue. Worth trying! Hang in there Ashley, things will get better!

  3. Heather,

    Your website has been very helpful, full of great information. My little guy is only 6 weks old. He definately has reflux. He gulps his food and air, grunts, pushes the bottle away, spits up once in a while, but mostly I can hear the food move up and down his throat. He is on meds and we have had a swallow study done. Poor guy!

    After reaing through your website I thought I should switch formula. We changed from similac advanced to gerber soothe. This helped calm his tummy down a bit but did not help with the reflux. Unfortuneately we have added cereal to his bottle to help make it thicker and stay down. This does help, but not a cure. He still struggles often.

    I reread your site again. It soulds like Enfamil Ar or Similac Sensitive might work out better since it is naturally thicker. What are your thoughts on these two products? Have you heard any success stories? I would love to hear from you. Thanks so much!!

    • Kristin, poor guy indeed! I’m so sad for him! But I’m also very happy for him, since he obviously has a good mother who wants to do all she can to help. (Well done!) I think you’re on the right track, thinking about switching to a more “reflux specific” formula. Start with the AR if you can, since I’ve heard more successes with that one. (Sensitive is also good, but I would start with AR.) You may also want to call your pediatrician’s office, sometimes they have AR and Sensitive formulas to give away to parents just like you to try.

      I HAVE heard great things about these formulas when it comes to babies with problems similar to yours, so take heart! The important thing in these situations is to just keep TRYING stuff. That way you feel like you are moving somewhere, and it makes the day-to-day endurance a whole lot easier. :-)

      Glad to chat, always here to help if you need me.
      Heather

  4. Thanks for the great info on your site! My little guy has had silent reflux since day one. He is happy all day, keeps his food down, but at night he is awake constantly. He is now 8 months old and the lack of sleep is getting to all of us. I’ve talked to the doc a ton and everytime its been about adjusting his medicine (zantac). Never once to I consider switching formulas, since he never spit up…why had it taken me so long to realize this?? He is on similac advance. I will try Enfamil A.R. but have also been told to try the Gerber Good Start brands. Do you have any info on those? What is the difference between them? Thanks so much!

    • Jen, I’m so glad it could be helpful to you. Gerber Good Start is my favorite regular formula, since it’s the most gentle brand on the market. In fact, their REGULAR formula is what most the other brands (Enfamil, Similac, etc.) use as their GENTLE formula (partially broken down proteins). Which means the Good Start GENTLE formula is even better (100% broken down proteins). I guess I would start with the Good Start Gentle and see if that helps first. It’s much cheaper. If that doesn’t seem to do it after 5 days or so, go ahead and give Enfamil A.R. a try. The good news is that Enfamil A.R is still a dairy-based formula (it is in the same “formula family” as Good Start Gentle). This means you should be able to switch abruptly without causing him tummy pain.

      Hope this can help! Heather

  5. This is what I needed to read. My daughter was diagnosed with acid reflux at 3 weeks (She’s 5 weeks now) and prescribed Zantac (1 mL twice a day). We also are using Lityle Remedies gas relief drops. We had her on Similac Sensitive which kept her full, feeding regularly and spitting up minimally. But we were lucky to see one bowel movement per day and the fussiness was just heartbreaking. We just recently switched her to Enfamil Gentalese and the bowel movements are regular…up to 4 times a day…and her fussiness is essentially gone…like a new baby. BUT she has started spitting up a lot and I know it’s from the reflux. We have her sleep in her car seat so she’s inclined and won’t even put her in there until maybe 20 minutes after feeding. I’ve also noticed that she has been sleeping less on the Gentalese than the Similac. I chalked that up to the Similac being a thicker based formula. I’m eager to try the Enfamil A.R. now to see if this will help her at all. Thx for the information, Heather!

  6. Thank you for the great articles! I found your blog bc I recently saw somewhere else about the red ring around baby’s anus and green stool being an effect of milk allergy. My son, who is 6 months, has been on reflux medication since he was 2 week old. He has had green stool since I stopped breast feeding at one month old. He also has a continuous red bumps on his chest that don’t react to coconut oil or steroid creams. Even though he is on axid twice a day (1ml each) he still spits up entirely too much. Sometimes I can hear him and he swallows it, sometimes it’s just clear liquid when it comes out but usually it’s white and thicker and stinky. The red ring around his anus doesn’t change with rash creams, yeast creams, or coconut oil either. BUT he doesn’t seem bothered when I put something on it. He is 6 months, 26 inches, and 16lbs 8oz. He only gained 1 1/2 lbs since he was 4 months. Also, we have been using Similac Spit up since he has been on formula (we did try others when trying to make his spit up amount less). He is generally a very happy and smiley baby! only fets upset when I dont feed him quick enough. last week we started solids too, but the poop is still green (with other pretry colors too- and thicker and one piece). So, after the background, what should I do now? He’s on a sensitive formula and still experiences a few of the milk allergy symptoms. We’ve seen a dr about his reflux and even saw a pediatric GI(who just simply told us he has reflux, which we knew already, and sent us on our way!). I don’t want to try soy bc of hormones if I can avoid it! Please help me, you seem knowledgable!

    • Amanda, it definitely sounds like he has an allergy of some kind. I’m assuming you’ve already seen my article on formula allergies (talks about the red ring around the anus), but just in case, I’ve linked it here.

      I guess I would recommend giving a hypoallergenic formula a try, and thickening it a little with cereal to help him keep it down. If that doesn’t seem to help the allergies (give it at least a week), try switching to Enfamil AR or one of the other specific acid reflux formulas here. :-)

  7. I meant to say he was already (and has been on similac spit up). So I guess I’ll give gerber soothe a try. If he does have a milk allergy, I’m going to be real upset with myself for not researching more and ‘just dealing’ with the spit up.

    Btw, is there a difference between similac sensitive spit up and similac spit up? The container I buy is green and doesn’t say sensitive on it. The one you mention is orange and says sensitive on it. I do know there is a regular similac sensitive but it doesn’t say spit up on it and the lid is orange. I’ve even looked at similac a website for the one you mention.

  8. Enfamil A.R. is the best. Nothing else worked not soy not alimentum nothing not even meds I switched to ar and its was truly a miracle no more changing of clothes or screaming babies god send I tell you.

  9. Amazing info! Thanks for sharing :)
    I recently (today) switched my lil girl to Enfamil A.R. because I heard good things about it. She isn’t in any pain, but she would spit up so much, and often, that she’s been wearing bibs since birth LOL!
    She also has been diagnosed with Tracheomalacia (sp?), which is basically, her trach is flat and immature, which causes her to make crazy kazoo sounding noises, which scares people, because they think she’s not breathing good LOL, not really funny, but I have gotten used to it, so I laugh, and even make the noise with her, and she laughs and smiles with me. Anyway…,all 3 of my girls were spitters, and I just dealt with the multiple launderings with the other two, but with this one, I tried adding cereal, and it helped some, but still she spit up, (just alot more chunkier, LOL), a lil less frequently though. She is 3 months old, and weighed 6.4oz at birth, and is now 12.12oz, so no problem with weight at all. She is thriving well, as a matter of fact, moving along way quicker in milestones, than she should be. She is also a happy baby, so the spit up thing is really just bothering the ones who hold her lol. Anyhow, I gave her the A.R. today, and she seemed to do well, yet when she spits up, it is curdled, not a whole lot of spit up, but frequent. So I’m just wondering if this is normal? Like maybe it will take a little bit of getting used to? OK, now that I’m done with my “essay” lol. I would appreciate your feedback. Thanks again ;)

    • Aliyah, what a good mom you are! Sounds like you know your babies well, and know when to freak out, and when to laugh. That’s awesome. As for the curdled spit up, I would give it a week and see if it improves. If your baby seems happy, and is spitting up less and still growing, I wouldn’t worry about it. If she seems to gag on it (too curdled?) or is spitting up MORE than normal, perhaps switch to a different formula for acid reflux and see if that helps. Keep trying things until you feel you’ve gotten the results you’re hoping for!

  10. Great information! My twin girls are ~11wks old. I breastfed and supplemented with Similac Advance for 1st 3wks. Due to emergency surgery at 3wks pp, I stopped breastfeeding and girls were 100% formula fed. Advance made them very gassy and fussy so switched to Similac Sensitive. One girl did ok while other still had issues. My husband wanted to try Similac Soy on that daughter and reflux kicked in and had to add rice cereal, which I wasn’t happy with. Both doing ok on different formulas but still cried when passing gas and bowel movements. Read about Similac Total Comfort (broken down proteins -very thin formula) and switched both girls 3.5 wks ago. Stomachs were great but eating 5oz almost every 3hrs with only a bit longer break at night. Met with pedi at 2mth checkup last Monday. He was concerned they were eating too much and wanted me to add rice cereal (1tsp per ounce of formula) to reduce formula intake. Girl with reflux has gotten worse and ecsema has flared up. Past 2 days she is crying in pain and spit up is sour. Its not gas pain but seems to be pain from burning in throat. Nurse at pedi office said to try pedialyte to settle stomach and call back if continues when try bottle again. I’m so lost on what to do and what to try next. I just want my sweet girls to be happy. Formula woes are not fun! Please help.

    • Terri, sounds like your reflux girl (with the eczema) may be struggling with an allergy issue. I would switch to Similiac Sensitive for Spit Up, as it could help with any allergy issues and is a good formula for acid reflux. Since it’s thicker you won’t have to add the cereal by hand (a bonus since they’re so young).

      Can you give that a try and then let me know if it doesn’t help? It’s very hard to have ONE baby whose struggling…let alone TWO! I want to help as much as I can. Hang in there, keep trying things and seek a second medical opinion if you have to. You and your husband are doing a great job, even if it doesn’t feel like it.

  11. Thanks for all of your info! My daughter is 4 months old & was diagnosed with reflux at 7 weeks, when I was still breastfeeding, & was prescribed Zantac. At 10 weeks we started formula, with Enfamil AR. She still spit up quite a bit with it. About 2 weeks ago she seemed really uncomfortable – gassy, constipated, belly was hard. We started Enfamil Gentlease…. The spitting up is even more, & the gassiness is still there. The spitting up doesn’t seem to bother her, but after feedings she just sometimes seems to be struggling (more so at nighttime) I have noticed a greenish tint to her stools a couple of times (but not all the time). Should I ask about switching medications, or should we try another formula first? She is growing fine, off the charts for height & weight, which is hard to believe with the volcanic amount of spit up! Any thoughts/recommendations would be greatly appreciated!

    • Maryjane, if the main issue with the Enfamil AR is constipation, I would try to keep using the Enfamil AR, but try different things to help with the constipation. For example, you could add 1 Tbs of prune juice for every 4 oz of formula. (Once she’s older than 4 months you can increase that to up to 1 oz prune juice/4 oz formula.) Add the prune juice in two bottles every day for a few days and see if that’s helping. The hardest issue to handle is the spit up. So if AR is really helping with that, than we can try different things to help with the constipation. Or, you could quickly switch over to Similac for Spit Up, or Parents Choice with added rice. Some babies just do better with different brands. You’re making progress Maryjane! :-)

  12. Hello I have a 7 week old baby girl. She was diagnosed with silent reflux at 2 weeks old. My family doctor told me there was nothing you could do. That she would grow out of it. Well I couldn’t accept that. Especially since she was in the er because of choking on the fluid coming up. It was very scary!! So I did some research and found that nutramigen was the way to go. So we switched her and she did great for about a week, then started the episodes again. We started to add rice cereal to her bottles and she was a totally different baby. But this formula is extremely expensive. I have noticed in the last couple days she is starting to spit up ( which she has NEVER done) and her bowel movements are complete yellow water! I was wondering if we could maybe mix something with the nutramigen to help with the cost and maybe with her bowel movements. Any suggestions??

    • That would be scary, Jessica! Firstly, make sure she doesn’t have diarrhea or is showing any signs of being dehydrated. I’m wondering what would happen if you mixed the Nutramigen with one of the thicker formulas above for thickness? That was one thing that came to mind you could try. The potential issue there is that the thicker formulas aren’t hypoallergenic. But it’s something to try. :)

  13. This formula info for colic & reflux is great but what about breastfed babies with colic and/or reflux? I’ve tried everything (besides giving her back to the hospital) and am losing my mind.

    • First Kate, I would speak to your doctor about possible medications to help with the reflux. Secondly, ask him about adding some rice cereal to pumped breastmilk in a bottle. Part of the issue with reflux babies is that the milk isn’t thick enough to stay down. Your doctor can help guide you as to how much rice cereal. You don’t want it so thick she chokes. Hang in there friend! I know it’s SO HARD right now, but it will get better. Hold on by your fingernails, and keep seeking information and trying new things. You’re doing the right thing!

  14. I am loving this site… thank you for all the info. I’m here because I’m not convinced our daughter has true reflux – she sleeps at night with no problems, but we have had issues with fussiness, spit up (recently), and my biggest concern is her breathing. Here are the basics:

    -7 wks old
    – diagnosed with reflux Thursday
    -currently on Gerber Gentle after switching from Gentlease
    – spit up after each bottle started around week 6 (after we switched to Gerber)
    – around week 6, would spit up a little even an hour or two after eating
    – a few days ago started sounding congested – lots of rattling
    – of course, no breathing trouble at appt. Doc listened to us describe her symptoms and diagnosed reflux.
    – Doc recommended trying Similac Sensitive (orange) and .8mL of Zantac twice a day. We asked about rice cereal and doctor said we could try it but it sometimes made things worse.

    So here we are, two days later. We have NOT switched her formula yet because I really want the Good Start to work… mainly because of cost (it’s free at daycare). So we’ve tried a few doses of Zantac and the rice cereal. The rice cereal has really helped with reducing the spit up – as in, none. But her breathing sounds worse… it really does sound like she’s got an awful cold. Not an emergency situation, but definitely making her uncomfortable and fussy.

    Going to try switching to the Similac today just to see if it is the magic difference, but I doubt it will be…

    My questions – does this truly sound like reflux? Since the spit up has reduced, could the acid have reduced too, but the extra congestion be due to an actual cold? How can I even tell?? Does anyone else have similar experiences?

  15. Heather,

    My little boy is 11 weeks and has acid reflux. When born, he only BF the first day (due to latching issues & lack of interest) so I had to supplement while in the hospital with Similac Advanced. He gagged often and spit up from time to time, but I was told it was due to him being past due & born via C section. When we got home from the hospital I pumped but still fed him the Similac Advanced and the spitting up got worse and then horrible gas pains followed. After a few sleepless nights, from all night crying (both of us) my sister suggested switching to Similac Isomil. He kept it down better but would still spit up & even arch his back and cry while burping him. After all of that he was diagnosed with Acid Reflux. The peds say it’s not bad enough for medicine and to keep him on Isomil that he will eventually grow out of it. Poor guy still spits up during every feeding, along with the crying but no more back arching. Isn’t there something I can do? We’ve even gone to the chiropractor to help it. Please help!!!

    • Isomil is basically a soy formula. I think what your baby needs is a thicker formula that will be harder to spit up. Try one of the formulas above. I really think they will make a big difference, Alisha! Just until he’s a bit older and the reflux goes away. Then you can switch to a regular, less expensive, formula. :-)

  16. I have a 7 week old baby boy who has reflux and colic. He is taking Zantac currently for the reflux. I am actually currently breast feeding but am thinking of going to formula. At around 4weeks old I tried supplementing with different formulas (enfamil newborn, gentlease, and similac alimentum) but also tried Prilosec at the same time. His reflux got soooo bad during that time! There was spit up EVERYWHERE! He also got a really bad diaper rash that bled. Well I decided to go back to only breast milk and go back to Zantac. His diaper rash is better and he doesn’t spit up as bad. But I am wanting to go to formula because he is still sooo fussy and isn’t sleeping good at all. When I’m feeding him, he sometimes kicks and screams the whole time through the feeding like he’s in pain. I’m just wondering if there is a formula out there that would make him feel better than my breast milk. Is there a formula that is good for reflux but also would not give him a severe diaper rash due to a possible allergy? I just don’t want to stop breast feeding unless I know there is something out there that will help him feel better.

    • That poor baby! Wow Holly, you guys have really gone through the ringer! I think you should try one of the formulas in the article above. The main issue with reflux is that, since the esophagus isn’t fully formed yet, liquids can pop back up and burn his little throat. A thicker formula has been shown to drastically reduce the amount of “popping up”. Since it’s thicker and heavier, it stays inside the tummy better, rather than taking a pleasure cruise back up the throat. Does that make sense at all? You may want to mix a little of the thicker formula into your breastmilk for a few feedings to see how he responds. That way, when you decide to make the switch permanently, it should be a little easier to transition. Hope this can help Holly! Good luck!

      • Does the Enfamil AR cause constipation? I’m scared to give this to him and for it to just cause him to fuss about something else. Is he too young to give him prune juice at 7 weeks old? Also how long should I give a formula to see if its going to help him?

        • I have heard of constipation issues with the AR, yes. But it’s hard to tell if it’s the cause or not. You can give prune juice in small amounts. Start with 1-2 tsps at that age. I would give the formula 5-7 days to see if it’s helping.

      • Also have you heard of Pregestimil? It is suppose to be for reflux and colic. Do you think this would be a good choice to start him on?

        • Pregestimil is a blend that’s designed for babies who struggle with digesting fat. I talk about it in my colicky baby formula article here. I think you’re instincts are spot on here, Holly! If you’re not happy with the AR, I would go head and give Pregestimil a try. It’s not as thick as AR, but if his reflux is linked to the fat-absorption issue, it may be just the thing. In fact, due to your comment, I’m going to add it in this article as well, as a back up plan. :)

  17. Christina Montano says:

    I have a 2 week old baby girl. She has been diagnosed with silent reflux. She is currently on Zantac. I also have her on Similac Sensitive. I switched bottles to Dr. Brown’s as the Avent nipples were too fast flowing and she would choke and sputter. Elevated everything…etc. She seems to be getting more fussy, more gassy, more miserable. Difficult to get her to wind down and stay asleep. Also give her gas drops and gripe water as she gets constant hiccups. Spit up not too bad but she is clearly suffering. Arches back and stiffens up. Sounds a little stuffy too. At best poops once a day. Doc recommends Similac Total Comfort. Hesitant to switch formulas…not sure what to do. Please help!!

    • Christina, poor little thing! Hopefully the Zantac will be good for her. In regards to pooping – once a day isn’t anything to be worried about, unless there’s red mucous or in little pebbles. My Bella poops every other day (sometimes every 3 days) but she’s not constipated. Constipation has more to do with the texture of the poo (nuggets of nastiness) than the frequency.

      As for the formula, I would strongly encourage you to try one of the formulas above for a little while. These formulas can help because they are thicker than the normal formula, which means gravity helps them stay in the stomach easier. Also, you could try letting her nap in a swing or a baby bean bag, the sitting up usually helps reduce the reflux burning.

  18. My 12 week old has been spitting up with occasional bouts of projectile vomiting and “waterfall” vomiting. We tried Similac for spitting up and one for gas. His poop on the sensitive one was black, sticky, and he had uncontrollable gas. He never stopped vomiting. We switched to Nutramigen which has helped everything but the throwing up. With the Nutramigen, he recently started having extremely runny diarrhea. So honestly I am not sure what to do now. His older brother had horrible reflux and was on medication for it.

    • Danielle, have you tried one of the per-thickened formulas above? I’m wondering if he would be able to keep a thicker formula down. That’s the first thing I would start with.

  19. I love you site but my problem is that we have tried several bottles and have trouble with LO not getting the formula out of the bottle. We us similca spit up cause that is what is covered by wic. Please help!! Thanks in advance.

  20. My twins both have reflux and a milk allergy. They are on neocate which is an amino acid formula, but very thin. Its making my sons reflux worse, but I can’t give him much else because of the allergy. Any thoughts?

    • Jenna, talk to your doctor about whether you could add cereal by hand. It’s not preferable, but it’s better than nothing. He may have some suggestions on how to add it without making it clumpy, or using a tool to prevent gas bubbles. Start there.

      • melissa says:

        My 4 month old daughter has reflux , formula allergies and severe excema.
        She has tried Enfamil infant, Gentlease, Nutramagen -helped with the colicky symptoms but not the vomiting excema or reflux. We started Zantac after 1 wk she who was having diarrhea every other day started to poop 6-8 times a day with mucous and blood in the stool, stopped the zantac. We are now on Neocate powder which makes her stop pooping, It’s now every 4 days dark green, sticky . She’s still vomiting and itchy red patches on scalp scratching is disturbing her sleep did not gain weight in 2 wks . So we started some rice cereal and colicky symptoms return within 24 hrs plus reflux symptoms worsening . Where do we go from here especially as far as formula….???

        • Melissa, go back to your pediatrician and ask him about adding prune juice to the Neocate – does he feel she’s constipated? I would also seek a referral to a pediatric gastrointologist. Those are the super-brainy doctors who know EVERYTHING about babies and digestion. It seems like there may be other issues going on that someone with the higher level of training (beyond your usual pediatrician) may be able to help. Hang in there. You’re doing a great job – being her advocate. That’s a sign of a great mom. She’s truly blessed!

  21. Thank you for all the info but I have a 4 month old son we have tried breastfeeding that didn’t work out so well, Then he was on Similac complete then we switched to Enfamil Gentle ease because all he did was cry and stiffin out his body and his belly would be really hard then I finally took him to the dr and he put him on Enfamil AR with Zantac twice a day but Enfamil AR didn’t work for him then we have since changed to Enfamil Prosobee soy based formula adding rice cereal with the zantac twice a day. But he is still spitting up and very gassy all the time. What would you suggest I am up for any help please!

    • Ashley, you could try switching to Similac for Spit Up or Prosobee. I’ve learned that brands do make a difference. Some babies just do better or prefer a certain brand over another. Also, just this morning I was talking with the mother of another post-reflux baby and she shared that this natural remedy by Hylands helped her son a lot. That’s all I know about it right now, but I wanted to mention it as a possible thing to try.

  22. My little girl has reflux and is on zantac. She is 10 weeks old and I have tried so many formulas that I would feel bad to change it again. She has been on enfamil newborn and gentlease then nutramigen then enfamil prosobee then similac alimentum then back to prosobee. She is on it right now and she still spits up alot but it has helped her fussiness
    and gas I think but has made her sooooo constipated I have tried extra water, juice, Karo syrup, and stimulation but she still OS constipated. Im wondering, im in the process of changing her formula to gereber goodstart soothe, is this a good choice or should I keep her on
    the prosobee and just deal with the constipation? this is the first day transitioning her to the good start soothe and she seems really fussy. is this normal? I’m only putting a little bit of the goodstart in her bottle and mostly prosobee. Im so lost and don’t know what else to do for her.

    • Firstly, you are trying new things for her. So don’t get discouraged, you’re doing exactly what good moms do: search for answers. :-) I think you’re doing the right thing with the formulas. Just make sure you give it a good 5-7 days to see for sure if it’s helping/hurting. For constipation, did you try the 1-2 tsps of prune juice? That could help. If after 5-7 days it doesn’t seem any better, you could try these Hylands tablets – reflux moms have told me those are helpful.

  23. My daughter is 11 weeks old today. Since we were in the hospital and breastfeeding she was spitting up and unconsolable. After we got home (and after a bout of Mastitis and then Thrush) her spitting up became progressively worse. She started to lose weight and it took several trips to the Pedi for them to take us seriously. They put her on Zantac and when that did not help they put her on Zantac AND Prevacid Solu-tabs….I was concerned about FPIES to milk and/or soy but the Pedi said it was extremely rare. I was not convinced and sought a second opinion once she started having problems pooping and was extremely gassy and spitting up non-stop from one feeding to the next and screaming all of the time. Her poop was lime green and mucusy. That was at 5 weeks. The first Pedi I mentioned said that since she did not have blood in her stool then she did not have an allergy (something I now firmly believe is a myth…blood occurs AFTER the digestive tract is severely damaged after being exposed to the allergen over and over and over). On my own I went dairy-free and then dairy and soy free….I did not realize that things wouldn’t change in a few days. I read it takes 2 weeks for the “offenders” to get out of the mom’s breastmilk and then an additional 2 weeks to get out of the babies digestive tract but even longer for the baby to heal. The second pediatrician we went to automatically said that I needed to continue being dairy and soy free, pump to maintain my milk supply but try out Nutramigen until my milk supply was “clean.” That gave both me and my daughter a break from breastfeeding- which by that time was much needed for my sanity and her healing. THe new Pedi also switched her from the Prevacid Solu-tabs to a compounded version of Prevacid as she said that the Solu-tabs can have traces of milk protein that can still effect severely sensitive babies. After a few days on the Nutramigen my daughter seemed so much happier and spit-up less. However, after a couple of weeks she was straining to poop and was screaming for days straight while passing gas…her BM’s were still mucusy. We were told to give it a little more time and then when she was 8 weeks we switched her to Elecare which is an elemental formula—-even Nutramigen has milk in it, as it is milk based….it can still bother sensitive babies…..we also were told to give her a milk-free Probiotic (BlueBonnet)……they also took her off of Prevacid and Zantac thinkign maybe the Prevacid was causing her to strain and the alcohol in the Zantac was irritating her esophagus….she still projectiles three weeks after these changes and the new medication…Axid….is not helping at all….she only eats 1-2.5 ounces every 3-4 hours….she is developing some sort of food aversion…her daily naps are no longer than 30 minutes and she is still choking in her sleep (even sleeping sitting up)…..I am tired…she is probably tired and always seems in pain…..so the Reflux is not manageable at this point but her BM’s are no longer mucusy. She still has a lot of gas….probably from screaming so much and swallowing so much air….

    http://www.refluxrebels.com is another great source in addition to this website- it shares common myths about reflux and milk/soy protein allergies/intolerances.

    • Wow Katelin. Just wow. If I were handing out Mommy Awards, you would definitely be at the top of the list. You are a mama BEAR! She is so blessed to have you. I know you’re exhausted and struggling, but take a minute and look back at this comment. You have FOUGHT. You have STRIVED. You are inching ahead, little by little, towards the sunrise. Don’t give up! You are closer to the top than you were 11 weeks ago. That baby girl has a mama who is fighting tooth and nail for her health. That is precious. And, sadly, it’s not always a sure thing. You have gone without so she could do better. You have rocked through the screams. Asked questions. Researched. Take a minute and bask in the fact that you have risen up to the mom challenge. Well. Done.

      Now, to specifics. I feel rather foolish throwing this out there, with all the stuff you’ve tried…but have you heard of these Hylands reflux tablets? I’ve had a few moms report good things about it, it may be something to mention to your doctor. Also, talk to your doctor about if adding some prune juice would trigger her allergies? It’s very good for constipation. Other than those things, I think you should keep consulting with your doctor. Your baby’s case is WAY above my brain waves. In this case, my best role is as your cheerleader. And I think you are doing so wonderful. Keep it up, keep trying, keep “surviving”. It will get better. IT WILL GET BETTER. Time heals all things – even acid reflux. xo Heather (also, thanks for that website! I haven’t heard of it but I’m definitely checking it out!)

  24. my baby is 2 months and suffers from colics and spit up:/ i tried giving her enfamil newborn but it gave her diahrrea. i then switched to gentlease and she would have super green bowel movements with bloody stools. then dr. put her on sobee (soy milk) and she became constipated. After she was put on nutramigen but started having acid reflux and doesnt pass a lot of gas. now i put her on enfamil infant but she keeps spiting up and cant poop. I dont know what to do i hate seeing her cry and suffer. what would the best formula be for acid reflux/spit up and gas/colics?

    • Jenifer, I would try the AR or the Similac for Spit Up, mentioned above first. If that doesn’t help, try looking through the colic formulas I mention here. Keep trying things until you hit a winner. And if you’re still stuck, come back and we’ll go to Plan C!

    • That poor thing Jennifer! If the biggest issue is the spitting up, I would try Enfamil AR – it’s thicker and can help keep things down. If her biggest issue is the gassy tummy and colicky symptoms, try Good Start Gentle. If her poop gets really hard and she starts passing pellets, slip 1-2 teaspoons of prune juice in the bottle. That should help soften things up. Good luck!

  25. Hi Heather! This site is very informative. My LO is 6 weeks. He has frequent hiccups, burps a lot, u can hear the milk hitting the bottom of his tummy during feedings. He spits up a lot sometimes it look kinda thick looking and yesterday I noticed it had a funny smell not to mention he has ecZema. Doc told me to get cetaphil. He is on Zantac 1ml 3x a day. But I stopped giving him that because it made him constipated…well not poop in a day. He is also on enfamil newborn I was considering switching formulas. He sleep throughout the night, when he is woke after feedings he is very fussy u can tell something is wrong. Only thing tht calms him is a bottle but I don’t want to overfeed. I tried gripe water drops worked for a minute or 2. I read that probiotic drops should work. Haven’t tried it yet and I want to switch his formula. What do you think? Please help

    • Liz, firstly on your comment on constipation…constipation isn’t related to how OFTEN a baby goes, but the texture of the poop when he DOES go. My children were never once-a-day poopers, but that didn’t mean they were constipated. As long as the poo isn’t pebbly, or boulder-ish, he’s fine. Just wanted to throw that out there, just in case, since it’s a common misunderstanding.

      Okay, have you tried a thicker acid reflux formula like the ones above? Or you could try a more hypoallergenic formula, the eczema makes me wonder if there’s allergies at play here. Here’s the list of sensitive/hypoallergenic formulas. They would also be a good thing to try.

  26. My son is now 9 1/2 weeks old, was BF for 4 weeks then went to good start soothe. He has spit up a lot, got worse with formula. It definately isn’t affecting his weight (14.6lbs at 2 mo check up lol born at 8.6lbs) and he doesn’t seem to be fussy when spitting up. I told the dr at his 2 mo check up that he spits up a lot and he said try giving him a little less formula more frequently and try using 1tbsp rice cereal per bottle.. If I give him less than 5 oz, he cries for more.. And I’ve tried putting rice cereal in every bottle but doesn’t seem to be helping. He sleeps on his belly and has been since about 5 weeks because when we would lay him on his back he would wake up. His little chin is all broke out from the milk, spit up or something .. I want to switch formula’s but am getting WIC, we have tried good start soothe and good start gentle. My daughter who is now 4 1/2 did very well on good start soy.. Wondering if I should try him on that.. ? Any suggestions are appreciated!! :) thanks!

    • Stacy, he spit up with soothe? hmmm…. Have you tried any of the spit up formulas in the article? Enfamil AR? or Similiac for Spit Up? That would be my personal Plan A. THen, for Plan B, I would try the soy, since your daughter did so well with that. And then, for Plan C I would contact the WIC office, or the doctor’s office, or the formula manufacturer and ask about free samples and coupons for a hypoallergenic formula. Give those suggestions a whirl and see if they help. Good luck Stacy, sounds like you’re instincts are good. Keep at it!

  27. Thank you for this! I’ve been pumping exclusively, and my milk supply is beginning to dwindle, so it’s time to start supplementing. My little guy has been on Zantac for acid reflux since two weeks, and I wasn’t sure which formula to use. Thank you!

  28. My son is 12 weeks old and his reflux has progressively been getting worse. While he hardly ever spits up during a feeding, 2 hours later he will spit up digested and/or undigested formula EVERY feeding. It’s not a large amount of spit up but it’s enough to go through multiple bibs and outfits throughout the day. I keep him elevated for at least a half hour after each feeding and I have him propped up throughout the day to try to limit the reflux as much as possible. His pediatrician does not want to treat his reflux as he does not have a problem gaining weight ( born 8lbs 4oz and was 14 lbs 9 oz at 2 month check up) but recommended switching from similac advance to similac spit up. I know you’re supposed to use the formula for at least a week before throwing in the towel but we only had him on it for 4 days before switching back to similac advance. The similac spit up was so thick that it was clogging up his nipples even after switching to the faster flow nipple with the larger holes. We would wait 10-15 minutes before giving him the bottle so the froth would go down after mixing it just to have to shake it up throughout each feeding to unclog the nipple. He was getting so frustrated,not to mention all the extra gas bubbles he was swallowing from the foam, and would cry and stiffen his back during every feeding which is something he never did before.I’m not sure if this is considered constipation but his bowel movements changed to a mash potato consistency and took a lot of grunting and pushing to produce. Should I keep him on the similac advance and deal with his reflux? As per similac’s instructions I used the larger nipples and waited a while after mixing before giving him the bottle.. Do you have any other suggestions that would make similac spit up not such a nightmare? Can you combine formulas? Could I maybe thicken up the advance a little with the spit up formula so it’s thicker but not too thick to drive him and me crazy each feeding? I would like to stick with the similac brand because aside from his reflux and never ending laundry we do not have any other issues. I would appreciate any suggestions.

    • Gina, what a frustrating journey you’ve been on! Here are some thoughts:

      1. Yes, you can combine formulas. You could try a sprinkle of advance to try to thin up the formula a tad. (Good instincts there, mom!)
      2. I wouldn’t normally recommend this, but since he seems to be growing healthy, another option is to try adding less formula to the water to thin it a little more. Fiddle around with the ratio to see if you can’t find the perfect consistency between getting through the bottle and being thick enough to stay in his tummy.
      3. Another option is to try a different a different bottle style. I’m going to try to write an article on the different bottle styles in November, hopefully that can help you choose.

      As for the poop, it does sound a little on the thick side. Try adding a teaspoon of prune juice into his bottle. Give it 4-5 days and see if that helps. Let me know if I can do anything else!

  29. Stephanie says:

    My son is 7 weeks old. I started out breast feeling but it got to where he would throw it up and it was kinda chunky ish and he started to act as if he was always hungry and got real fussy and started to not sleep well so I switched him to gerber gentle which worked great for about a week I took him to the Dr and the switched him to similac alimentum and he was like a whole new baby he was happy he sleep great for naps sleep all night but not even a week later it started getting the same as it was plus he was real gassy now they are trying him on premie formula plus zantac 2 times a day so far he isn’t throwing up just a little spit now and then but he still doesn’t sleep well at all. He will sleep maybe 10 minutes at a time then he will start to fidget real bad and wake up fussy!! Do you have any opinions on this? Should I maybe try Soy?

    • Stephanie, you are in the middle of really tough time, hang in there, it will get better. How long has it been since you tried the latest thing? Give it at least a week or two before switching. When it comes to reflux, the Zantac can take several weeks to finally kick in. Try some gripe water to help with the gassiness, that may be why he’s not sleeping as well.

  30. I really appreciate the article. My son is 6 weeks old and for the first five weeks of his life, his spit up became worse and worse. He gaged in his sleep often, spit up in his sleep consisitently and then began waterfall spit up during feeds. The doctor kept saying spit up is normal and my son is gaining weight so everything was fine. After only being able to keep an oz down and falling asleep for hours I demanded to switch to Similac for Spit up. We did and it worked wonders. The problem now is his bowel movements have nearly disappeared. He was doing ever other day and now he’s last one was on Monday and today is Thursday. He’s screaming and it seems like its because he hasn’t gone. Monday’s poop was massive and all green. He was very fussy before it and back to normal after it so I think it’s not having moved his bowels that is making him so fussy. Gripe water helped but not so much anymore. What can I do? How can I help him to go? The doctor said 7 days without a bowel movement is normal but that’s not normal for my son.

    Also, we switched to Similac for Spit up. What is the different between that and Similac Sensitive for Spitup? Thank you!

    • My favorite line: “The doctor said 7 days without a bowel movement is normal but that’s not normal for my son.” You GO GIRL! You are exactly right. Just because the stats and medical reports say it’s normal, doesn’t mean it will be normal for your baby. So way to rock the mom thing! Firstly, I would start adding 1 teaspoon of prune juice in his bottles. Then once he has a bowl movement, see if it looks any different – is it softer, and seem easier? If so, then move it down to 1tsp a day, and see how that affects him.

      As for the difference, I honestly can’t tell you about that, I’ve not researched that deeply on those two yet. (Making a note for the future, though.) I would try the Sensitive for Spitup and watch him for a week and see if you notice any changes. Hope this can help!

  31. Trisha Brown says:

    I have a 6 week old who has been diagnosed with acid reflux. She is on Zantac twice a day taking 1 ml each time. She is taking the similac sensitive. My older daughter was the same Zantac and similac sensitive.
    She will arch her back and cry when burping still. She is still spitting up about 2-4 times each feeding. She sleeps in a napper and we never lay her down flat! She only spits up during the feeding when burping. She also has a rash on her face and chest. Its little red bumps that are rough to the touch. Older daughter never had that. We also switched from avent bottles to dr Brown’s.
    Just concerned with the spitting up and the rash. She is fussy during and right after a feeding and then will be content until next feeding. We are doing everything we did with our first that helped her but this one is still uncomfortable!!!

    • Trisha, it sounds to me that she may be having an allergic reaction. The first thing I would try to deal with is the spit up. Have you tried any of the thickened formulas in the article? Those could be helpful. Or, if you’d rather try to fix the allergy issue first, and let the Zantac work on the reflux, start with Good Start Soothe – it’s 100% whey, which is very very easy for a baby to digest. If after a week she’s still showing allergic reactions, you may need to consider switching to a hypoallergenic formula. Hope this can help!

  32. My daughter is now 7 weeks old, been to the ER several times and just got out of the hospital a few days ago. She has been spitting up horribly since she was 2 weeks old. After several ER trips due to dehydration they hospitalized her over night and diagnosed her with Acid Reflux. I was happy to get an answer finally as to why she couldn’t keep anything down.

    Well now our issue is formula. I personally prefer Enfamil and would love be able to afford the Enfamil AR, however I can not. She is on WIC and they will cover Gerber, which was fine with my frist daughter. Now here comes the bigger issue… I thought that maybe I could exchange my Gerber for the Enfamil AR so that she gets the right formula. Can’t do that, WIC restricts it to where you have to take it down to the office and return it… Well they also refuse to put her on Enfamil AR even after the doctor faxed a prescription for it to them. So now I’m stuck making my daughter suffer because I can’t afford what she needs. Does Gerber have a version of AR? I’ve looked on their site and they’ve got one for fussiness, gas, and colic which is the closest I can manage to find. I’ve called them and am currently awaiting a call back from their “dietician”. I just want my daughter to keep food down! Any suggestions? My next thought was to call WIC tomorrow and see what all my options are or if I am restricted to only Gerber because Silminac has an AR formula. This is so frustrating!

    • Samantha, it definitely feels like an up-hill battle. The good news is, even if it doesn’t seem like it, you’re winning. You know WHY she’s having such issues, so that’s a huge battle won. I know the war isn’t over, but you are doing a GREAT job trying to get what your girl needs. Gerber doesn’t have a spit up formula right now (that I’m aware of, anyway). So I think you’re best bet here is to add rice cereal to the Good Start by hand. Talk to your doctor for his advice on how to thicken the formula in the safest way possible. You need it a little thicker, so it stays down, but not so thick that she gags on it. It may take some tinkering to see which ratio works the best.

      Also, WIC may not cover Enfamil, but Medicaid may. I would contact your local Medicaid office and see about eligibility. It's possible you can get reimbursements there. Again, I'm not sure…it's just a hunch you could check into. Hope this can help, hang in there. It gets better, promise. :-)

  33. My first had GER (now 4) and I discovered the AR formula then. It changed so much for my lil guy. During the day he was a tummy sleeper. Babies with reflux are so much more comfortable on their tummies.

    This new baby has the same issues. He is on the AR formula. Breast milk even hurts him :( I am in the process of getting a napper to help keep him upright when sleeping. Fisher Price, Summer Infant, and Bright Stars make upright nappers that are fairly priced. I hope that will help with my guy.

  34. My granddaughter is 4 1/2 months old. My daughter-in-law breast fed exclusively for almost three months, but now we have to supplement with formula once in a while due to DIL not being able to pump as much while working. She only gets about 4 to 5 bottles of formula during the week. I’ve had two episodes where two hours after feeding her a bottle of formula (one Infamil w/ iron, one Soy formula), she vomited the whole bottle. Then about every 10 minutes she would gag and spit out mucus (nothing else in her poor tummy to throw up). She wouldn’t cry, but would be listless afterward. This lasted for about an hour and a half. We changed the formula after the first time, but she did it again on the soy. It doesn’t happen every time…..just those two times. The only thing similar both times was that we mixed the formula with Nursery water. Could this be reflux? She gets hiccups a lot, and spit up a good bit early on with the breast milk, but it has gotten better except for these two times (and they were about 3 weeks apart in occurrence).

    • Madeline, firstly, the word “listless’ concerns me a little. If your baby does that again, call your doctor. She may just pooped out because she’s vomited so much, but it could be something else, like dehydration, which is really serious for babies.

      I don’t think reflux is the issue here…I suspect it’s the nursery water. Nursery water is rather ill-named, since it’s not recommended to be used with formula at all for children under 1 year. The nursery water has “extra flouride” – but for teeny bodies, it’s often too much (which is why she may have thrown everything up). I suspect that if you stop mixing the formula with the Nursery water, you will see those episodes stop.

      Personally, I never gave my children nursery water. The topic of added flouride is actually a hotly debated at the moment. We live in an urban area, so the city water is treated, and I can see in the yearly report that I don’t need to add anything. If you live in a rural area, you may want to consider the flouride water, but not probably until the first birthday has passed. Hope this can help!

  35. Wendy Ahmad says:

    Hi! Love your articles! So here’s my dilemma . My 3 month old was exclusively on breast milk ( pumping every 3 hours because he never latched) he started arching his back and screaming bloody murder during every feeding! I thought it was something I was eating so I cut back a bunch of stuff and nothing change. So unfortunately I stopped pumping. My Pedi suggested gentle ease but made my LO super gassy! He would cry and cry so here came the gas drops and tummy massages at 3 am. Then I noticed he started to spit up, sometimes formula and sometimes clear stuff way after feedings. Dr said he had reflux. Put him on a medicine 2 times a day and it didn’t work. So he gave me Prevacid. No more arching of the back episodes but now he is gassy doesn’t want more than 2 ounces. He will eat more if I put cereal in it but I think that’s what makes him gassy and constipates him. I’m currently on gerber gentle per your blog. Liquid kind. So should I keep using GGS formula, with rice cereal ? What are your thoughts about oatmeal? Also what do you think about gripe water?

    • Wendy, I’m so glad the blog is helping you! I do recommend gripe water, but understand that for some babies it works great! while others not at all. You just won’t know until you try.

      Have you tried Good Start Soothe? That would be worth experimenting with.

      I don’t usually recommend adding cereal to formula unless you’ve tried the formulas in this article already, and it’s clear you need a hypoallergenic formula. There are no thickened hypoallergenics right now, so in those cases adding cereal may be the best choice.

      I would either give Soothe a try, or a prethickened formula like AR above. Hang in there, I know this is hard, but you really are doing great,

  36. Woah Nelly says:

    woah, lots of comments here.. just wanted to say that (in South Africa), a product called Bennets Colic Mixture does wonders

    and btw, the quote was from Macbeth.. or some Shakespearian play

    • Woah, good score on the quote! ;) 50 parent points! I haven’t heard about that mixture, but it sounds wonderful. I’m definitely going to do some research on that. Thanks so much for recommending it,

  37. My 7 week old started on Enfamil Gentlease formula due to fussiness and gas. The fussiness didn’t stop so we switched him to Gerber Good Start Soothe a few days ago. I want to say about 3 weeks ago he started getting more and more difficult to burp. He arches his back and cries uncontrollably, so from the sounds of it he has reflux. Should I switch him to Enfamil A.R, or Similac Sensitive, or another Geber Good Start formula? I have an appointment with the pediatrician next week. He doesn’t cry at the sight of the bottle and drinks it with no problem. He just cries when I stop feeding him to burp him. It’s impossible to burp him. He does spit up on occasion. Sometimes the spit up just looks like formula and other times it looks to be curdled. And when you mentioned silent reflux…at times whe I burp him it does sound like he is spitting up but he doesn’t actually spit up, so I wonder if he is swallowing it. I am wondering what I can do to help him until my appointment next week. Thank you for your help.

    • hmmmmm….have you tried using gripe water? Is he constipated?

      I would be surprised if it’s silent reflux, since he doesn’t seem to try to avoid eating, or cry a lot during/after feedings. However, I do think you’re right about the gas bubbles. Which bottle are you using? I’m currently doing a ton of research on baby bottles, so it could be that he’s not “clicking” with the bottle you’re using, and is swallowing too much air.

      • I have tried using gripe water and there is no change with that. We have been using Colic Calm gripe water. We are using Dr. Browns bottles. He has always preferred that bottle, as we have tried them all. He cries during feedings when it comes to burping, but other than that he doesn’t cry. I nursed with formula supplements for 4 weeks, and as soon as he went on full formula he spit up. He doesn’t spit up every day, but enough to make me worry. He has spit up during the feeding, after the feeding and sometimes hours after a feeding. He also during feeding has choked as well, which also makes me nervous. At times the choking is so bad, he can’t get his breath.

        • Hmmm…In that case, I would give the Enfamily AR or Similac for Spit Up a try. Hang in there, Eden. The choking is so scary. (Hugs). If the AR doesn’t help, I would try a hypoallergenic formula. Frequent spit ups are usually related to reflux or milk intolerances. Try the AR for the reflux, and then give Plan D (hypoallergenic) a try if that doesn’t work. We’ll get there!

  38. Hi there,
    I am breastfeeding right now and supplementing with one or two bottles a day of Nutramagin in the evenings just to give my self a break as breastfeeding has been very uncomfortable for me and can last an hour since my LO is a slow eater. With a four year old at home in the evenings, I don’t always have an hour to breastfeed. Problem is my LO spits up after every feeding, whether bottle or breast. It is usually with chunky digested bits in it as most of the spit up happens an hour or so after eating. He m ay spit up every now and then with the burp, but it happens more later. I try to burp very well but it seems to happen no matter what. Most times it’s enough to soak his arms or top of his clothes and other times it goes down my back completely. He is also very gassy, and seems to be the worst when I am trying to soothe him to sleep either day time or night time. He will just get red-faced and cry, arch his back and kick his legs out. THis is very disheartening to see and is so frustrating that I am filled with anxiety over it. Also, unless he falls asleep in his car seat or in my arms after BF he will only sleep for 20 minutes or so before waking up and crying if he’s put in his swing to nap. I wonder if he is waking up with a pain or something and can’t stay asleep? he also as a lot of hiccups after spitting up. Do you think this is acid reflux? Would switching from BF to formula make things worse? I am considering moving to formula soon My DD was formula fed and while she did have some gassy episodes, she did fairly well on the formula. I don’t know, perhaps it is some kind of food allergy? If you have any advice, I’d appreciate it. I have an appointment this coming Monday with the pediatrician but I am feeling so anious to know what is going on with him so I can help.

    • Christal, I think before you try to work on his sleeping, you’ll have to get his feeding issues solved. I think that may be the reason he’s having a hard time sleeping. My guess is that since he’s spitting up so much, he’s hungry a LOT, which may be waking him and making him fussy. It’s my hope that if you can get the food to stay down, he will feel full longer, and some of those sleeping issues may resolve themselves.

      That said, since you’re combo feeding, it’s really hard to figure out what could be causing the spitting up. Is it something you ate? or is it the Nutramigen? I think the Nutramigen is an interesting choice, since it is designed to help babies who are allergic to cow’s milk. Cow’s milk is closely related to breast milk…so I’m wondering if the Nutramigen is reacting negatively with the breastmilk in his tummy?

      hmmmm….thinking this over, I would recommend switching to Good Start Gentle first, for your combo-feeding, and then give that a few days to see if there are any improvements. (Unless there was a medical reason and your doctor recommended Nutramigen??) If he does better, than we have the culprit. If not, we’ll have to try something else. Hang in there, we’ll figure this puzzle out. :-)

      • Thanks Heather. The only time he gets the Nutramagin is the nightime bottle, and if for some reason I dont have expressed milk, but that has only happened once or twice. Its almost always the expressed breastmilk. Do you think the 3 ounces or so of formula would upset him all day when the rest of the feeds are breast? Thats why I think he may have the reflux since he is spitting up and then has hiccups after. He also smacks his lips a lot after the feeding and seems to be swallowing something that bothers him.
        Also, on the Nutramagin, I only bought that because the lactation consultant said it was the least worst of the formulas. In the beginning I had to supplement with formula because he was tongue tied and was not gaining weight due to not transferring milk from my breast. We were able to correct the tongue tie and now he is feeding better although it takes him a looong time to eat.

        • Christal, you may be right about the reflux. Hopefully your doctor can shed more light on that on your appt. Monday. Your lactation consultant…hmmm…”least worst of the formulas” I’m not sure I would take formula advice from her, since it sounds like she has some passionate feelings about using formula in the first place (Forgive me if I’m wrong, but that would make me feel very anxious about breastfeeding, which would tank my production – my milk supply was very tied to my emotions. :-) ) That’s a “pressure to preform” that you don’t need right now.

          Formula is just a another way to have a healthy baby. (Show me the evidence that 100% of all Harvard grads were breastfed, and I’ll jump on that “everyone must breastfeed or they suck as a mother” bandwagon. But unfortunately, that evidence just isn’t there.) It’s one of the blessings of living in the 21st century.

          My guess, right now, is that it’s not the formula (although I would stop overpaying for the Nutramigen if he doesn’t need it. Good Start Soothe or Gentle would probably work and be a lot less expensive.) What if you pumped and added a little rice cereal (like a teaspoon) into the expressed milk and gave him that? If it is reflux, that could help keep it down. Give your doctor a call today and see what he thinks about that idea, and how much to add. Hopefully this will help. You’re doing great there, Christal. You are the best mom for your little boy. :-)

  39. Trisha Jones says:

    I have been reading this…..it seems like most comments are about babies much younger. I have a 5 1/2 month old daughter that constantly spits up after bottles. She is currently on similac isomil due to being very fussy and gassywhen she was 2 months old and of course the constant spit up as well. She constantly passes gas and her poops are pretty solid ( I can handle that) what I cant handle is the constant vomiting or spiting up after bottles. Even 15-20 minutes after drinking shes still spitting up. We live in bibs and burb rags its crazy. She has been on solids now since 3 1/2 months and shes dosent spit up the solids which makes me think she needs to switch maybe to enfamil A.R???? If I do that, would I just slowly introduce the new formula and mix them until I change completely??

    • Trisha – I think your instincts are spot on. Give a switch to AR and see if that helps. And you’re also right again – introduce the formula in stages for a few days, it should help her get used to it. Well done, mom!

  40. My LO is 2.5 months old and suffers from silent infant reflux. For the first 24 hours after birth he was on similac advance and spit it up really bad. Once he turned 24 hours old he was switched to similac sensitive, he done wonderful on it. The reflux was our only problem on it. His ped recommended to switch him to enfamil ar, which I did. Now he Is suffering from constipation and I can’t really tell that it has helped his reflux. He has been on it for 5 day. Should I try similac for spit up?

    • Two things: to help with the constipation, add a teaspoon to his bottles for a day and see if that helps. If you still can’t tell, go ahead and switch to Similac for spit Up and see if you notice an improvement. The good news is that you should be able to switch right away, and not have to do a slow transition. You’re doing great Mom!

  41. My daughter doesn’t spit up every time she eats, but when she does, it’s a lot and come spraying out of both her mouth and nose. We are going to try enfamil AR, but are wondering if it will flow easily through a slow stage 1 nipple?

    • I haven’t heard of it being an issue with the stage One nipple, but if you think it’s a problem add a teensy weensy more water. Hope the AR can help Ashley, poor baby girl!

  42. We just switched from Similac Sensitive to Gerber soothe for our 8 week old. She was very uncomfortable with the Sensitive. She’s having a hard time getting the Gerber down as it’s so much thinner, any suggestions?? Thanks!!

    • Cara, you could sprinkle a little extra formula in the bottle, and see if that helps. If she’s still having trouble in a week, you may need to shift to a new strategy. Let me know and we’ll come up with a Plan B. Doing great though, Mom! Hang in there!

  43. I also thought my baby had silent reflux and was told 3x by my pediatrician that she just had a sensitive tummy. She wouldn’t sleep for more then 20 min, had horrible painful gas, would only sleep on my shoulder sitting up, could not even be laid down for diaper changes, but not spitting up so all was ok according to the dr. I noticed that she was wheezing onmilk based formula and switched her myself many times until nutramigen seemed to be an expensive godsend. Also, she was finally diagnosed after she started gasping when I would lay her down and I took her to the ER scared out of my mind for her. Found out silent reflux was burning coming up and taking her breath away. I do want to say that probiotics and gas drops helped. but for 3 months she slept in a rock n play sleeper or on my shoulder. :( at 9 months almost like it never happened.

    • Wow Jen! That’s so stressful! I’m very thankful, though, that she’s doing better now. Very encouraging for other reflux-suffering parents to see that this does pass! Thanks so much for sharing it!

  44. hello, my baby was borned at 29 weeks after 21/2 months at the hospital. we went home he was fussy all the time, arxhing, bubbles in the mouth, hiccups not sleeping at night. but he wasn’t vomiting. ths pulmonologist ordered zantac which made the reflux worse. so the gastroenteroligist order nexium and carafate. it helped him for a couple of weeks but now he is vomiting, projectile vomiting 2-3 times a day and spit ups almost after every feed. he is 4 montha now and instead of getting better he is worse. he… is taken similac neosure since he got out of the hospital alternating with breast milk. I stopped the breast milk cause he will vomit more with it. even with rice cereal. I dony know if chamging the milk willl jelp him amd will give him eveeveything he needs bsing he is premee. please let me know what you think about my situation. I barely sleep cause im afraid he will aspirate. I elevated the head of the bed dont know what else to fo cause. he doesnt stop spitting up or vomiting now

    • Bless you Yahaira! What an ordeal! Talk with your doctor about using Enfamil AR or Similac for Spit Up. Since they are thicker formulas, they can really help reflux babies keep the formula down. A few readers have also reported that this Hylands product has helped their baby with reflux. Also something you could try. Hang in there, Yahaira! It’s going to get better.

  45. Hi. My son is now 4.5 months old. He had a complicated history with needing open heart surgery at 13 days old and since then has had terrible reflux. He is on zantac and prylosec and maxed out on both meds for his weight at all times. He is also on Prosobee due to milk protein allergy (blood in stool). His reflux is getting worse and worse, and he had a scope down his nose because he is having such trouble breathing/gagging/coughing and basically his mouth/throat is a mess from the reflux. We are waiting 3 weeks to see GI and our pedi has not been super helpful. Do you think we should switch his formula? He is also super constipated always and needs pear juice to go to the bathroom without it being hard balls. Thanks for any advice!

    • Oh Heidi! What an exhausting (emotionally and physically) five months! Massive virtual hugs cyber-flinging your way. :-) It’s possible he could do better on a different formula. I’m wondering if he would do better on Nutramigen AA, Neocate, or Elecare. (Details on those here.) They are hypoallergenic: dairy and soy-free. That said, it’s not going to help much with the reflux. All the reflux formulas I know of are dairy based. You would have to add a thickener (like rice cereal) by hand.

      Due to his previous health issues, though, I wouldn’t do ANYTHING without running it by your Doctor first. If your pedi isn’t being helpful to you, start doing some research to see if you can switch to someone else. A supportive doctor takes away a lot of stress! :-)

  46. Stephanie says:

    Hi Heather! After searching the web for the magical answers I have found that your blog is the best. My question for you is, my daughter is 6 months old and she has just developed eczema or it has just started to flair up. Never was a problem before now. I have taken her to the dr and they have gave a steroid cream but said to discontinue after a week because it can thin the skin. So I have opted not to use it and use aquafor. Seems to help. But the kicker is, when she eats oatmeal or rice cereal it seems to flair up! Is this common? Second question, I have been thinking about switching her formula (Gentlease) to a different formula because of her AR. She is on Zantac and has been since she was 6 weeks old. Is there any one formula you would recommend for AR and eczema to keep it at bay? Thanks so much for any advice. BTW I LOVE your blog. I have found more helpful info on here than any other site.

    • Stephanie! What a sweet encouragement you are! Thank you! I’m just thrilled to be able to help. Those baby days can be so tough! Two things. Firstly, it sounds like an allergy may be present. It’s true about the steroid cream, it can thin the skin, so it’s good to give Aquaphor a try. (Put it on immediately after you’ve pat-dried her after a bath, it’s most effective then.) That said, my kids were given a cream that I mix with vaseline and it is NOT a steroid. So if it doesn’t improve, ask your doctor about that. (If he doesn’t know what I’m talking about, let me know and I’ll grab the actual name. Don’t have it here with me at the moment.)

      As for the AR – I’ve heard several people speak favorably about the Enfamil AR – that it was helpful to them. Try that first, then try the Similac for Spit Up – and if you’re still having issues, let me know and we’ll come up with Plan C! Thanks for the comment, Stephanie. I’m always happy to help when I can! And thanks SO MUCH for reading!

  47. neocate.FORMULA. reflux treatment ,colic treatment ,nothing worked.afer 3 months of screaming 7 days a week 24 hours a day with a baby that would sleep only for 10minutes out of exhaustion before waking for the next round off screaming .i was told my baby was naughty !!!!!what.i went on a soy free dairy free and citris free diet.i was at my wits end.Then neocate was offered .Magic result straight after first bottle.

    • That’s great Fee! So glad to hear that you finally found a solution! Your story is encouraging and will give other parents things to try. thanks for sharing it!

  48. My daughter is 3 months and has reflux. It doesn’t seem to hurt her but, it will come out nose and mouth. Sometimes projectile. We switched her to Enfamil Ar and seems to work really well with her. Along with burping frex. We had her on a 2 oz every hr diet (with rice). Well I’m sorry for mother and daughters sanity we had to learn how to work that a little different. That is where the Enfamil came in. She can now take 4/6 oz and sleep regularly. If you are questioning I would deft try the AR and see if it helps.

    • Robyn, if she’s doing better on the Enfamil, stay on it. :-) I would only encourage you give AR a try if other, cheaper formulas, aren’t working as well. You did the right thing – every mom has to figure out what fits her family best, and it sounds like you’re doing just that. Well done. :-)

  49. After a few trials my 3 month old baby is on enfamil A for the past month. Spit up decreased however we still had painful reflux and gas pain with the formula and so he was just prescribed Zantac. Is it true that the AR formula is ineffective when on Zantac. I heard that bc Zantac decreases the acid the AR formula doesn’t thicken as it should. Is it better to transition to another formula and just add rice cereal? Is there a better formula to help the GERD along with using the Zantatc ( nutramigen didn’t work for us).
    Thanks

  50. Help please!
    I have been breastfeeding my little one since birth, he is 4 months today.
    I have eliminated dairy and soy for almost 1 1/2 months. I am now pretty much on a total elimination diet.
    I struggle to eat and I am sure that effects my milk!
    We have battled the food issues, and thrush (still are).
    He is currently on Prilosec OTC. Which is causing tummy issues, ( ie, cramping, green poops, new issue is black specks)
    I am over breastfeeding! I can’t do it anymore! I don’t eat like I should, my hair is falling out, and I am a real “B” (if you know what I mean)!
    Where do I go from here? GI said to stop breastfeeding and use Nutramigin a month ago when I asked to change meds. ( not real helpful!).
    I am now ready to change. Do you recommend starting Nutramigin first sine he has MSPI?
    Thank you for any suggestions!

    • Friend, first of all, don’t feel guilty about letting breastfeeding go. We all do at some point anyway. :-) Considering he is having such problems, I would recommend in your case starting with the Nutramigin, just so you can hopefully see some relief faster. Then after a few weeks or months, you can start trying other less expensive formulas and see what happens. BTW, Nutramigen isn’t the only hypoallergenic on the market, so if that one isn’t quite THE ONE, you still have options. Hang in there, things are going to get better!

  51. Hayli Danz says:

    Hi there! I’ve been reading everything on your site and I’m desperate for some insight! My baby is 4 weeks old. She started out on similar advanced in the hospital and did fine with it but we switched her to Gerber Soothe because my cousin had a lot she could pass to me. She was a fabulous, easy going baby for a week or 2. She started getting really irritable so we tried enfamil gentlease & she wouldn’t take it well. Then I noticed the acid reflux so we tried AR and she seemed worse so we went back to Gerber soothe with rice cereal added (as suggested by doctor). She is now on zantac and the 2 nights following, she slept GREAT! However, while the reflux seems better, the last 2 nights she has been awake screaming for 3+ hours. I can feel her stomach rumbling but I’m not sure if there’s anything I should do or change? Please let me know if you have any suggestions!

    • Hayli, I’m not sure this abrupt change is due to the formula, since she’s been doing better on the Soothe. …Unless you’re saying she’s been doing this since you switched back and added the rice cereal? Is she spitting up? or is it the gassiness that you feel is the crying culprit? If you noticed this after adding the cereal, remove the cereal for a day or two and see if things change. Then add just a LITTLE back in and see what happens. Then let me know if we need to pull together another round of ideas.

    • Hayli Danz says:

      I’m almost positive it is the reflux now. She is squirmy/fussy/ screaming all day long if she’s not sleeping. Doctor suggested doing zantac 3x/day instead of 2, but I’m not convinced that thats going to do the trick on its own. I’m going to try Colic Calm drops and if that doesn’t work, I plan to start Similac Alimentum. What do you think?

  52. jenna buttke says:

    Hello! So I exclusively breastfed until my Son was 3 months. He has always thrown up and the Dr diagnosed him with Acid reflux at like 4 weeks old. He was on zantac that didn’t work so he switched it to axid. (Sp) at 3 months Dr had me give him a bottle with cereal mixed in it because maybe my breast milk was too thin. This worked for a little until I could no longer keep up with producing then milk my son needed. I tried everything to up my production. So I had to switch to formula. I put him on similac sensitive and he did okay then started spitting up a ton. Also he gets constipated a lot so we have been giving him prune juice since like 2 months. I just started him on enfamil AR and he is still spitting up a lot( not as much) but still a lot. Also I noticed he spit up a lot more when I get him his medicine too so I stopped giving him it for a day and he spits up less. He has been eating solids too since 4 months and he is now 5 months old. Also he was starting to sleep through the night and since I switched to the AR he is back waking up at 3am to eat. I dont know what to do. Do I switch his formula? Do I give him his medicine? What about the constipation? Everytime I give him prune juice he basically spits it all up. I tried the prunes baby food today and he was Puking everywhere so I don’t think he can handle that well. Help!

    • Jenna, firstly, you clearly are doing a great job problem solving what could be causing him troubles and then trying “fixers”. That’s totally awesome. :-) Here’s what the options sound like to me: Combo #1: Give him Similac Sensitive plus medication = sleeps through night better, but spits up a lot. Combo #2: Give him AR and drop the medication = spits up less, consistently wakes up at 3am to feed. Combo #3: Try Good Start Soothe with medication = ????

      If you choose Combo #2 – try the Sleep Shuffle instead of feeding him at 3am, and see if you can wean him off that feeding. If you CAN, it seems Combo #2 may be your lucky winner.

      Now about the constipation…congratulations. I’m about to do something I vowed I would NEVER DO on this website. I’m going to link to an article on my OLD GERIATRIC website that I haven’t touched in years. I’m warning you, it’s hideously ugly, very disorganized, and should have a bright yellow “NEWBIE” printed across the top….but I’m trusting you can over look all that because some of the articles are actually really helpful, and until I get that subject written up here on this website it will have to do. :) So click here and read about the various ways you can treat constipation at home and then give some of those a try.

  53. Hayli Danz says:

    She takes the Gerber Soothe well and had no trouble for about a week. She then started spitting up a little but I didn’t think much of it. She spits up very frequently now. It’s not projectile, but it’s with every burp and even hours after she eats she’s spitting up multiple times. She is SO miserable and we’re hardly getting any sleep.

  54. jenna buttke says:

    Thanks Heather! What is the sleep shuffle? Right now I am still doing the enfamil AR and I started giving him his medicine again at 230am because he seemed in pain? He has spit up a little more today but not as much as before. Do the medication and AR formula cancel each other out? Lots of great tips on constipation too! When he takes a tub (every other night) I give him a baby massage and rub his belly. I always do the bicycle with his legs and it seems to help. Today he got his peaches and oatmeal and had a huge BM so that was good!!! I just hate seeing my little man in pain! He is sitting up better so I’m hoping this reflux will start to go away! Thank for all your info :) love your blog!

  55. We had tremendous success with the Similac for Spit Up. However, at the time we used it (with my now 2 1/2 year old) the powder form had been recalled so only ready to feed was available. EXPENSIVE!!! When the powder formula was available again, we tried it but it was difficult to get it to mix well. So, we just decided to bite the bullet and pay an arm and a leg for the ready to feed. It was a ton of money over the months but we decided it was well worth it for the baby to be happy (and for us to keep our sanity). :)

    • Thanks for sharing that Tricia! I’m amazed at how many parents have found the Ready-to-Feed premixed formulas to work better than the powdered. Thanks for adding your input!

  56. Hi, my baby will be 4 months this Thursday. She is on nutramigen because she was diagnosed with colic. She also takes medicine for eacid reflux and has been deemed a Happy Spitter. The nutramigen deff helped her colic and her sensitive tummy. I rarely have to give her gas drops anymore. But after 4 months of happy spitting I just want it to stop! She spits up 24 /7 …first its milk colored then when its almost time for her to eat again its all clear but doesn’t bother her. Should I mix her nutramigen half and half with the AR?? I’m just so scared to try anything new because she is doing so good with her tummy and gas issues on the nutramigen. Should I just suck itup and continue to change her bib 20 tines a day??? TThanks for your help!

    • Chris, what if you added just a teaspoon or two of rice cereal to the Nutramigen? That would thicken it up a little more and perhaps make the spitting up decrease. Give that a try and see what happens. *fingers crossed!*

  57. Our 6 week old is battling what appears to be silent reflux – minimal to no spit up, wailing cries during burps, congestion, that “phlegmy” sound in his throat, hiccups, etc. He is a happy baby for the most part, but his cries during and after feedings kills me. He is formula fed thanks to breastfeeding issues. He was on Similac Advanced but that made him terribly fussy. He’s on Similac Sensitive but that doesn’t do anything for reflux. The pedi told me to try switching formulas, so I’m planning to try Similac for Spit Up. I’m concerned, however, about the constipation factor. I had tried Babys Only Organic formula between the Similacs and he was backed up so badly he got a fissure. In an effort to possibly reduce the constipation that may come with the Similac Spit Up, can I mix it with Sensitive? Or would that not help at all for reflux or constipation? He has daily (usually) poops now.

    • Kristina, I would try the Similac for Spit Up, but I would add a little bit (1 teaspoon) of prune juice in his bottle once or twice a day, then see how the poops go. If they seem a little runnier than normal, cut back on the prune juice. If they seem a little harder- pebbly, then add the prune juice to his next bottle and see what happens. That way hopefully we can take care of the spit up AND the constipation in one go. Let me know if it’s not working though, and we’ll come up with a new plan.

  58. Hello –
    I am almost certain my 1 mo old daughter has silent reflux. She is incredibly fussy when she is awake which most of the time is for feedings. She gets the hiccups pretty much after every feeding. She does spit up from time to time and when she does, it isn’t much. She will only sleep on her belly or propped up on my husband or I. Oddly, sometimes she just likes to lay on her back on the floor. She has no problem drinking a bottle as I’ve heard lots of moms say the baby turns there head to the bottle. The ped prescribed he generic zantac, 2x per day at .5 mL each time. It seemed like it was helping her a few days in and doesn’t seem to be helping anymore. I put her on nutramigen yesterday and it seemed like it was making her even more unhappy so I went back to gentlease. What do you suggest? Should we try Enfamil AR along with the zantac?

    • Mary, I think you’re instincts are good. I would try the Enfamil AR or the Similac for Spit Up and see if that helps. But firstly I would try Good Start Soothe – it’s very gentle and less expensive. See how that affects her, then use the AR and Similac for Spit Up as your Plan B and C. This will get better, Mary!

  59. Im trying to find what is best for my LO. He is 5 weeks old. When he was born he started with enamel newborn since i had a lot of trouble nursing and he did fine with that until he was 2 and a half weeks old. He was diagnosed with GERD and was put on zantac 2x a day. He was never a heavy spitter and does not consistantly spit up his meals. He is wheezy and grunts and snorts most of the time, usually around feeding or after, frequent hiccups, fussy and extremly gassy. I have tried a couple formulas since:gerber soy which was recommended by his pedi. He spit up occasionally with that but stopped pooping. we have been giving him prune juice as directed but does not always help which makes him uncomfortable. He does not cry very often, just whimpers and and is super fidgety and strains to try and poop. We have also tried similac sesitive but he is the same on this one as well.Our pedi also had us try nutremigen but we are not positive he has a milk protien allergy and I dont think he is colic even though he is fussier at night. We tried it today and he struggled taking an oz- spitting it out, and shaking his head, and did not take the bottle at all. Im wondering if we should try enfamil AR because it is thicker but wondering if it will help with his reflux. What are your thoughts? He has not been diagnosed with a milk allergy.

    • Kelly, I think your instincts are good. Try the AR and see if that helps. The thicker formula may really help him. If that doesn’t help, the Plan B I would suggest is Good Start Soothe. It’s the most gentle non-hypoallergenic on the market. Then let me know if we need to come up with a Plan C. Hang in there!

  60. Hi my daughter is 4 mo old and I suspect she may have silent reflux. We put her straight away on soy formula since she was born and has always been a fussy baby which I assumed was just colic. She’s been less fussy but still spits up a lot- like 2 hrs after a bottle she’s still spitting up. Also putting her to sleep is such a battle. She screams and cries until you get her in a right position and Is constantly swallowing and getting herself upset. She cries a lot when pooping but it comes out creamy and she only poops 1-2x a day. I’m thinking of switching her to dairy formula but wanted to know if you thought it would make a difference? Also does it sound like reflux?

    • Maggie, it does sound a little like silent reflux to me. I would try one of the formulas above, that are pre-thickened and see if those help. They are designed to thicken up in the tummy so they’re harder for her to spit up. She doesn’t sound constipated (since it’s creamy). Also, some babies only poop 1-2x a day, and some babies poop every OTHER day, and some babies not for SEVERAL days. Use the consistency as your guide – if it’s harder than peanut butter add a little prune juice to help soften things up in her bottle. Hope this can help!

  61. Hi
    My little girl, two months old, has reflux. She was diagnosed with reflux as she started vomiting after almost every meal when she was 4 weeks old. We started AR formula and the vomiting stopped however all the symptoms of reflux continued. Reflux turned into silent reflux And I could hear her re-swallow milk.
    The pediatrician then suggested a hypoallergenic formula. We started using it and the vomiting started again. As soon as we put her to sleep she would start chocking. I had to hold her during the day and during the night in my arms. She slept on me as she would wake up and cry when placed on her back.
    I suppose the reason is that the hypoallergenic formula is not thickened. My husband and I panicked with all the vomiting and decided to try another AR formula after only two days. She now seems to have silent reflux again! I am wondering if we gave up on the hypoallergenic formula too quickly.. ? How much time should we give for it to work? Please let me know what you think, my little one is suffering :(
    Thank you
    Anna

    • Anna! How scary and exhausting! I would ask your doctor if you could either A) mix in a little of the AR formula with some of the hypoallergenic formula or B) hand thicken the hypoallergenic just a little with rice cereal. Ask your doctor how much he would recommend you add to get the right consistency. See what he thinks of those options. Keep trying things! Not only does it increase your chances of finding a solution that works, it will give you a sense of hope through this difficult time.

  62. My son is almost 3 months old. He was diagnosed with silent reflux. I am looking for the best formula for him. He is currently on Prevacid 7.5 mg solutabs. I have tried Similac Advance, Similac Sensitive, Gerber Good Start and Similac Alimentum. He seems to do the best on the Similac Advance. However, it seems like he wants to eat all the time. Sometimes drinking up to 7 ounces at night. I know this can be because of the reflux. He doesn’t really ever spit up. He is a happy baby unless he is feeding. Then he kicks his legs like crazy and turns his head from side to side but is still hungry. It makes feedings frustrating for both of us. I am scared to try the Similac for spit up due to the chance do constipation. He isn’t a very good pooper on any formula. Do you think this formula would work for silent reflux and worth a try? He starts daycare in 2 weeks and I sure would like to see him better at feedings when I take him there.

    Thank you,
    Jodi

    • Jodi, I can’t say for certain that it will work for silent reflux, but I can share that I know that it has worked for other reflux babies. As for the constipation…oftentimes that is something you can work on. Like adding some prune juice to every bottle, or other techniques to help keep things softer. I would discuss your idea to switch over to spit up with your doctor, and get his thoughts on your constipation concerns. Then follow the mobster’s advice to slowly do a switch, if you decide to. He also could be going through a growth spurt (common at 12 weeks) and is eating more than normal because of that. Did his hungry-all-the-time appetite peak recently? Hope this can help!

  63. I have a question! So happy I found this and read everything. My LO is 10 weeks (5 week gestational) and has been on nutramigen due to allergies she experienced with other formulas. I honestly can not tell if she is just colicky or has silent reflux. It’s not every feeding but some feedings (usually evening or early am) she will drink a couple ounces and then scream and take awhile to finish. Also sometimes (usually when she’s awake between feedings) she will act like she’s starving 2 hrs later. She will cry off and on. I thought at first it was mostly afternoon and evening but just depends. She does have a cough here and there and seems stuffy constantly. Gets the hiccups a good bit. And she spits up when burped almost every time. Sometimes she is easy to burp. Sometimed very difficult. But she does pass gas quit often! I asked doc this week and they said to just watch to see how she is. Whether it gets better or worse jn next couple weeks. But I don’t want her in pain :/ so I can confused on which it could be. Considering its not every feeding etc. Any input is very much appreciated! Thanks

    • Ashley, I would seek a second opinion. Some of those symptoms could be linked to acid reflux. I would see what another doctor says, if it is medication might be able to help. You could try one of the thickened formulas above, but I would wait until your doctor has looked him over first. If he has allergy issues, you don’t want to switch only to discover that the thicker formula triggers an allergy, and wasn’t needed in the first place. :-)

  64. My son is almost 3 months. We have been on several formulas from similac advanced to similac sensitive, to similac soy, then nutramigen, now on evecare. Plus been on 3 past medicine and now on 2 different ones. He fights to eat…be gags, pushes it away, and screams. I know he dont like the formula. He sees a specialist for acid reflux. He still throws up, regurgitates, screams, but wants to be happy. He also has problems with constipation. What can we try next? Maybe we can get the doctor to try…I’m tired of my baby being sick. Plus I can’t leave him with a babysitter due to I don’t trust they will see him choking in his sleep because it’s silent so I’m not working still…Please help!

    • Lisa, I would strongly encourage you to go back to your doctor and tell him these things aren’t working and you need a new treatment plan. If it seems that’s going no-where, look for a second opinion. If you can, look into seeing a pediatric gastrointologist – they have MUCH more experience in these types of situations than a normal family doctor or pediatrician. There are answers out there, we just have to push until we find them. There is hope, my friend. Keep being the awesome advocate your little man needs. I know it’s exhausting and discouraging, but you are fighting a good fight here for him. He’s very blessed to have you.

  65. Hi! Your site is my new addiction! It is so helpful and well written! (And it gives me a few chuckles when I’m up all hours of the night! The Muppets and breastfeeding…pure genius, and of course I have an Animal!) And of course my little guy has an issue…or two, or maybe more in my sleep deprived paranoid mind. He has recently been diagnosed with silent reflux (as my first son had it as well…he also had a milk protein allergy, but unlike my seven week old term baby he was born at 28 weeks…not sure if either of these could be genetic or just coincidence?) This is such a guessing game for me this time…I had a while NICU staff addressing all issues before. Anywho…my seven week old is breastfed and supplemented with formula (originally Enfamil newborn, then gentlease, and transitioned to Gerber soothe two days ago.) Besides the reflux, he is very gassy and fussy and cries out frequently in his sleep (a few times an hour.) What could be causing this? My ped seems to think th Gerber formula will help address this…I’m trying to be patient as I know it takes some time to work, but Momma is going back to teaching soon and I need some sleep too (our longest stretch without crying out has been 45 mins!) My kids will eat me for breakfast I’m this zombie like (no, literally they may…who’s bright idea was it to assign Lord of the Flies while I was on leave?!) Any suggestions would be tremendously appreciated!!

    • LOL – Thanks Jenn! I’m always happy to hear I can make other people (besides myself, husband, and parents) chuckle. :-) As for the formula, I would stay on the Soothe for at least a week before switching, that will make sure any reactions are due to the Soothe and not the residuals to previous formulas. Also, do you have him sleeping on an incline? There’s a “U” trick I shared in this post that shares how to incline the crib mattress slightly without having him roll to the bottom like a cute sliding caterpillar. If after a week you’ve seen no improvements, talk to your doctor about using one of the prethickened formulas above.

      BTW, you get 50 bonus points for two excellently linked references – zombie with Lord of the Flies…LOL. (Are you always this much fun when exhausted? :-) Very thankful to have you part of our little community, tucked in an obscure corner of the Internet! :-)

  66. I have a 3 week old baby girl. Just last week at her 2 week old check up her doctor told me she had GERD. Her doctor gave me enfamil A.R to try it has helped with the spitting up but got really constipated and she was having trouble pooping. I ran out of milk and gave her similac advance what I have been giving her since she was born. I Don’t know if it’s still the GERD or because I switched her milk I have tried the orange similac for fussiness and gas but I just don’t know what I can do to help her not be in pain. She constantly cries at night and arches her back and spits up. It’s normal for baby’s to spit up but I’m not sure how much is normal. Do you think changing bottles would help or is it the milk??? I am scared to keep trying different milks because if her little sensitive stomach. Please help me I would really appreciate your advice!!

    • My guess is the Similac isn’t thick enough to stay in her tummy so she’s spitting it up and it’s burning her throat. (Heartbreaking!) My suggestion is to go back to the AR and talk with your doctor about different strategies to help with the constipation, like perhaps adding a little prune juice (1tsp) to the bottle to help. But I would definitely talk to him about that, she’s very little, so any adjustments should have a doctor’s approval. Then, if you run out of AR again, ask your doctor if you can thicken the Similac by hand with a little rice cereal. You’ll want to stir it in, with a spoon, and avoid shaking the bottle (which creates air bubbles babies can swallow). He can again help you with the specific amount of rice cereal. Hope this can help, Yolanda. You’re doing a fantastic job being her mother. Hang in there. (hugs!)

  67. Hi,

    So my daughter is 3 months old today. She has already had an upper GI done which proved her reflux but confirmed that there is nothing else wrong with her in terms of things being twisted or getting backed up etc.

    We started her on similac sensitive because my other 2 were on special ones, nutramigen and alimentum. So we tried the sensitive which I thought she was ok but then started having issues so we put her on Similac Soy. She seemed to be ok with that but her spit up was projectile at least 3 times a day and I was constantly worried about her choking on it since she had choked once before. So the doctor decided to put her on Alimentum. We also went through Zantac which helped for about 2 wks. Then we changed her to prilosec. She is still on it but still having major problems with the spit up and choking. We must change her outfit like 4-5 times a day just because of how much she soaks her bibs/outfits. I know spit up is normal for babies but I am not sure if this is excessive or not.

    I can’t change brands of formula because we are on WIC and they only work with similac and that is it. The doctor has also said, do 1 tsp of cereal for every 4 oz of milk. Ok well she went from drinking 5 oz of Soy every 4 hrs to now doing 4oz of alimentum every 4 hrs. She was having spit up problems so the doc said to do 2 tsps of cereal for the 4 oz of alimentum. But the problem with this is..it isn’t working and she is still insanely constipated.

    I have not gotten any sleep. Yes I know infants are supposed to wake up at night but she wakes up every three hours for the next bottle. We feed her, it takes an hour to put her down because of the reflux and then she is out for the next three hours. This is her night. During the day it is sometimes the same and some times she doesn’t sleep at all. She sleeps in her swing because she can’t lay flat and hates her crib despite the mattress being raised. She can’t sleep with me because then I won’t get any bit of sleep at all.

    Needless to say I don’t want to resort to surgery to fix this problem. That is not an option in my book. But I am in desperate need of sleep but also in need of figuring out a good solution so she can sleep and be comfortable.

    • Wow Alison! You’ve certainly had a crazy stressful few months! I can’t speak specifically about her GI issues, since I don’t have a medical degree. My encouragement with that area is to to discuss those concerns with your doctor, and if you feel you aren’t going anywhere with that, feel comfortable to seek a 2nd opinion.

      I would let her sleep wherever she sleeps and don’t feel a second of guilt about it. Right now, the goal should be 1) work through her reflux issues more with your doctor so she’s eating better and spitting up less and 2) Survive, doing whatever it takes to get as much sleep as you possibly can. They do have these special bean bags that help babies sleep sitting up (but help wean away from getting addicted to swinging). You could try one of those. These months are insanely hard, and although I’m sure it feels hopeless at times, you are, every day, pulling a little closer to the edge of the pool. Keep trudging through…and you’ll start to feel the sand beneath your toes at the shore. And of course, me and the other Incredible Infant readers are here to encourage you. (hugs!)

  68. Heather,

    Love your site. Thank you so much for providing such great information.

    My little guy is 20 weeks. He does not have reflux, but he spits up constantly. He is a happy spitter, I’d say. I’ve tried to figure out if there is something in particular causing the spit (feeding position, type of bottle, etc.) – but I can’t notice any patterns.

    Sometimes he spits (lots) right after his bottle, and he also can still spit up hours later (curdled spit, yuck). We are currently on Kirkland (Costco) house brand basic formula, which is comparable to Similac Advance. He has been on this formula for about 3 months now, but the spit up has really increased in the last month.

    While I’m super glad he’s not in pain, I am going crazy with the spit up. Today, we went through 10 bibs and 8 outfits in 12 hours!

    My questions:
    1. Do you think that non-reflux baby who spits a lot could benefit from either Enfamil AR or Similac Spit Up?
    2. I normally mix bottles as I go (right before feeding baby) using room temperature water. Do you think there’d be any benefit in pre-mixing and using a bottle warmer? It just occurred to me that perhaps that may have an effect?

    • Katie, so glad that you’re find the website helpful! It’s very common for spitting up to get worse between the 4th and 5th month. I think you’re instincts to give the thickened formula a try make a lot of since. While it’s good that the spitting up isn’t irritating his esophagus, thickening the formula may cut down on the problem. I would experiment with your pre-mixing and warming idea and see what happens. Try it without for a week, and then try it the other way the next week and see what happens. :-) (Let us know if you notice a difference! Other parents may want to give that a try as well.

  69. So glad I stumbled upon this! It’s comforting to know that we’re not alone. Here is my dilemma. My daughter is one month old. I was breastfeeding and supplementing with Similac for supplementation. At about two weeks she started spitting up a lot and forcefully. She would grunt and strain until it came up. Burping was almost impossible. Bowel movements were normal. Took her to the doctor and they diagnosed aid reflux and started her on .5 teaspoon Zantac. Worked for about three to four days. Called doc, switched the formula to Similac for spit up, stopped Zantac. She threw it up as soon as it hit her belly. Strictly breastfed for a couple of days, still straining and grunting and excessive spit up. Called the doc, they thought dairy allergy. (Brief history-my seven year of has a compromised immune system due to severe allergies, he has the immune system of a three or four year old. When diagnosed at two his food allergies included dairy, oat, legumes, tomato, coconut, sesame seeds, onion and all nuts, we were told by his immuneologist that our newest addition would probably have food allergies but there was no way of knowing what they would be) Anyway, started on similac soy exclusively per docs orders. I continued to pump. Instant difference! Well that didn’t last! I was asked to eliminate dairy from my diet. I had gastric bypass and rely on protein shake and bars for a good portion of my nutrition. So I stopped pumping, cried, dumped about 30 ounces of milk from my freezer and cried some more. Now it almost seems just as bad if not worse than when it all started. I’m at a loss. She still strains and grunts a lot. Her bm’s are sticky and sometimes a little hard. She does burp better now but is spitting up more and more. She’s gaining weight good. I thought maybe we were over feeding her so we cut back. I’ve snuck and nursed her at it doesn’t seem to make things better or worse. Wondering if it really is a dairy allergy or acid reflux or ??? Please help!

    • Jessica, it’s often hard to stop breastfeeding. Especially if you feel you have to stop before you planned. That said, be encouraged that everyone stops at some point…so you’re no less a “good mom” because you stopped early. You sound like a great, attentive mother. Did the doctor check to see if there was blood in the stool? (A common dairy allergy sign). Another thing that doctors will suggest is to give your baby probiotic drops with L. Reuteri in them (here’s some on Amazon). Those have shown to help babies with colic and reflux signs. I would also take your story back to your doctor and get his thoughts about switching from Zantac (which makes the spitup less acidic) to an inhibitor like Prevacid or Prilosec (which actually prevents the spitting up. Prevacid and Prilosec have some side effects, and they’re only short term solutions, but it may be a helpful conversation to have with your doctor. You may also want to discuss using a hypoallergenic formula like Alimentum or Elecare or one of those, if the thickened formulas don’t seem to be helping. Hope this can give you some encouragement, Jessica! You’re doing a great job!

  70. Hey I have a question, my son who is going on 7 weeks his pediatrician diagnosed him with milk/soy intolerance I have him on alimentum for about 3 weeks now as well as Zantac for acid reflux. He seemed to be doing well these past 5 days finally not colicky or pains in his belly so today I tried putting oatmeal baby cereal in his bottle like the doc said because he eats about 32oz+ a day and I find that he had a lot of pains today.. I want to know should I try it again or wait until he’s a bit older. I hate to see him in pain but I also find he’s eating way too much i just don’t know what to do.

    • Sara, firstly I would share this with your doctor, so he knows what’s going on and can give you some suggestions to try. One option is to use rice cereal instead of the oatmeal. Oatmeal can be hard for some babies to digest. Also, if this continues to be an issue, you could also try one of the pre-thickened formulas mentioned above. Hang in there Sara! You’re being a great mom. It’s hard to know what to do sometimes, he’s just so little and you’re just getting to know each other! That said, you’re doing everything you SHOULD be doing: finding answers and comforting anyway you can. He’s blessed to have you!

  71. This article was quite informative and I absolutely appreciate the time you put into sharing such valuable information. I have a little girl turning 5 months in about a week. I was strictly breast feeding her at birth but noticed she kept spitting up. Being that she’s my third child, I thought I could surely master the situation but have failed greatly thus far. I kept her propped up, even use the rock n play for her to sleep in, tried a papasan swing, a wedge under her mattress, burped her during and after feedings but was still not succeeding. Her weight gain was right on track so the doc said not to worry. I took her to another doc and explained that I can hear it coming up in her throat, her eyes well up with tears, and she begins gulping very hard before a spit up. She said it was certainly reflux. So I had to stop breastfeeding at 3 months which was very hard for me. We went straight to the AR formula and saw no change. The doc also prescribed Zantac but still no change. Sometimes it comes up and she just swallows it quietly and tearfully but mostly she actually spits up. Sometimes she spits up a clear frothy slimy substance but most of the time it is white and milky, sometimes even curdled. I do not let her be jostled in any way and have not noticed any difference in waiting 30 minutes after a feed or an hour and a half. It just always comes back up no matter how still or propped up I may keep her. As she has gotten older she has been harder to keep as still after a feeding as she wants to kick and roll around. She never eats more than 4 oz at a time either which has in some cases led to more frequent feedings, sometimes every 2-3 hours. Her poo is sometimes mushy but at times so solid and difficult for her to pass that I have to help her with a q-tip and Vaseline and a happy distraction as she works on it. Her belly seems tight at times as well and she is an absolutely pleasant baby but gets irritable after feeding, straightening her legs and fussing, sometimes gassy as well. As for her sleep patterns- she sleeps mostly all night with an occasional feeding once a night at times. I have introduced her to cereal and a few homemade whole veggies and fruits run through the beaba baby cook and she enjoys it but doesn’t want very much of it at this point. I give her a small amount of diluted prune juice once a day as well to assist with the constipation but still cannot get everything sorted out. I hope this was not an overbearing post but I am desperate to solve this for her and help her become more comfortable and less likely to spit up. Any advice or tips would be greatly appreciated :) thank you for reading :)

    • Leah, firstly I’m so sad to hear this story! And that you had to stop breastfeeding! That is a bitter blow, my friend. :-( My suggestion at this point is to go back to your doctor (or see a pediatric gastrointologist – who specalizes in these things) and ask him about using Prevacid or something like it. Zantac is commonly used because it can be used long term. It makes the acid less acid-y. Prevacid is often used as back up plan, because it actually helps reduce the amount of acid being produced in the first place. They won’t want it on her long term (because they body actually needs the acid!) but sometimes it can be helpful in the waiting game, since much of this is just waiting for your baby to get a little older and more physically mature. I would go back and seek his opinion on this option. You may want to share that you’re concerned about long-term eating struggles and want to avoid that if possible. Namely, we don’t want her to associate eating with pain. If she does, we can overcome it, but it takes a lot of work. Best to avoid it if possible. I hope this can help Leah, hang in there. You are a little further down this path than you were, and that’s a good thing. Every inch towards a solution helps!

  72. Hi! Thank you for this article. I had twins two weeks ago. They were born at 34 weeks and 5 days. One is eating and doing great. The second has still to gained her birth weight back. The pediatrician put her on alimentium with rice cereal in her bottle and axid today. Won’t this be too hard on her stomach. She is still 3 weeks early. I don’t want to cause more problems. Thank you.

    • Katie, I can’t argue with a doctor’s suggestion. They are WAAAAY smarter than I am. :-) However, if you feel concerned there’s nothing wrong with seeking a 2nd opinion. Even if that’s not with another doctor, you could try a nurse’s hotline or something. I have no formal medical training, so as much as I’d love to help you with this issue, I can’t say anything that would be worth listening to. You need to speak to our well trained doctors and nurses on this one. *hugs*

  73. My 4 week old LO was just put on Zantac 1.5ml 2x a day for four days so far. He is extremely fussy all day still spitting up quite a lot. The spit up doesn’t seem to bother him as much as the gas and pain he’s in always arching his back when he eats. We had him on enfamil newborn in the hospital for supplementation while breastfeeding due to issues with jaundice. Then noticing he was spitting up a lot and fussy tried enfamil AR which he seemed to do well with but started to have real trouble pooping and when he did it was explosive. Not sure if it was the formula or the breastfeeding. The Dr. Advised to stop the AR and let the Zantac work. So far it’s been four days on the medicine and he crys all day. I took some advice from this site and started him on Gerber Soothe formula, will try this for a week. I don’t want to completely stop breastfeeding maybe it something I’m eating that makes him have so much gas and be in pain. I’m at my breaking point with the constant crying and it seems he only wants to be held. I feel so bad for him that I can’t tell how to make him feel better.

    • Susan, some studies have shown that eliminating dairy from a breastfeeding mom’s diet can help with reflux and gas. Before you throw in the breastfeeding, you could try that and see if it helps. Also, you could talk to your doctor about adding a little prune juice to perhaps counteract the constipation from the AR.

      I know this is SUCH a hard time for you guys, but know that you’re doing exactly what a good mom does. You hold him, try to help him, ask a TON of questions, try new things…all signs of loving and wonderful parents. :-) You may not be able to fix things right away, but you’re not giving up.

      How has the Soothe done? Any better?

  74. Lindsay says:

    Hi there,
    I’ve been reading your site for a few weeks now and I have found it to be so helpful! Thank you so much for all the information you have provided and for taking the time to help so many desperate mommies like me! My son will be 5 months old this week. When he was 3 weeks old he was diagnosed with colic and since my older son had it, I knew all too well what we were in for. So I dealt with the screaming and prayed for the day it would stop. Well, I started to notice a difference between this baby and my older son. He was spitting up a lot, lots of juicy burps, and NEVER slept. He would wake up screaming every 20 minutes at night and during his naps during the day. So the doctor said he had reflux and put him on Ranitidine. It did seem to help with the spitting up, but not the rest. I also did 2 weeks no dairy, just to rule out a milk allergy. It didn’t make any difference. He was not very good at nursing from the start, but I blamed that on my overactive letdown and oversupply of milk. He would choke and gag constatly, even if I pumped before feeding him and I always used a nipple shield because he just could not handle the flow. Well at 10 weeks, he started refusing to nurse. He would arch his back and scream. So after a week of him not eating, I decided to pump exclusively and give him a bottle. This did go a lot better, but we still struggled with him crying during and after feeding time, but he was at least eating! So a week before he turned 4 months I decided to introduce formula at night because not only was I exhausted from the non-stop crying, but the not sleeping, and pumping around the clock was taking its toll on me. I had a lot of milk stored in the freezer so I figured if I gave him formula at night and breastmilk during the day, he would be getting breastmilk for a while longer and I could stop pumping. So i started with the Enfamil for supplementing and he did very well with it. Actually, the day after he turned 4 months, the crying had stopped. (The doctor said because he outgrew the colic.) Well I wasn’t sure if he could stay on the supplementing formula forever. It doesn’t say on the can and I couldn’t find it online. So I figured I could move on to a formula he could stay on. We used the Parent’s Choice gentle with my older son so after doing the supplement formula for a week and a half, that’s the direction I went (but I just did the premium, not the gentle). He did well on this at first. He was eating like crazy, but I assumed he was just going through the 4 month growth spirt. Then after about a week and a half, he started crying about 2 ounces into his bottle and then vomiting. So after several days of this, I started searching the internet for help. That’s when I found your site. So after reading so many of your articles and their comments, I decided to switch him to Good Start Gentle. The day I did this I did take him to the doctor and she thought that was a good choice but she also upped his reflux medicine. Well the throwing up stopped, but now he was just refusing to eat after 1-2 ounces and still spitting up and crying after feedings. So after being on this for a week I took him back to the doctor because he was still refusing the eat. The most I could get him to eat was 15 ounces in a 24 hour period, and most of that was only if he was asleep! So she switched him to Nutrimigen and said she wants to rule out a milk allergy before she tries switching his reflux meds. I have to call her after he’s been on it for 5 days and let her know how it is going. He has been on that for 3 days now and there has been no change. I still can’t get him to eat and he is still spitting up the little bit I can get him to eat and crying after. On a side note, I still have breastmilk to give him, but when he started this whole spitting up everything and refusing to eat, I stopped offering it because he just wasted it. So my thought is that his esophagus is sore and he now has a food aversion due to pain. So after I talk to the doctor, I’m thinking I will have to change him to Enfamil AR, but I’m not sure how to go from Nutrimigen to AR without completely throwing his digestive system for a loop. Do I follow that same mixing procedures when switching between formulas that you have described on your site? I know he will become constipated, as he was constipated on the parent’s choice. Do you have any suggestions for me at this point? This refusing to eat is extremely stressful and I think I’m going to ask his pediatrition to be refer him to a GI specialist. I don’t know how to get my baby boy to ever want to eat again. I did try mixing rice cereal with the Good Start gentle at my doctors recommendation, but he still wouldn’t eat much and spit up even worse. Any and all suggestions are appreciated. Thank you so much in advance!

    • Lindsay, thank you so much for taking the time to write out your comment and share your story. What a wild ride you’ve been on! Despite this difficulty, I verbally cheered you (yes, out loud) when I read this sentence, “So my thought is that his esophagus is sore and he now has a food aversion due to pain.” This sentence ALONE just shows what great mommy-instincts you have! That is exactly what I was going to say. I also want to high-five your instincts on seeking a GI specialist referral. It seems to me that this is the next logical step in his treatment.

      I had a few thoughts to share with you – PLEASE go over these with your doctor before changing anything. The doctor is your best friend when it comes to helping your son get past these difficulties!

      1. Regarding the food aversion, there is such a thing as “food therapy” for babies who have stopped eating because of reflux. Obviously, though, you can’t do that until the pain is better controlled. I think a specialist may be your next best step.

      2. Regarding switching to AR, AR is really just a pre-thickened formula. There’s a toss up between which is better “pre-thickened formula” or “hypoallergenic formulas” when working with reflux. So I would discuss those two options more with your doctor (or GI specialist). Do you switch to the AR? Or do you just thicken the Nutramigen with rice cereal by hand?

      3. If he gets constipated, try adding a little prune juice to the bottle. (Ask the doctor about the amount of prune juice, I honestly can’t remember at the top of my head.)

      4. Finally, recent studies have shown promise with reflux by giving probiotic drops (like these on Amazon). That’s another option worth considering!

      You have suffered through it all, and yet you are still pushing forward for answers. I’m virtually hugging you right now! You’re doing such a great job at being his wonderful loving mother!

  75. Thank you so much for all of your help and support. There is nothing worse than having this feeling that you are all alone and no one will help you. After refusing to eat the Nutrimigen all day yesterday, I was sick to my stomach about how he was not getting anything to eat. By 9:00 at night he was screaming from being so exhausted and I’m assuming starving. He was sucking on absolutely everything! So even though the doctor wanted him to be on the Nutrimigen for at least 5 days, I just couldn’t stand the thought of him not eating and had to try and get him to eat something else. So I started with breastmilk. At first he would suck vigorously like he was starving and then by the second gulp would scream. I just kept at it and kept putting it back in his mouth and eventually he started sucking and swallowing without crying and ate 4 ounces. So determining whether he has an allergy or not went right out the window, but I was happy he ate something. He did “sleep eat” 2 more times in the night, but refused again all morning. So I did take him back to the doctor today and she was not very helpful at all. He lost 3 ounces in 3 days and has lost almost an entire pound in 2 weeks. She doesn’t want to change his reflux meds due to new research how it affects his stomach later on in life. She doesn’t want me changing formulas again, at least for a while. So she wants me to stick with the Good Start Gentle and thickening it even more than I tried before. She even tried to feed him while I was there and he just kept turning away and pushing the nipple out with his tongue. He ate 2 ounces, which is the most I can ever get him to eat, but it was literally force feeding him. She said some babies are just like that (What??? I don’t think so… and he never was before.) Since he wasn’t crying she said she really didn’t think it was his reflux that was keeping him from eating. He just has “baby ADD,” which she followed up with “Not that there is such a thing, but he is just too interested in what is going on around him.” Anyway, I obviously know this which is why I always try and feed him in a quiet room with no distractions, or the complete opposite and get him focused on one thing so that he doesn’t know he is eating. She did agree to refer him to a GI specialist since he is losing weight. So I guess that is where I’m at. I really don’t know if he is in pain or not. It’s so hard to tell because he gets so mad when I try to feed him that he might be crying because I’m trying to force him to eat! It’s so hard to tell. I’m just going to keep trying to get him to eat until he gets in to see the specialist. Again, I can’t thank you enough for all the information on your site and for responding with such helpful, SUPPORTIVE, feedback. Your kind words brought tears to my eyes. Thank you!

    • Although I hate to bring tears….I’m glad you felt encouraged. :-) I think you’re doing exactly the right things. It sounds like, though, you don’t feel 100% confident in your pediatrician. If that’s true, I would encourage you to ask around and perhaps consider switching to a new doctor who can support you in the parenting adventure. I’m not a fan of switching doctors for tiny things, but if you don’t feel cared for or confident in your doctor’s care for you it’s time to look around. Much care to you friend!

  76. Great post! My baby has reflux and I saw that similac alimentum is a Good option. What are your thoughts between this one and similac spit up? Thanks!

  77. Hi! I really like the info here! Nice to hear similar histories as mine. My baby is 6 weeks old, and she was spitting up since day one. Some days a lot others days not so much. The doctor said she was fine since she had gained over 2 lbs. since birth (but I’m sure it is because I hold my baby up for at least an hour after every feed). So you can imagine I wasn’t getting any sleep and this make everything even more difficult for everyone. Anyway, the doctor prescribed anti- acid medication and suggest if I wanted to change formula to try the most gentle one. I haven’t tried the medication yet (I’m going to hold on it for now). As she has been taking similac since 2nd day we were in the hospital due to weight lost right after birth and low breast milk supply, I gave her similac – spit up. It has been only 1 day, but I can already see that has helped her! I’m so happy!! I’m not concerned about constipation because I’m also breastfeeding and it seem to keep her stool loose. The formula is a supplement due to low supply as I’ve mentioned, but it is about 60% of her total feeding.
    I hope this help others. Thanks and good luck to all!

    P.s.: similac – spit up has a thicker consistency and I had to use flow #2 nipple in my baby’s bottle because she wasn’t eating on #1, as I was using for similac advance. Much better now.A

  78. None of these helped my little one her reflux is so bad that she is already on her second medication and it is even making a difference and I have had her on so many different formulas idk what to do she is now on Nutramagin but its not any better than the ones used for babies who have reflux, gas and colic I feel so bad for her cuz Idk what to do

    • Kaylynn, I’m so sorry to hear this! Are you seeing a pediatric gastrointologist? Or just a regular family doctor/pediatrician? If you are NOT seeing a pediatric gastrointologist, I would recommend you ask your regular doctor about getting a referral. If she’s tried all these things and is still struggling, it sounds like it’s time to “kick it up to 11″ and see a specialist. Pediatric Gastrointologists are like the Dream Team of acid reflux babies. They LIVE AND BREATHE acid reflux, and should be able to get your baby sorted out as quickly as possible!

  79. Your info is so helpful. Im reading all I can. My issue is I have a ten week old boy with heart failure who started having bloody mucous in his stools. So we switched to alimentum bc doc had samples. It fixed the stool issue but he would not drink more than two ounces…i think bc of taste (tested that theory by offering similac total comfort after alimentum and sure enough he drank another ounce). So now he is on Nutramigen….however he
    now cries with feeding and wiggles so much and does not want to eat. I think he has had silent reflux for awhile and just now is crying about it. We are about to start zantac. Im just wondering if we are on the right track or if a formula swap is needed?

    • I would stick with whatever your doctor suggests. 10 weeks is still teeny tiny, so go with your gut and talk with your pediatrician. I’m a complete outsider, so your instincts and the doctor’s imput will be much more valuable. I hope the Zantac can help! If you don’t see a change after a few weeks on Zantac, perhaps ask your pediatrician about Prevacid. They treat different parts of the silent reflux, so if the Zantac isn’t working, the Prevacid may be a good backup plan. Hang in there friend!

  80. mercedes says:

    Hi I’m not sure if my son has acid reflex, when he was two months old I told the doctor about my son spitting up almost at every feeding she told me to try enfamil ar it helped he’s not spitting up a lot after every feeding but he spits up milk that looks like cottage cheese like an hour or two after feedings, it doesn’t seem to bother him he sleeps fine, he drools a lot and sucks on his fingers a lot, today I was at the mall when I checked on him he had a chunk of milk like cottage cheese on his bib I got scared cuz other times was just watery, once in a while I’ve noticed that when he sleeps he makes faces like he’s nauseous other than that he’s a happy baby.

    • Mercedes, I can’t tell you whether that’s acid reflux or not – I simply don’t have the training. It does sound like you’re concerned about it, so I would either call up your doctor and ask him over the phone or bring it up at your next well child visit. He can look down your infant’s throat and let you know if it’s irritated. Then you’ll know if it’s reflux or just the standard spit up. :-)

  81. My baby boy was diagnosed as a happy spitter at 7 weeks old. I knew from around a day old something was wrong. But the nurses and doctors said to continue the formula because it wasn’t good to switch. So we continued with the same formula but were told to add a teaspoon per oz of formula. He had been eating 3 1/2 oz since he was two months old. Around 2 1/2 months old he become constipated assuming it was the rice cereal which had tremendously helped him. And age has also helped him with his reflux. So I had to lessen his rice cereal to 1/2 teaspoon per 3 oz. And the reflux started back up, you could here it come up in his throat and he reswallows it. He’s battled bad gas and reflux for a while. But instead of his dr changing his formula he started him on Zantac, which I really hate giving him. He’s had 3 doses so far. It seems as if it works the same as the rice cereal. So if I were to take him of his Zantac and try the similac for spit up, do you think it would constipate him, since the rice cereal did? And also we were giving him a little bit of prune baby food because the prune juice hurt his belly with gas, and the doc thought it was too soon, but it worked and helped him poop. Do you think it’s too soon at 4 months for prune food?

    • Amber, I cannot give you specific medical advice – I can only give thoughts for you to talk over with your doctor. He/she will be your best source of information, since he A) knows more than me B) knows your specific situation and C) can physically examine your baby. That said, if you’re feeling a little hesitant over the advice your doctor is giving you, I WOULD encourage you to feel free to seek a 2nd opinion from another doctor. You don’t have to actually switch doctors. It’s just a confirmation that you’re on the right path (or new medically-advised things to try).

  82. My little boy is 6 weeks old with silent reflux, he has screamed the house down since day 4, which has been heart breaking for us to go through.
    He is obviously in a lot of pain. He was put on losec one week ago and we were told to give him mylanta to relieve him until the medication takes full affect, and although we have seen a change it’s not been a huge one. He’s still in pain.
    He arches his back, throws his head back, pulls his legs up, sometimes screams until he’s purple in the face and hyperventilating. He has frequent hiccups, gulps down air as he drinks his bottles and his breathing is very raspy with a bit of a squeak. He chokes on his bottle about 2-3 times each feed. I can hear his stomach rumble (with air?) as he drink. He dribbles, and his milk spits out the side of his bottles, it’s not the bottles, we’ve tried several different ones. He has a rash on his face and neck that he has had since 2 weeks old. Because he cries so much his devolpment has suffered, he doesn’t baby talk or smile often because he is either asleep (if we’re lucky) or crying.
    I have elivated his cot, we feed him sitting upright, and keep him upright after feeds but it seems to make no difference. He is currently drinking novalac colic formula. Which is reduced lactose and ‘easy to digest’. He has gained weight, but he is a comfort feeder, he will force himself to drink sometimes an hour apart because it’s the only thing he can find to sooth the pain. We’ve tried to give him a dummie but he refuses to take it.
    Do you think this is more than just reflux?

    • Marina, that poor little darling! (And his exhausted parents!) I would seek a second opinion just to make sure. Perhaps with a pediatric gastrointologist, since it seems so severe. When you do, ask him about how the novalac colic formula compares to a hypoallegernic formula like Alimentium or Nutramigen. Studies have shown that in severe cases like yours, the standard “Reflux formulas” aren’t as helpful as a hypoallergenic formula. I would also ask him about his thoughts over giving your baby probiotic drops (example on Amazon). Recent reflux studies have shown probiotics may be helpful as well. Start there, and keep asking questions. You are in the furnace of parenthood right now Marina, and you’re going to come out as pure gold. He’s a lucky little boy.

  83. Ashalynns mom says:

    My daughter has chronic reflux, she is now 8 months but at 2 weeks she started projectile vomiting and wasn’t gaining weight, she is now on two different medicines and on thickened formula , we tried just about every kind but when she was put on Enfamil AR it got worse once we put her back on similac sensitive for fussiness and gas with rice added things got better but she has to have her meds but now having problems with BMS that are burning and cause redness n soreness on bottom, she is changed very regularly n always has cream but what would help better? Zantac didn’t help my daughter but Prevacid did it shuts of the valves so the stomach won’t produce so much acidm I would ask doctor to try another medicine

    • I would suggest talking with your doctor about using a hypoallergenic formula like Nutramigen or Alimentium. It’s possible she may be having an allergic reaction to the formula (the red/sore bottom). Also, studies have shown that reflux babies can oftentimes do better with a hypoallergenic formula. (a href=”http://www.incredibleinfant.com/infant-formula/baby-colic-formula”>See them here.) You could also ask your doctor about how to thicken the hypoallergenic formula by hand – if it’s not thick enough. I hope this can help!

  84. My baby is 6 weeks old now, I started her off breastfeeding but I got an infection so I stopped around 4 weeks of age. She has been gassy, hard to burp, common hiccups, and spit ups from the day we brought her home from the hospital. The doctor told me to try gas drops and probiotics while I was breastfeeding but no help. When I switched to formula I tried a sample can of similac sensitive with the drops and probiotics but I saw no improvement. She is now on similac total comfort with gas drops, her gas pain has gone away and it’s easier to burp her but she is spitting up twice as much now even with adding rice cereal.

    Should I try a different formula again or just be happy the gas pain as gone away and deal with all the spit up? It doesn’t seem to bother her and she is gaining weight.

    • Kaci, I would have her checked out for acid reflux (regular or silent reflux) just to be sure. If the spitting up isn’t affecting her health and she’s gaining weight, than you’ll have to decide if switching and trying a new brand is worth it. On one hand, it’s possible that things will improve. On the other hand, it may take some more time of trial and error before you find the right one. Whatever you decide, try to give each new formula a full week before moving on, it will give you a better picture of what’s working. If you switch too soon, you may find her reactions are leftover from the previous formula. Does that make sense?

      • Yes that does make sense!
        Since I last posted, her gas pains have came back and she is straining to pass gas and passes it all the time and now having bowel movements every other day when before it was once a day. The stools aren’t hard or anything and are a forest green color. I also notice her having a lot more salvia coming out of her mouth and hear her swallowing it but that might just be normal baby stuff?
        I tried stopping the rice cereal Sunday thinking that was the reason but no improvement. I told the pediatrican about the spitting up when I made an appointment when she was 4 weeks old and at the time her gas pains were gone so he was the one who reccommended rice cereal to try and stay on the formula she is on now. He said that reflux symptoms peak at about 6 weeks of age and didn’t want to give her meds until then. I’m thinking that is what is going on. What do you think? And any recommendations on what fomula to try next?

        • If she’s refluxing, a hypoallergenic formula may be worth trying (or one of the acid reflux ones above – they are much gentler on the tummy than adding cereal by hand). Or, to avoid spending tons of extra money without needing to, you could try her on a Gentle formula from Similac or Good Start. :-)

  85. Jessyca says:

    Enfamil A.R. – It was amazing after I figured out what was wrong. I wish I had known about it sooner. As soon as I saw it in the store I called her pediatrician and asked for a change in formula, he okay’d it right away. If I am ever lucky enough to have more kids I am going to remember this so they can have it too.

  86. I know that they don’t have regular prune juice for babies. Just the apple-prune juice. So when you say give the baby prune juice, is it regular prune juice out of the juice aisle? What kind do you think is best? And for a 5 month old, how much is appropriate? Thanks in advance!

    • I’ve always given my kids regular ‘ole prune juice, in small amounts. My guess is that the baby prune juice is diluted, but you’d need to check the label to make sure. It’s important, though to ask your doctor about the dosage. If you give too much you could cause diarrhea and cramping, which is no fun either. :-)

  87. Rosaria says:

    Hi Heathermy son is currently 10 weeks old.
    My son was on Goodstart for many weeks after birth- spitting up constantly, sometimes 2-3 hours later. When he started to show signs of pain- screaming during and after feedings and when burping, arching back , etc. I decided to try something else. We switched to enfamil A+. Spitting up issue was gone but then he had bad gas pains. Two weeks after switching it seemed the reflux issues were back- no spitting up but the rest. Is this common? Could it be something else besides reflux which I assume would be constant?
    Next we switched to Goodstart Probiotic- again, 5 days of bliss- no gas pains, no screaming etc. but then reflux symptoms , (minus actually spitting up) back again.
    Finally decided to try Nutrimegen. Have been on it for about 5-6 days.
    It seems like he’s in less pain but now has diarrhea.
    With all the formulas, he sounds like something’s stuck in his throat. He constantly chokes on it and stops breathing which either startles him awake or into a fit of crying. Laying him down makes it worse. I have done the usual- burped more often, held upright, elevated crib- these things helped a bit but not entirely.
    Questions:
    1. Would true reflux come and go when we switch formulas like it has for us or could it be something else?
    2. Since he’s not actually spitting up, do you think a thickened formula would help with the “stuff” stuck in his throat.
    3. Dr. prescribed Zantac but id rather that be a last resort. Would the medication help with the “stuff” stuck in his throat.
    4. If he continues to be pain free on the Nutrimegen, would it be ok to slowly mix some feedings of Goodstart (like a bottle a day and then slowly progress) I’d think it might help with the diarrhea
    Thanks in advance

    • Rosaria, if he’s stopped breathing a few times, and seems to be choking, you need to take him to the ER or the doctor right away. The doctor will definitely want to give him a physical exam as quickly as possible. I don’t want to weigh in on the other things until you’ve checked in with your doctor. I will, though, mention that you may want to check him for mucuous settling in the back of his throat. Does he have a cold? Is his snot yellow and thick? Start with the doctor on all this, then feel free to give us an update and go from there.

  88. John McGonagill says:

    For the parent’s and for ideas for you coach…my wife and I have had issues with both of our children having reflux. We have found using a thickening agent ( name brand Thick It) instead of baby cereals to bottles helps a lot. It brakes down much better than the cereals and it take very little to thicken most anything. Most pharmacy have it and CVS/Walgreens has name brand as well as store brand.

  89. Hello!
    I came across this website and have read so much I am confused and need help! My baby boy is 9 weeks old and has been struggling with reflux and colics almost since birth. Ped chNged him from newborn, to gentlease, nutramigen and now AR.
    He was doing ok with nutramigen but still spitting up since it’s so thin but was sleeping longer and only gets colics sometimes but the spit up is constant.
    So yesterday I went to the pediatrician and he changed it to AR but since then, baby has been really gassy, his tummy is always making noises and he really doesn’t last long with the feedings. When I changed his diaper in the morning I saw a tiny bit of poopie (I guess from all the gases at night) and it looked phlemi or mucusy to me. What could this mean? He looks sooo uncomfortable it breaks my heart. Should I go back to nutramigen? Should I try Similac Sensitive? Should I try Neocate? I don’t know what to do!!

    • Yedi, I would encourage you to give your doctor a call and share this information with him. In these cases, he is your best resource. It is excruciating to watch our little ones suffer and not know what to do about it. Just remember, that you are actually doing something. You are asking questions, going in to doctor’s appointments, commenting on blogs :-), making phone calls…you are advocating for answers. What I see here is a great mom who is searching for answers. Your little man is blessed to have you. Continue to offer him comfort during all this, and then call your doctor with this update, asking him about going back to the Nutramigen, or going up a notch to the Neocate. Hang in there, friend. It’s a storm of uncertainty, yes, but you are providing emotional shelter for your struggling little man through it. That is a job well done. The picture in my head is a mom, clutching her little boy to her chest, fighting through all the wind and rain towards the lighthouse in the distance of safety. That is you. Keep going. Keep asking. Keep trying new things. (hugs)

  90. Hi Heather,
    Thanks for this great article. My baby girl is 11 weeks old and spits up almost every meal during the day. Night time she is much calmer and she seems to do better keeping it down. Per our pediatrician’s request, I’ve eliminated diary from my diet, and we have her on Zantac .8 mL, 2x/day, as well as adding rice cereal to bottles of pumped breast milk. A lot of your suggestions on this page a great for people who are formula-feeding but I’m breast feeding. Do you have any magical potions or tried-n-true recommendations for breast-feeding mamas to help with reflux/constant gas and spit-up? Also, she seems to drink better when I give her a bottle of pumped breast milk, but gets very angry & refuses to feed when I try to breast feed. Any thoughts on why that could be? Any insights you can share would be much appreciated!
    Thanks!
    ~Anjali

    • I think it’s great that you’re ditching dairy for while. I’ve also heard that giving a reflux baby probiotic drops (like these on Amazon) can be very helpful as well. Perhaps talk your doctor about that and see what he says? I’m not surprised about the pumped milk – depending on the position you’re feeding her, it’s possible that the bottle is more comfortable because she can drink in a more upright position. Have you heard of the upright breastfeeding position? That may also be very helpful and worth the try. xo

  91. Brittany Carpenter says:

    Hello!
    I’m so glad to run across your site! I have 8m old twin boys and we found out after a couple weeks of being born that they had reflux. We have tried similac advanced, sensitive, and currently using soy. They have always taken zantac, and rice cereal in bottles since 3m old. As they get older it has got so much worse, especially with one of them. He probably spits up every 10-15mins some days, most days I should say. His brother has spells where he does this but not as often. They puke up baby food, cereals, table food, anything really. They also have a rash since 4m old, that they keep saying is eczema but never disappears. I’m pushing for a GI specialist to see them so I hope to get answers. But do you have any recommendations? They have symptoms for sensitive formula, but no symptoms for formula allergies. Thinking of trying Gerber Good Start gentle, thoughts?
    Thank you!

    • Brittany, firstly congrats on your double blessing. :-) Secondly, I’m so sorry to hear that you’ve been having all these reflux troubles. Reflux in ONE baby is tough. Reflux in TWO…mega hugs to you, my friend. :-) I would encourage you to consider one of the pre-thickened formulas above first, since they’re cheaper. If nothing improves after a week or so, I would talk with your GI specialist about using hypoallergenic formulas like these. Studies have shown they are helpful with refluxing babies. Also, ask your GI doctor about using probiotic drops like these. The doctor I talked to shared that new studies have show probiotic drops can help. Good luck friend! Hope you can see some improvements quickly!

  92. Courtney says:

    Hi there! Such a great post! Thank you! Was hoping for your opinion! My daughter has had reflux symptoms since birth. She even had trouble when I breast fed. Her case is certainly not as severe as most but we are having trouble either her spit up, gas, tummy pains, etc. She’s been on similac sensitive, similac total comfort, similac soy, and similac spit up. Adding cereal to all but the spit up. If any worked they only helped for a week or two. We are wondering what to try next. Obviously similac isn’t for her. I’m not big on adding the cereal so am stuck between trying the Emfamil AR , Gerber Gentle ease, or Gerber soothe. I’m ready to have a formula that will work! Lol so I’m nervousnes the AR will be like the similac for spit up and that the Gerber good start will be to hard on her stomach. But is going to soothe to drastic at this point? Oh and she’s on zantac which seems to help, laying flat has been better since she was put on it.

    • Usually the best formulas for reflux are either the reflux-specific formulas (Similac for Spit Up or Enfamil AR) or a hypoallergenic formula like one of these. You could switch to the AR and see what happens, brands do matter with the more-sensitive tummies. Good Start is a very gentle formula, and it may help with the gas, but I’m not sure you should expect help with the spit up. Another thing you could try is probiotic drops. New studies on reflux have indicated that can help as well.

  93. So I’m a little confused on which is gentler: gerber soothe or gerber gentle?
    My little guy I think has reflux. We have started Zantac and it’s helped some, but I’m not satisfied. I’ve read that the hypoallergenic formulas should be a last last resort as the triglycerides aren’t there that baby needs for proper development. Myth? Truth?
    So if one were to suspect or want to rule out a dairy sensitivity aggravating the reflux and try similac alimentum, it still has casein-from cows milk…?
    We are using similac for spit up- to clarify other commenters question- similac for spit up and similac sensitive for spit up are the same thing, just a packaging change. It seems to help him keep stuff down, but doesn’t decrease the painful episodes.
    I’m wanting to try the gentlest of the gentles -gerber gentle vs gerber soothe confusion – plus above reader’s suggestion of ThickIt. What do you think?

    Also- is there any significance in the forest green poop other readers have mentioned? My dr said everything was normal except blood. Similac advance produces the closest poo to when I could breastfeed. Enfamil anything was grey thin clay, which I thought was very strange and unacceptable. Similac for spit up results in a lot of these forest green stinky thick poo days and occasional more normalish yellow seedy poops. Poop should be the same every time if you’re eating the same thing every time right?

    • First on Soothe/Gentle: Soothe is the more-gentle of the two. Usually people start with Gentle, and then if that’s not helping, move to Soothe, and then if that’s still a struggle, switch to a hypoallergenic.

      Second on triglycerides: I would talk that over with your doctor. I’ve not heard that and have a hard time thinking doctor’s would prescribe something that’s NOT going to be good for your baby (but I’m generally pro-medical-community, so that’s my bias.) If you are afraid of a dairy sensitivity, I would start with Alimentum or Nutramigen, and if that’s not helping go to a straight amino-acid formula (the hypo-hypoallergenics) like PureAmino or Neocate. Your doctor has tests that can help you figure out the milk allergy issue. ThickIt is something I have no experience with or research on. You’ll need to read the suggestion and make your decision on your own for that one.

      Thirdly on poop: Green poop is very normal (see my poo color guide article). Poo colors will change, no matter if you’re using the same formula over and over again – it depends on absorption of vitamins and minerals. I wouldn’t worry too much, as long as you avoid the colors I mention in the article. I hope this can help Brooke!

  94. My son is 1 month now and we started him out on enfamil newborn then gentlease and when he became so gassy and uncomfortable we switched to gerber sooth buy there was no change. The doctor recommended nutramigen thinking he may have a milk allergy and an extra hard time breaking down the milk particles.
    Since that change he has had a much easier time with BM’s And passing gas (still some small episodes but he is no longer in pain all day from gas). We also found out he has reflux, his is more silent not too much spit up but he does spit up a little bit at a few feedings the ought the day. He’s been on the generic for prolosec now for 2 weeks. He hates taking the meds and we honestly having seen a huge change yet. Some feedings he is fine other he still seems to be arching his back, pushing the nipple out of his mouth and just really struggling to eat. I don’t know if I should be doing something else for him. My daughter had a pretty similar issue minus all the gas issues. She stayed on the gentlease formula and was put on generic for Zantac and we saw improvements. Should I ask the doctor about switching him to Zantac instead or is there any other tips you could give??

    • Jessica, if you don’t see any changes within the next few weeks on the Prilosec, I would ask about Zantac. Prilosec is an inhibitor – which means it actually reduces the amount of acid being produced. It can only be used for a short period of time. Zantac doesn’t reduce the amount of acid, but makes it less acid-y. It can be given for much longer period of time than Prilosec. It’s possible your doctor was hoping to start with a bang with the Prilosec and then eventually move to the Zantac. If you don’t see much improvements in another week, I’d give him a call and see what he says. I’d say you’re on the right track with the formula, though. Nutramigen (and other hypoallergenic formulas) have been shown to be really helpful with acid reflux. Another new development in the “baby acid reflux” world, is that infant probiotic drops (like these on Amazon) can also be really helpful. Hang in there friend!

  95. Hi I have a question I have a one month old. First week when he was born he was spitting out milk so I took him to his pediatrician by a guess she said he had acid reflux she Put him on Similac for spit up. He kept throwing up after every meal making him fuzzy and nothing will seem to soothe him. She then put him on Zantac making him more constipated and fuzzy. I took him to the er and to them it’s normal that my baby won’t poop up to 7 days and this bumps he has in his face it’s hormones ???? So we kept him on Similac for spit up but I was frustrated he’s been losing weight not gaining any so I decided to swith brands I’m a second time mom but my daughter never gave me no problems at all so I just changed him to Enfamil gentlease. I just started giving him not knowing I needed to do little by little . He seems to keep throwing up but seems more calm but he won’t cry. It’s weird and I don’t know if maybe I chose the wrong milk he seems to drink the milk I burp him after every ounce but after drinking his bottle he will just fall asleep. I am really frustrated already I don’t know what to do. Can u help?

    • Edith, it’s possible he may be having an allergic reaction to the milk. Oftentimes babies with reflux who don’t do well on the pre-thickened formulas will do better on an hypoallergenic formula like Alimentium or Nutramigen. I would seek a 2nd opinion from another pediatrician and ask about moving to one of these formulas in addition to the medication. Usually I recommend switching slowly, but since he’s not growing and seems to be having such a hard time, you may want to switch abruptly. Ask your doctor about that for sure. Hang in there, friend. You are being an AWESOME mother. You are seeking questions and being his advocate. That’s Motherhood 101 and you’re totally getting an A+.

  96. Fantastic articles here- these are very helpful. Wondering if I could get your opinion… My 3 1/2 month old started out breastfeeding. At 8-9 weeks we started introducing regular Enfamil formula with Iron. He incurred tummy pains, gassiness, frequent spiting up, and constipation– of which he never had with breastfeeding. His father has a dairy/lactose allergy (not sure which one, he just avoids dairy all together or else he feels like crap). His father also has diagnosed reflux. (My son is doomed!)

    So we decided to switch baby’s formula to Up&Up Sensitive- Target’s brand of Similac Sensitive. Baby seems better, but still spits up more than normal. He has wet burps and after burping him after each feeding- he still spits up frequently and has more little burps. I notice it happens more when he lays on his back- so he naps in his swing daily. This formula is still making him somewhat constipated, gassy, and have frequent spitting up incidents. We’ve added Rice to his bottles and even started feeding him solids in the evenings– but mostly because he just seems to hungry all the time. (He’s already doubled his birth weight!) I have no concerns for his health, as clearly he is growing, but the clothing stains, messes, and his uncomfortable nature is driving me crazy…… Is it time to try the AR?

    • I laughed out loud at the “my son is doomed” comment. It’s amazing that all the things we DON’T want our kids to get from us they end up getting… (sigh!)

      I think trying the AR is a good idea, at least for a week. If it persists and it seems your husbands dairy/lactose allergy has been passed down you’ll have no choice probably but to go to the hypoallergenics (but your doctor will be the guy to ask about that!). You also may need to get him on some reflux medication – another thing to ask the Doc. It’s very common for reflux babies (which what it sounds like to me, but I’m not a doctor) to be hungry constantly, because they’re spitting up half of every meal. I would try to work on controlling his acid reflux with giving the AR a try first (with perhaps some probiotic drops – those have been shown to help with reflux also), and then if that’s not helping talk with the doctor about medication and perhaps a free sample of a hypoallergenic you could try. Hope this can help friend!

  97. I’d love some advice. I have a 5 week old silent refluxer who was recently started on Zantac. The med has helped w/the fussiness, screaming, and pain, but since 2 weeks until now, she only ever eats 1-2oz every 2-3hrs. Minimal spit up. If she only drinks an oz, I’ll feed her again in an hr or 2 – she’ll drink another oz or she won’t drink at all. Other times she’ll drink 1.5-2 and won’t eat for another 2-3 hrs. There’s no real schedule for her. Total intake in a day ranges from 15-18oz.

    We’ve tried Gentlease & Nutragemin but it hasn’t changed anything. She is otherwise alert & happy, but I just worry if she’s getting enough to eat/nutrients/calories. She gained 2lbs since birth, but 1lb was in the 1st week – the other was in 3 weeks. Ped keeps wanting us to try soy, but I don’t think the formula is the problem, is it? Am I just worrying too much?

    • Vivian, firstly it’s okay for you not to have a schedule with a baby this young – especially one who is struggling with eating and reflux issues. You’re instincts to keep offering her food are very good. The more food she can take in, the better. That said, since she is struggling with reflux, it’s understandable that she doesn’t want to eat. Poor baby! I have a few thoughts, though, for you to discuss with your doctor.

      1. Hypoallergenic formulas have been shown to be helpful with refluxing babies. However, if the Nutramigen didn’t seem to help, perhaps you should try a pre-thickened reflux formula like Similac for Spit-Up or Enfamil AR.

      2. Zantac is usually the first medication doctors give for refluxing babies. The second is usually a beta-blocker like Prevacid. Zantac doesn’t reduce the amount of bile, it just makes it burn less. If she doesn’t improve and if she continues to struggle to eat you could talk with the doctor about trying Prevacid – which actually cuts down on the amount of spit up that’s going back up the esophagus.

      3. New reflux studies have shown a good correlation with using baby probiotics like these on Amazon. Might be worth trying.

      There are few thoughts of things to talk over with your doctor. I know this is exhausting and so difficult, but you really are doing a GREAT job Vivian. Your mom instincts are spot on. She’s a blessed little girl. :-)

  98. I just started using Gerber Good Start Gentle today. I noticed she seems happier or doesn’t strain to pass gas or stool so far. The one thing I did notice is that the gas/stool smells pretty horrible (almost like rotten eggs). Is this something from the probiotics in the formula? Does it get better after using it eventually and not so smelly?

    • Beth, it’s hard to tell after only a few days. I would give it a week and see if you’re still noticing something. It could be her system just adjusting to the new formula. :-)

  99. I have a question? I am having serious problem with my baby. She is throwing up bad and has acid reflux gerd..I was on Enfamil Gentle that didn’t work so Dr. said to try Enfamil AR that didn’t work so we tried similac spit up with rice and she is still throwing up, fussy, acting like she is going to choke because of the acid coming up! I am on wic so I am having a hard time with figuring out what formula to use. We have been buying it but its getting ridiculously expensive. What do you recommend. I am tired of waiting on the Dr. to call back. I will be making a appt with Gi specialist Monday. What is your thoughts?

    • Firstly, I have to encourage you to follow whatever your doctor says. I’m in no way a doctor, or have the expertise that can help you with these kind of medical issues. I can, however, give you some things to think over and talk with your doctor – hopefully they can help you work out a solution to a very tough situation!

      Last spring I sat in on a talk with a well-known pediatric gastrointologist to hear his thoughts on acid reflux treatments. He suggested several things I’ll share with you to talk over with YOUR doctor:
      #1) Try a hypoallergenic formula if the thickened formulas aren’t helping. They are more expensive, but have been shown to be helpful. Ask your doctor for free samples or coupons.
      #2) Make she’s sleeping on an incline – use these tips to incline the crib mattress safely, or put her in a swing or car seat to sleep.
      #3) Talk to your doctor about probiotic drops. Recently studies have shown they can be helpful.
      #4) In cases like this, medication may be your best chance of getting a handle on it. Zantac is usually the first drug prescribed – it makes the bile less acidy. It can be prescribed and used for a long period of time. Prevacid is usually the next thing they prescribe. It actually reduces the amount of acid being produced. Because of this, it can only be prescribed for a short period of time – which is why it’s usually the last resort.
      I hope this can encourage you! You’re doing great. Being a parent of a refluxing baby is not easy at all. She’s a blessed baby to have such long-suffering and caring parents. Hang in there friend! Xo

  100. mary grant says:

    Hi my little girl is 4 weeks and has silent reflux she has hicups all the time very fussy after a bottle very alert all the time not a good sleeper making a wooping noise al the time sinzzing all the time to and crying out in pain when some of the milk comes up her throat I just dont knkw what to do she is on cow and gate comfort and gavisons but its not working she was on nutramigen but she went mad on that would not settle at all after drinking it what should I use now as the we petnis wracked and so unhappy

    • Mary, I would talk with your doctor about getting her on a medication of some kind – Are you in England? If so, ask your doctor about Ranitidine (Zantac here in the states) or Lansoprazole (Prevacid in the States or Zoton in Australia). You could also talk to your doctor about giving her some probiotic drops – some studies have suggested that can help with reflux. Start there, friend. Hang in there, things will improve!

  101. Any tips for breastfed babes who may show signs of reflux? He seems so uncomfortable after nursing sometimes. (exclusively breastfed) I feel so terrible because he looks like he’s got gas/pooping troubles on one end and some kind of discomfort on the other end! He’s 8 weeks now. I think it’s also interrupting his sleep. Sometimes I”m able to put him down “drowsy but awake” others he is just so uncomfortable I need to hold him upright till he’s good and sleeping. He’s eating well and producing regular wets and dirties so I’m not concerned about nutrition.

    • Danielle Miller says:

      Jill,

      Reflux is not fun! My little one is struggle with the same problem right now (breastfed). We switched her to sleeping in a Rock n Play and that has helped a lot! Also, wearing your baby helps if you need to keep him upright after the feeding. Hang in there, most likely he will grow out of this before you know it!

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