If your baby has reflux it changes everything! Symptoms can range from your baby bringing up milk after ever feed, but more of it, to the so-called “happy chucker” who does reflux but is not crying and thrives well, through to a very distressed baby who does not feed or sleep well, and cannot be comforted easily. On top of that you may have to deal with colic, diarrhoea, or eczema as well. You will have talked about it to relations and fiends, and had many visits to the doctor, particularly to see if medicines help and just how much medicine to use. It can be quite overwhelming!
You may have wondered if diet may have a role. You may have thought of diet more in relation to the other symptoms than for the reflux. In fact that is how I discovered diet has a role in reflux back in the 1980s. Mothers whose friends had babies who responded to diet for irritability or sleep problems – wakefulness, restlessness, even night terrors – or diarrhoea or eczema, trialled diet and found that where it helped with any of those symptoms it also decreased the reflux. Other mothers who had other children without reflux on diet for their eczema or behaviour, tried the same family diet in their baby with reflux, and reported improvement.
What can we say? We can say that reflux is another symptom that diet can change.
Diet is not the cause of reflux, nor is it the complete solution. Diet factors can make reflux worse and attention to diet can decrease the reflux. As well diet does not help everyone with reflux. Who does it help? Overall a baby is more likely to be food sensitive if you as a parent have seen a reaction to something eaten, or of you come from a family with any of the symptoms mentioned above, or others such as ADHD, ASD, allergic symptoms, migraine, or IBS. Diet responding families may have a sensitivity to salicylates [usually aspirin], and they often have increased sensitivity to smells, both in food and in the environment.
There is no specific diet for reflux but the right diet can be learnt through a type of organized trial and error that I call “diet detective work”. Families often learn that commonly suspect foods such as milk or eggs are a problem, and additives or spicy food are better left out. The best way to get the most benefit from diet is to use a family elimination diet for four weeks and challenge carefully with excluded suspect foods. The easiest way to do this with all the necessary hints is outlined in Are You Food Sensitive? with a whole chapter on managing food sensitivity in a baby. In fact diet is easier to manage in a baby as you have less foods to deal with and you can control foods better.
Why doesn’t your doctor suggest diet investigation?
These days fortunately some mothers do have a doctor who is supportive, and they can see a dietitian to discuss a specific diet to start investigation. You can also check on nutrition issues with your dietitian. Because there is no one diet for reflux, and because the doctor is busy checking nothing else is causing so much distress to your baby, and managing the medication, diet may not be mentioned. As well it is wise to wait until investigations are done and medicine is organised before giving more attention to diet. Then you may need to look at whether any medicines have any additive colour or flavour.
It is wise to join a group with similar problems, such as the Reflux Information and Support Association. They have recently produced a wonderful book called Reflux Reality, which included a chapter I contributed on introduction of solids to a reflux baby. [ Note the review in the Book Reviews section.] An important idea discussed there is that those with reflux also have to deal with not just whether a food is causing a reaction but also its texture, thickness, stickiness and glugginess. Acceptance of food may also be affected by the temperature, and smell and flavour. These are all part of what is really “eating development”. We have all heard of speech and coordination development and can now realize that eating development is also a gradual process. Mothers of reflux babies may also notice that their baby may also be supersensitive to particular noises or touch. You can make sense of all this, and why introduction of solids may be more difficult or take longer, by reading all that has been learned over the last 25 years in my book Fussy Baby.
Yes diet may help with all these frustrating problems, but the problem that most mothers of diet responding babies most appreciate improvement in is the amount of pain their baby seems to be having.
Hey, what about diet and reflux in children, teenagers and adults?
All the same ideas apply. Adults with reflux also report diet can help where they have begun with a Family Elimination Diet as described in all of my books, preferably with the help of an experienced dietitian. Reflux can improve and worsen at different stages over a lifetime, so diet can be relaxed or made stricter as necessary.
Joan Breakey Dietitian specialising in food sensitivity
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