Inside: A step by step guide to weaning your reflux baby
Before I had kids I had absolutely no idea about the trials and pitfalls that can come your way. I assumed it would be relatively simple – all they do is eat sleep and poo, right? I have dealt with a multitude of issues now, including allergies, intolerances and of course reflux.
Weaning a reflux baby needs to be taken slowly, taking into account different foods, new textures, and consistencies. The later you start the process the better – they are more likely to progress well if they are older so early weaning is not advisable. Keep a list of food tried and stop a food if it causes issues.
As someone whose baby was diagnosed with one of the ‘worst cases of reflux’ our doctor had ever seen, I can tell you that she is now a healthy child who can eat absolutely everything. I hope this guide helps you through this stage.
Why reflux affects weaning
When a baby has reflux, whether silent or not, it means the muscle between their stomach and oesophagus (lower oesophageal sphincter) is not developed properly.
As babies, this presents itself through a spectrum of symptoms ranging from discomfort (in silent reflux) through to severe projectile vomiting (with reflux).
As babies get older and move towards weaning, their diets will nolonger consist of just milk. So, whereas before they would bring up a liquid, they will now bring up solid food. Not at all pleasant I think we can all agree.
This is what makes weaning a reflux baby so tricky as any number of things can trigger a reflux reaction. From starting too soon, to choosing the wrong food, to eating too much in one go.
But there is a way forward and most certainly light at the end of the tunnel.
What age should I start weaning?
This question raises a debate between parents and doctors time and time again regardless of whether it is for a reflux baby or not.
Medical professionals have given different advice over the years, from 4 months old in the 80’s, to 9 months old in the 90’s to a middle of the road age of 6 months old now.
But what about reflux babies? Do the same rules apply?
Well, as someone who has had both a silent reflux baby and a reflux baby, I can tell you that no, they don’t. You have to use your own judgement on this one. Doctors may tell you one thing but you know your baby best at the end of the day.
Case study 1: Grace
My eldest was born with silent reflux (no vomit, just discomfort). It took me 3 months to realise what exactly was wrong with her but as soon as we made allowances for it she improved rapidly. At 4 months old we were told by doctors to introduce solids (in the form of purees) as that would help ‘settle her stomach’.
In this instance it most definitely worked and she never suffered with any discomfort ever again. She moved from purees to baby led weaning at around 7 months old and thrived.
Case study 2: Lily
My youngest daughter was born with severe reflux. Each and every feed was a nightmare. She would bring up the entire feed in a projectile manner which would mean she needed feeding again and again to keep her weight up.
Eventually we were prescribed Gaviscon to thicken the milk and that helped no end! The nightmare was over until we needed to start weaning.
Again we were advised to start weaning at 4 months and so after the success with Grace we began the process. Big mistake, huge. She brought up everything and was so uncomfortable.
We stopped immediately and continued on milk until she showed signs of wanting food. This turned out to be around 6 months old and so we tried purees. Disaster! So much pain and vomit. So, we stuck with baby led and never looked back.
As you can see, both were very different. It could have been the difference in silent and non-silent reflux or it could have just been different children have different needs.
In my opinion, if your baby is fine on milk then don’t rock the boat. Wait until they are 6 months old and do baby led weaning. Purees seem to just aggravate everything you’ve worked hard to avoid.
Signs your baby is ready for weaning
I was so excited to start weaning with all of my children. It is such an exciting milestone and seems like a step closer to ending the endless feeds. I have come to realise that time goes way too fast and I should have focused on the now rather than pushing forward constantly.
So, focusing on whether your baby actually needs weaning is what needs to be done rather than us as parents getting excited and starting when we are ready.
But what do you need to look out for? How do you know if your baby is ready to start weaning?
Well, at roughly six months old they will be able to sit up unaided and this is a big step. You don’t want to start before this really as otherwise they’ll be lying down and all of that food will seep up their oesophagus and they will get that burning discomfort again.
Signs to look out for:
– Coordinating hands, eyes, and mouth. If they are able to put objects towards their mouth then their bodies are preparing to put food in their mouths.
– Interested in your food. You will suddenly find that they try to grab food off your plate and put it to their mouths.
– Able to swallow food. It’s one thing putting it to their mouths but are they able to chew and swallow it?
Still hungry after a milk feed. If they aren’t hungry after their milk then don’t worry about weaning yet, they just aren’t ready. Remember, “food is fun until they’re one.”
But my baby is hungry at 4 months old?
This is super common and probably why so many people start weaning early. But it actually ties in with a growth spurt / leap at this age and their appetite quickly returns to normal. Just up the milk during this phase and hold off on the food unless they are displaying the signs above.
Purees or solid food?
As mentioned in above, purees seem to aggravate so many babies with reflux that it really isn’t worth it. Plus, I know from experience what an absolute faff they are if you make them yourself.
Generally, purees are used for earlier weaning. so as it’s more likely you’ll start later on with a reflux baby then you won’t be using them.
That’s not to say you have to avoid pureed food altogether. Lord knows that I turned to jars and pouches on the days when I just didn’t have the time to think about mini sandwiches etc.. But on the whole, I didn’t start using these until much later as I knew that they would upset her reflux.
Solid food is great for 3 reasons: firstly, it is easier to prepare – whatever you are having, bung some of it in a bowl and you’re done; secondly, it means your baby has developed a bit more by the time you give it to them, meaning the chances of success are greater; thirdly, it is important for babies to experience food as it comes. I know a great number of babies who are such fussy eaters now as they don’t like the texture of solid foods.
Foods to avoid when weaning a reflux baby
There are a number of foods that trigger a reaction in reflux babies so let’s start off with the ones to avoid in the early days.
– bananas (I’ve never seen such a reflux attack and the pain was awful to see)
– tomatoes
– oranges
– apples
– fruit juice
– spicy food
– fatty food
You’ll notice these are acidic foods, which makes total sense when you think about any reflux you may have had as an adult.
I would say that by the age of 1 year Lily was able to eat this fine without any issue. So this guidance is just for those early months of weaning while they get used to food other than milk.
How to introduce new foods to a baby
Whether you are weaning a reflux baby or a baby with no oesophageal issues at all, there is a process you must work through to rule out any allergies at this stage.
You may already be aware of allergies already if your baby reacted to dairy in formula or any other foods via breastmilk. However, some foods only seem to show up once weaning starts so caution is still necessary when introducing new foods.
The rule of thumb is to give a new food for 3 days in a row, noting down any reactions (if any) before moving onto a new food.
So your week may look like this:
- Day 1: Introduce porridge
- Day 2: Porridge
- Day 3: Porridge
- Day 4: Porridge for breakfast and pear for lunch
- Day 5: Porridge & pear
- Day 6: Porridge and pear
- Day 7: Toast and pear
So every 3 days you can start with a new food. However, should you notice any adverse reactions then you stop with the new food immediately.
If the reaction is reflux related then you can try again the following month but if your baby should display any signs of an allergic reaction (hives, swelling, etc…) then you should consult a doctor straight away.
Foods to offer your reflux baby
So with the foods to avoid out of the way, let’s look at the initial foods you will want to offer your baby to get them started on their weaning journey.
Foods for a 6 month old:
Breakfast ideas:
- Porridge
- Toast
- Pears cut into strips
- Baby rice / rice cereal
Lunch & dinner ideas:
- Bread/ toast cut into strips
- Chips
- Chicken strips
- Mashed potato (white potatoes as well as sweet potatoes)
- Fish chunks
- Carrots mashed or cut into batons
- Parsnips mashed or cut into batons
Foods to avoid at this age:
- Citrus fruits
- Added salt
- Sugary foods
- Honey
- Nuts
- Soft cheese
- Undercooked eggs
- Shellfish or fish containing mercury at higher levels
Increasing fluids and reducing milk
As you begin the weaning process, you will want to introduce a beaker of water for your baby to sip at mealtimes. As mentioned above, you want to avoid squash and juice as they are too acidic for their delicate stomachs.
It is important to note that at the beginning of their weaning journey, food is very much for fun and an ‘added bonus’ to their milk diet. You should not be looking to reduce their milk intake at all.
As the old saying goes “Food is fun until they are one”.
So don’t worry about how much food they eat, the process is more about teaching them the skills of putting food in their mouths and learning to chew, while ruling out any allergies, rather than providing a full meal.
As they approach their first birthday, you may notice that they start to eat more and want less milk. That is absolutely fine and you could cut out an afternoon feed. By this stage you will instinctively know what to do, I promise.
Essential items for weaning
I always enjoyed kitting out my children with new plates and cutlery etc.. (although by the time my third one came along it was all hand-me-downs of course!).
But what do you actually need?
A highchair. You want one that is easy to clean and that can stand on its own or can be pushed up to the table so baby can join you as a family.
Bowls. I actually didn’t start using bowls until later on when I could trust my baby not to fling it. Before that though, I plopped the food straight onto the highchair tray. No distractions, just food.
These days, however, there is a large variety of different baby-friendly tableware designed to avoid food mess and entertain the child during the food intake. From bamboo baby bowls to suction plates, these come in various shapes and forms – from a horse to a unicorn, and most importantly, feature a suction base that prevents the plate from flipping over and resulting in a mess.
Spoons. Again, babies can start off using their hands for many foods but for things like porridge of course I used spoons. I got some that were easy for baby to grip if she wanted to try for herself.
We loved these:
Sippy cup. My word, sippy cups are such a personal choice for each baby. All 3 of mine preferred different types. Grace liked ones with straws, Lily liked ones with rim like a proper cup and William liked the super cheap ones that have a flip up spout . My advice is to try different ones until one sticks!
Bibs. Silicone bibs are the best as baby can scoop up anything they have dropped out of the bib. Muslin cloths are also super handy of course!
Messy mat. Protect your floor at all costs – especially if you have carpet.
FAQ
What are the symptoms of reflux?
Reflux symptoms are:
- Projectile vomit straight after feeding
- Sneezing
- Hiccuping
- Choking/ gasping type sound- best way to describe it is fighting for breath
- Not wanting to be on their back
- Not napping well.
- Not gaining weight (although we found the opposite as Lily fed more as she was always hungry)
What causes acid reflux?
Reflux is officially called Gastro-oesophageal Reflux Disease (GERD) and is caused by a weak valve between the stomach and your oesophagus. When the stomach is full, the valve would normally prevent any food from going back up again but with a weaker valve it will slip through. The weaker the valve, the worse the reflux.
When do babies grow out of reflux?
There is no set age as babies are all different. However, reflux will always start to improve once a baby starts to sit up (around 6 months of age). Because babies spend a lot of time lying down, it is much easier for food to travel along sideways – so when they start spending more time in an upright position gravity makes it harder for food to move upwards.
Their first year of life is when reflux will be at its worst but beyond that they will continue to improve.
How can I help my reflux baby?
Keeping your baby upright as much as possible will help prevent the stomach contents from moving out of the stomach and into their throat. You may encounter massive sleep struggles as of course lying in their cot at night will mean they feel the acid burn. The best way to help is by placing a foam wedge in their cot will help elevate them to a point that keeps their food in their stomachs.
Good luck!
Felicity
Friday 3rd of March 2023
Thank you for writing this. I am having a really tricky time with my third baby, with symptoms definitely not improved by weaning. His reflux is severe. On 20mg of omeprazole a day. We’re your little ones ever medicated too?
Katy
Monday 6th of March 2023
Oh I am sorry to hear this. We did try Lily on Omeprazole but it made her really lethargic and I just didn't like that as a side affect. So, in the end we just stuck with gaviscon in her bottles (half a sachet at a time I seem to recall) and avoided weaning until she was older. I'd say by about 18 months old it was all sorted - although even now (age 9) she feels a bit sick if she ever eats too much.