Regurgitation and digestive problems
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Regurgitation and digestive problems

Regurgitation, gastro-oesophageal reflux, diarrhoea, constipation, milk intolerance… Digestive problems are common in babies. Whilst some of these problems are benign, others require particular care and attention. Do you need advice and recommendations to help you get through these problems? Let yourself be guided!

Regurgitations are commonplace and trivial in babies

A little reflux here, a little reflux there… These regurgitations, which are referred to as “physiological regurgitations” are very normal in newborns and generally occur a short while after a meal. They are painless and don’t seem to upset baby generally speaking. Whilst these regurgitations can be surprising, you can be reassured in the knowledge that the actual volume of milk that is regurgitated is less than it appears…There is no impact on baby’s growth, even if baby regurgitates very frequently. The regurgitations are the result of a diet that is essentially fluid and the significant volumes of milk consumed compared with the actual size of the stomach in a child in a lying position and whose stomach has not yet developed its anti-reflux anatomy and physiology. These regurgitations don’t mean that the child is not digesting their milk.

On the other hand, if they seem to be too abundant and cause excessive crying, consult a healthcare professional.

EXPERT ADVICE: how to soothe and prevent “simple” regurgitations?

  • Ensure you are in a calm environment to feed baby.
  • Ensure baby is correctly positioned: vertical, with their back well-supported.
  • Don’t give baby too much milk in one go. Take little breaks during the breastfeed or bottle and help baby expel any air they may have swallowed by burping. Hold you baby in a vertical position against you whilst gently patting their back to encourage burps. Changing baby’s nappy in the middle of a feed is an opportunity for a break and often prompts a burp.
  • If you are bottle-feeding your baby, choose a suitable teat with flow that is neither too fast nor too slow, and preferably use bottles with a valve at the bottom so that air does not only enter the bottle through the teat.
  • Loosen baby’s nappy off as much as possible and avoid tight clothing to avoid compressing the stomach.
  • Avoid “jostling” baby after meals.
  • Avoid a seated position (maxi cosi seat) after meals; raise the head-end of their bed slightly and never put them down on their stomach.
  • If symptoms persist, you may want to change milk and opt for milk with a thickened formula or an anti-regurgitation milk. A healthcare professional will be able to advise you.

Gastro-oesophageal reflux (GOR): it gets more complicated!

Sleeping problems, significant regurgitation, pain and irritability… Whilst some forms of regurgitation are not cause for concern, others can give rise to complications.
Pathological GOR can cause oesophagitis accompanied by considerable crying, the appearance and aggravation of respiratory or ENT disease and discomfort with a tailing off in baby’s weight gain curve.
Note that a GOR diagnosis of this kind is rare and that babies generally experience benign regurgitation. If you are in any doubt, ask your doctor to examine your baby. They will prescribe suitable treatment.


Diarrhoea: upset little stomach

A bottle-fed baby’s stools are generally brown, sometimes greenish, and fairly solid. On the other hand, a breastfed baby’s stools are yellow, fairly soft or even liquid. It is completely normal to observe a change in colour and rhythm from one day to the next. Digestive transit varies from baby to baby. So, provided that they are eating and growing correctly and sleeping and gurgling as usual, there is nothing to worry about!

Only if stools suddenly become very liquid and abundant and your baby seems to be suffering and in pain is it diarrhoea. There are various causes: gastro-enteritis, poorly prepared bottle, allergy, etc… Consult a doctor who will prescribe suitable treatment.

EXPERT OPINION: what should I do if my baby has diarrhoea?

EXPERT OPINION: what should I do if my baby has diarrhoea?

  • Wash your hands and baby’s hands.
  • Handle food and milk with precaution.
  • Ensure that baby does not become dehydrated: weigh them often to check this. Give them small quantities to drink regularly and frequently. You need to give them as much oral rehydration solution as they will take. It contains sugar and mineral salts (sold in pharmacies).

If they begin to lose weight, consult your doctor immediately.

Constipation: the need to re-establish a rhythm

Baby may frequently experience problems in expelling their stools. If they eventually manage and there are no traces of blood, there is no cause for alarm.

It is a different matter, however, if baby is red, crying, their stomach is strained and their stools are hard with traces of blood. Consult a doctor who will prescribe suitable treatment.

Note that after a few weeks of breastfeeding, stools generally become less frequent, or even very infrequent, causing no discomfort in the child: this mock constipation in breastfed children does not require treatment.

EXPERT ADVICE: how can I help my baby to stop suffering from constipation?

  • Gently lift and straighten their legs several times: a movement that will help them relax. To encourage them to expel a stool, you can fold their thighs back up against their stomach.
  • Massage their stomach in a clockwise direction.
  • Ensure that they are hydrated and give them water with a low mineral content (dry residue at 180° less than 500mg/litre), but limit their intake of Hépar water as it is not suitable for their little kidneys.
  • A glycerine suppository may help, but should only be used infrequently.
  • Never use a thermometer to try and prompt evacuation of the stool: there is a risk of bleeding.

If your baby is severely constipated, your doctor may advise you to use a “transit”-type milk

Cows milk protein intolerance

Regurgitations, crying, diarrhoea, skin problems, coughing, slow or no weight gain… These are all possible symptoms of cows milk intolerance. It affects about 2% of children. Note that if there are close family members who suffer from milk intolerance, the risk of your baby suffering is increased.

It is sometimes difficult to distinguish between cows milk protein intolerance and GOR. To ensure that the correct diagnosis is made, consult your doctor. In certain types of cows milk protein intolerance, biological examinations (presence of anti-milk antibodies and skin tests) are required to make the diagnosis, but very often these tests are negative when in fact the baby is suffering from a cows milk protein intolerance. The only sure way to make a diagnosis is to carry out a milk-free dietary test for 3-4 weeks using a specific infant formula (hydrolysate).

ZOOM: which milk should I use in the event of a cows milk protein intolerance?

ZOOM: which milk should I use in the event of a cows milk protein intolerance?

To replace the traditional infant formula, which are generally predominantly made using cows milk, your doctor will suggest a hydrolysate formula (the proteins are broken down into tiny fragments using enzymes, thereby reducing its allergy-inducing properties). These milks are sold in pharmacies only and two types are available:

  • Cows milk protein extensive hydrolysate formula
  • Rice protein hydrolysate formula.

You will need to avoid any food containing milk when you introduce new foods into your baby’s diet.

If hydrolysate formula is not suitable or if your baby’s intolerance is severe, you may be offered an amino acid-based preparation.

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Questions / Answers

If your baby is allergic to cows milk proteins, seek the advice of your doctor. They will help you find the best alternative.

Your baby knows when they are hungry and when they have had too much to eat. You must respect their appetite and never force them to finish what is on their plate. Just like adults, your baby may have more appetite on one day than on another and may not always want to finish what you give them for various reasons. Nonetheless, it is important to make sure they have an appetite at mealtimes by restricting how much they snack between meals and always offer them age-appropriate sized portions.

Dietary diversification generally starts between 4 and 6 months. Certain signs indicate that your baby is ready to accept other foods apart from milk, particularly the fact that they seem to be very interested in what you have on your plate and watch you eat by following your movements. They may also mime chewing and they know how to let you know that they have had enough to eat. Diversification takes place slowly. Different products are introduced progressively and with certain textures.

For more information and advice on dietary diversification, take a look at our tools:

Rest assured, a baby who is still hungry will quickly let you know. A baby who is full also knows how to show it it you! It is important to respect baby’s rhythms and their signs that they are full. Never force them if they are not hungry. If the quantities prescribed by your doctor don’t correspond with what your baby actually consumes, don’t hesitate to talk to them about it.

Making up a bottle is very easy. There is nothing complicated about it, you just need to apply a few hygiene rules and use the right quantities. Don’t hesitate to take a look at our detailed illustrated tutorial and you’ll soon be making up bottles like a pro!

After 12 months, other foods can be introduced into baby’s diet and quantities can be increased. For more information, refer to our calendar of flavours and textures.

Furthermore, milk is still an essential part of baby’s diet after 12 months. It is therefore recommended that between the ages of 12 and 36 months, you continue to give baby a 3rd stage growth milk, specially formulated to fulfil the nutritional requirements of babies in this age range: they are low in protein and contain the nutrients that baby may be lacking, such as iron and essential fatty acids.

After 6 months, infant milk is still just as important! Between 6 and 12 months, it is possible to give baby a 2nd stage follow-on milk.

Additionally, at 6 months at the latest, dietary diversification has started and baby can be given different foods in addition to milk (breast milk or infant milk). For more advice on what baby can eat between 6 and 12 months, quantities and textures, refer to our calendar of flavours and textures.

Nactalia follows WHO recommendations and encourages exclusive breastfeeding for the first 6 months. If you cannot or do not wish to breastfeed, talk to your doctor who will be able to prescribe a suitable 1st stage milk. Between 4 and 6 months, baby’s diet can be diversified and other foods can be given to baby, provided that they are a suitable texture. For more advice, follow our calendar of flavours and textures.

Up to the age of 3, baby has very specific nutritional needs. In particular they need more iron, calcium and essential fatty acids than an adult.

“Normal” milk, or cows milk, which the whole family drinks is generally too rich in proteins and lacking in iron for baby. Infant formula fulfils their needs more effectively.

Between 1 and 3 years, the dairy equivalent to be consumed is 500ml/day. The minimum recommended amount of growth milk (which is specially formulated to provide all of the nutritional requirements of babies in this age range) is 300 ml/day, which is then supplemented with other dairy products to make the recommended 500ml.

Cows milk does not fulfil the specific nutritional requirements of baby before the age of 1.

Between 1 and 3 years, cows milk can be given to baby, but it is preferable to continue with growing-up milks : they contain less protein and all of the nutrients which baby may be lacking, such as iron and essential fatty acids.

Between 0 and 6 months, opt for exclusive breastfeeding and if you cannot or choose not to breastfeed, seek the advice of your doctor. Between 6 and 12 months, it is possible to give baby a 2nd stage follow-on milk. Between 1 and 3 years, it is preferable/advisable to give baby a 3rd stage growth milk.

Progressing from the breast to the bottle corresponds with weaning baby, or in other words is the moment when baby stops breastfeeding and starts using a bottle or starts to have a more varied diet if they are between 4 and 6 months old. It is an obligatory step that can take place very calmly if the transition is managed gently.

To guide you in this transition and help you wean baby gently, we have prepared lots of advice and tips which you can find in our article “A gentle transition for successful weaning”. For even more advice, take a look at our tools for mothers:

Each infant milk has a different flavour and it takes time for baby’s body to adapt. It is recommended that you introduce the new formula progressively, alternating it with the previous one.

Weight gain is not significantly different between breastfed children and those fed with a bottle. Additionally, regular, continuous weight gain is fundamental during baby’s first months. There is no need to worry, each baby is different and grows at their own rate. However, if you are concerned about your baby’s weight, don’t hesitate to talk to your paediatrician.

If you have chosen industrial infant milk, it does not usually cause intestinal gas.
However, if your child is suffering from minor physiological problems such as intestinal gas, certain milks have been specifically formulated to reflect these requirements. For example, Nactalia AD-LF milk has been specially formulated to help babies who are sensitive to lactose to recover from the temporary or permanent symptoms of lactose intolerance, such as intestinal gas, irritation and diarrhoea.
We recommend seeking the advice of your doctor.

Note that intestinal gas may also be the result of colic since babies cry a lot and swallow air

Food allergies are common in children.
Breastfeeding remains the best protection against allergies. Even if breast milk only provides partial protection against the risk of future allergies, no infant formula does any better.
Additionally, if you have chosen an industrial milk, it may be that your child is allergic or intolerant to the lactose or the cows milk protein present in the milk that you have chosen. Solutions are available for children who are sensitive to this kind of allergy, such as the milks containing extensively hydrolysed proteins which have proven to be effective in clinical studies.

However, if this is the case and before doing anything else, we recommend that you consult your doctor.

If you have chosen industrial infant milk, it does not usually cause constipation.
However, if your child is suffering from minor physiological problems such as constipation, certain milks have been specifically formulated to reflect these requirements. For example, Nactalia COMFORT milk has been specially formulated for the dietary treatment of intestinal problems such as constipation.
Before choosing your milk, we recommend seeking the advice of your doctor.

If you observe minor physiological problems in your baby, such as colic, regurgitation, constipation or diarrhoea, this can mean that the infant milk you are using is not fulfilling the requirements of your baby (even if gastrointestinal problems are very common during the first few months of life).

In any case, there is no reason to worry, solutions are available! But before choosing, we recommend that you consult your doctor.

The quantity of milk baby requires each day depends on their age. Note that Nactalia follows WHO recommendations and encourages exclusive breastfeeding for the first 6 months. For more information on how much milk to give your baby each day, you will find instructions on your Nactalia box indicating the volume of water and number of measuring scoops to give your baby depending on their age.

It is important to note that these quantities are only averages that need to be adapted to reflect your baby’s appetite and how quickly they gain weight.

Never force your baby to finish their bottle if they don’t seem to want to: just like you, there are times when they will be hungrier than others. It is may be that they leave half of their bottle at one meal and then want more milk at the next meal: let them eat in accordance with their requirements! Similarly, the times that they want eat and the intervals between bottles can also vary: it is important to respect baby’s rhythm.

The World Health Organisation (WHO) recommends that babies are exclusively breastfed for the first 6 months as breast milk is the optimal form of nutrition for a baby.

If you cannot or do not wish to breastfeed, it will be necessary to choose an infant formula suited to the child’s age. These infant formula fulfil their nutritional requirements, both in terms of macronutrients (lipids, carbohydrates, proteins) and micro nutrients (vitamins, iron, zinc and other minerals…), as well as the absolutely essential provision of calcium.

Do not hesitate to contact your doctor to advise you in your choice of milk.

Breastfeeding is the best way of fulfilling baby’s specific requirements. This is why Nactalia encourages and recommends breastfeeding up until the age of 6 months. If you cannot or choose not to breastfeed, your doctor is the most suitable person to advise you.

Attentive to the needs of mothers and their babies, our scientific teams have studied in depth the composition of breast milk and have devoted their efforts to formulating infant milk formulas that best meet the baby’s natural needs and specific metabolism.

Nactalia offers a range of different formulas to provide the necessary nutrients to ensure your baby grows and develops healthily.

Making sure that baby grows healthily is the n°1 concern for parents!
And achieving this starts in the very first days of life, ensuring that baby gains weight, regularly, every month.
Breastfeeding is the best way of fulfilling baby’s nutritional requirements. However, if you can’t or don’t want to breastfeed, the infant milk formulas of Nactalia have been formulated to provide baby with all the necessary nutrients for healthy growth.

Each child has their own specific requirements and children do not gain weight in the same way. So don’t worry!
But if you are feeling overly concerned about your baby’s weight, then talk to your paediatrician.