Helping parents manage common feeding issues just got easier.
Digestive Concerns for Moms
When moms have a baby who is fussy, gassy and crying, they come to you for answers. Sometimes a little parent education can go a long way in easing their issues. For breastfeeding babies, it may help to counsel moms to recognize their baby’s hunger signals or watch out for certain foods in their own diet. For formula-feeding babies, changes in formula type may be what they need.
Help educate parents to ease and enjoy feeding times with their infants. Download this FAQ for parents about easing gas and crying.
What causes tummy issues?
Problems digesting some nutrients, such as protein and lactose, may be presented as fussiness or gas in some infants, and it is common practice to consider a change in formula at this time.
The enzymes lactase and enterokinase are involved in the breakdown of lactose and protein, respectively, in the digestive system. Due to the immaturity of the digestive system in infants, these enzymes may not be produced in adequate amounts resulting in some lactose and protein traveling to the large intestine without being fully digested. They may be fermented by bacteria.
Bacterial fermentation in the large intestine may cause gas, which may lead to fussiness or crying.
A Range of Options
Standard milk-based formulas have intact proteins derived from cow’s milk. Through a process called hydrolysis, proteins can be broken down during manufacturing. Formulas with partially hydrolyzed proteins are designed to help ease digestion4. Extensively hydrolyzed formulas should be considered for cases when cow’s milk allergy is suspected.
Recommending the correct formula can help your patients and give moms peace of mind.
| Intact Protein Formulas With Full Lactose |
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Healthy babies' first choice when breastfeeding is not possible.
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| Partially Hydrolyzed Formulas With Reduced Lactose* |
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Easy to digest for healthy babies rejecting first choice formula or with digestive discomfort. 73% of babies experience digestive discomfort.1. |
| Extensively Hydrolyzed With No Lactose |
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For confirmed or suspected cow's milk protein allergy (CMA).
2%-7% of babies experience CMA.6. |
| Extensively Hydrolyzed With No Lactose |
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For confirmed lactose intolerance.
Lactose intolerance is extremely rare under 3 years of age7. |
Looking for Formula Solutions for Your Patients?
Learn More About Mead Johnson Nutrition’s Solutions
When to Recommend a Probiotic Supplement
Emerging data show that probiotics may be beneficial for supporting overall digestive and immune health8-10. Fostering a healthy infant gut microbiome regularly—not just after a bout of gastroenteritis or following a round of antibiotics—may be beneficial for baby.
Learn more about the link between gut bacteria and immune health.
Lactobacillus rhamnosus GG (branded LGG®)
The most widely studied probiotic, LGG has been used in food and dietary supplements for close to 30 years with a well-documented safety and efficacy profile.
Bifidobacterium lactis (BB-12®)
Also well-studied, BB-12 may have beneficial effects on gastrointestinal and immune function.
Lactobacillus reuteri (RC-14®)
Originating from healthy vaginal sources, this strain has been used safely since 2004.
Lactobacillus reuteri (DSM 17938)
This strain was isolated from the breast milk of a woman living in the Andes.
Nourishing a Robust Microbiome Can Help Support Digestive and Immune Health
Depending on the strain, probiotics may help your infant patients in the following ways:
- Improve gut barrier function11
- Support immune health8
- Lower risk of atopic/allergic disease9
- Ease digestion issues like colic8
While most studies at this time revolve around individual strains, emerging evidence suggests combining some probiotic strains can have synergistic effects9.
Provide Your Patients with Clinically Studied Levels of LGG® and BB-12® Probiotics
See the options Mead Johnson Nutrition has to offer.
LGG and BB-12 are trademarks of Chr. Hansen A/S.
GER Occurs in 66% Healthy Infants12
Healthcare professionals understand that babies spit up, but parents often worry about it. A lot. In fact, research shows that spit-up is the topic of discussion at 25% of routine 6-month visits12.
GER is common—it can occur daily in 50% of all infants. Spit-up, regurgitation or vomiting are often the most visible symptoms.
Knowing the difference between uncomplicated physiologic reflux (GER) and actual gastroesophageal reflux disease (GERD) is key in managing symptoms—and reassuring worried parents.
Identify the Source of Spit-Ups
GER is a normal physiologic process caused by an immature lower esophageal sphincter (LES). In younger infants, the LES isn’t strong enough to prevent backflow from the stomach to the esophagus. As the LES matures, GER usually resolves on its own.
Overfeeding
Positioning during/after feedings
Burping frequency
Intolerance to maternal diet
(e.g., milk or egg)
Type of formula used
Current Guidelines for Managing Reflux
Many worldwide expert groups have published recommendations on managing GER and GERD, including the American Academy of Pediatrics. According to their latest guidelines, it is critical to properly distinguish between GER and GERD. In either case, lifestyle changes are the first-line treatment12. This includes:
- Making feeding changes
- Positioning therapy
- Modifications of maternal diet (if breastfeeding)
- Reducing feeding volume
- Increasing feeding frequency
- Educating parents about avoiding environmental factors such as tobacco smoke
Empiric use of acid suppression medication is not indicated for uncomplicated physiologic reflux. Additionally, in April 2020, the FDA requested that all prescription and over-the-counter products containing ranitidine be pulled from the market due to safety concerns13.
If there are signs of more complicated GERD, closer evaluation is needed. The newest guidelines emphasize weight loss as a critical warning sign. Subspecialist consultation and pharmacologic treatment may be warranted.
Figure 1. Approach to the infant with recurrent regurgitation and vomiting 12
Do Thickened Formulas Work for GER?
When managing GER, choosing a thickened formula may work for otherwise healthy, non-breastfeeding infants. Commercially available thickened formulas offer a more balanced nutrient profile with less mess.
By using ingredients such as rice starch, for example, formula flows normally through a standard nipple, only thickening when “activated” by the gastric juices of the stomach.
Energy of thickened formulas meets the recommended 20 kcal/serving, while adding rice cereal to standard formula can increase the energy density to 34 kcal/serving, effectively diluting the protein and fat ratios.
References