It is best to encourage breastfeeding for the first six months of life to boost your baby’s immune system development and help in nutritional growth. However, when you begin supplements or if you’re offering a new kind of infant formula, there might be some changes in feeding patterns. Infant feeding problems are one of the most common causes of concern for parents. If you are worried about the growth or appropriate weight gain of your baby, it is best to discuss the issues with your healthcare professional. They will guide you on any prevailing feeding issues and investigate if your baby has any health issues that need medical attention. Some common feeding problems in young children are food allergies, intolerance, cow’s milk allergy, colic, and gastro-oesophageal reflux disease (GORD).
Allergy & Intolerance
Allergy and intolerances are different situations that might need different solutions. An allergy involves the immune system and triggers an allergic response, while an intolerance does not. Normally, an allergy is considered as an over-reaction to the immune system by a regular harmless substance. However, the symptoms of the allergy can range from mild, moderate to severe and even fatal in some cases. On the other hand, intolerance is a non-allergic reaction to some chemicals or substances in foods or the environment. Generally, metabolic, toxicological and/or pharmacological reactions are common body processes involved in intolerance responses.
Allergic reactions are caused by allergens, which may be harmless to most people but can cause an allergy in others. The most common food allergens include peanuts, tree nuts, sesame, egg, fish, wheat, soy, cow’s milk and milk products like infant formula, and more. The body’s immune system considers such allergens as an enemy invader and generates an attack response. This can lead to allergic symptoms of hives, vomiting, or swelling around the mouth. Sometimes, allergic reactions are revealed after a while as the body’s immune system can take a few hours or even a day to denote the symptoms. The delayed reactions can be tricky to diagnose and in such cases, it is best to visit an expert allergy doctor.
A more severe allergic reaction is called anaphylaxis, which occurs within minutes after the body comes in contact with an allergen. It involves the body producing large proteins called IgE antibodies, which the immune system uses to identify and deactivate the upsetting substances. If your baby has anaphylaxis, he will require immediate lifesaving medical treatment. After identifying the cause of anaphylaxis, the allergen must be avoided completely. You can speak to your healthcare professional to offer alternate dietary intake that continues to meet the energy and nutrition needs of your little one.
Cow’s Milk Allergy (CMA)
Cow’s milk allergy affects around 2% of Australian infants and toddlers. Children diagnosed with a CMA must avoid all food and drinks that contain cow’s milk, even in the smallest amounts. This will also include some kinds of infant formula and toddler milk products like A2 Platinum®. In some cases, breastfed babies might also show sensitivity to cow’s milk in their mother’s diet and in such cases, it is best to seek assistance from an Accredited Practising Dietician (APD). The key to diagnosing CMA is to understand the family history and conduct a few tests like the skin prick testing or the RAST test. Usually, doctors will advise you to eliminate cow’s milk products for a period of two to six weeks to see if the symptoms show any marked improvement.
Normally, children outgrow the allergy by the age of four, but in some cases, it may continue into adulthood. Formula-fed babies might need to switch to appropriate alternative formula, which is whey or casein based and are extensively hydrolysed formulas (eHFs). Nearly 90% of children with CMA can tolerate this formula. Soy milk, rice, oat or coconut milk should not be used as first-line milk alternatives until the age of 2.
Various substances or chemicals either in food or in the environment can cause intolerance reactions in children. Such reactions involve the non-immune system and though they can be bothersome and uncomfortable, they rarely constitute a medical emergency. All children have different tolerance levels to triggers that may cause intolerance and if the exposure reaches the threshold levels, an adverse reaction can occur. Some reactions occur instantly while others can take days to show symptoms. Some common reactions include stomach and bowel problems, headaches, hives, feeling unwell or run down. You must visit a specialist dietician to determine intolerance as allergy tests can’t identify intolerance reactions. Breastfed babies can also show intolerance sensitivity if they are exposed to any troublesome substances in their mother’s diet. It is best to seek help from your GP or an APD in Australia or New Zealand to determine the cause of intolerance.
Many parents often use the term colic to define their baby’s unsettling behaviour. Colic normally affects about 5 to 20% infants and is a condition where the baby cries for more than three hours in the late afternoon or evening. It is commonly found in babies of two weeks to four months and can be extremely stressful for parents. Colic babies can be tough to settle by cuddling or any other calming techniques. Symptoms are usually seen from the first or second week of life and can include drawing up of knees, clinching the fists and arching the back. You may also notice your baby’s face turning red along with frowning. Other symptoms include stomach noises and passing wind or faeces when crying stops.
Causes & Treatment
There are various theories related to the cause of colic. Some include maternal diet, maternal drugs, unfamiliar gut sensations, immaturity or difficulty in adjusting to life outside the womb. Normally, doctors don’t recommend a medical treatment unless a medical cause is diagnosed with colic. In case your baby has reflux or any allergy history, oral drops might be considered for a one-week trial. Based on its results, the doctor might advise to continue for 3-4 months and then slowly wean over a week’s time. However, remember that unless diagnosed with colic, babies should not be given any medicine.
Tips for Parents
- Staying calm is important while dealing with colic babies
- Try to feed or cuddle to help your baby cope with distress
- Let your baby suck the bottle or breast based on the amount of feeding time and quantity suggested by your doctor
- Try gently rocking or holding your baby in your arms or a carrier or sling
- Speak softly or try gentle singing as your voice can also soothe your baby
- A warm bath, light massage or soft music will also work
Diarrhoea should be treated quickly or else it can lead to dangerous dehydration in infants. Signs of diarrhoea include frequent bowel movements, loose and watery stools. When babies suffer from diarrhoea, they lose large quantities of water along with important electrolytes like potassium and sodium, causing dehydration. It can be caused due to a stomach bug or a viral or bacterial infection. Diarrhoea can also be a result of any food sensitivity, allergy or a reaction to any particular medicine. Mild to moderate diarrhoea can be treated in babies with the help of continued breastfeeding/formula feeding and oral rehydration if required. If symptoms persist, make sure to visit your healthcare professional for the right medical treatment.
Constipation is the passage of dry or hard stools that may be difficult to pass for babies or toddlers. Painful bowel movements and distress can cause discomfort to babies, and they might experience bloating or stomach pain when suffering from constipation. If a baby is teething, not feeding properly, has an illness or has just started solids, he might get dehydrated and show signs of constipation. Normally, medical intervention is not required to treat constipation unless the condition is severe. Parents can try giving a gentle tummy massage, a warm bath, or practice cycling with your baby. Also, give extra fluids in moderation like cooled and boiled water, especially if the weather is hot. If you’re using formula, don’t dilute it, prepare it in the exact concentration mentioned on the pack.
Gastro-oesophageal Reflux Disease (GORD)
Gastro-oesophageal reflux is highly common in infants and normally starts at the age of eight weeks. Almost 90% cases get resolved within the baby’s first year. When a baby’s stomach contents come back into their food pipe (oesophagus), it can cause a baby to spit up milk or vomit. Such reflux normally occurs soon after a feed. As parents or caretakers, you can try simple remedies at home such as burping your baby after every feed, giving smaller feeds at regular intervals and avoiding tight clothing. Also, don’t put your baby to bed immediately after a feed. If you notice that your baby is showing additional troublesome symptoms like distress, chronic cough, feeding challenges or hoarseness of voice other than normal reflux, you must consult a doctor immediately.
If you are noticing any of the above feeding problems in your infant or your toddler, it is recommended to consult your GP or APD in Australia and get the required medical attention at the earliest. Especially if the conditions are interfering with the feeding of your infant, you must seek help so that your child’s growth and development is not stalled.