Brief Answer:
Paediatric gastroenterologist for management
Detailed Answer:
Thank you for asking!
Allamentium and elecare are both nutritional formula milks and they leading to reflux and
indigestion might be the wrong techniques feeding. It would have been friendly if baby's age was mentioned. Age of less than a year needs every 3 hourly feed with no more than 50 to 60 ml in one feeding as stomach can not compensate for more than that. Reflux occurs when you over flow the gut, as milk has to go some where so it get back to mouth. Next is the posture of feeding, keep the baby at minimum 45 degree and keep and at that position even after feed for at least an hour.
Lets suppose there is no problem and technique is good then we need to discuss the gut anatomy and structural or functional compromise and for that some work up would be necessary to sort out probable causes for this reflux with hiatal hernia on the top.
Reflux babies usually present with the following
Typical or atypical crying and/or irritability
Apnea and/or bradycardia
Poor appetite;
weight loss or poor growth (failure to thrive)
Apparent life-threatening event
Vomiting
Wheezing, stridor
Abdominal and/or chest pain
Recurrent pneumonitis
Sore throat,
hoarseness and/or laryngitis
Chronic cough
Water brash
Sandifer syndrome (ie, posturing with opisthotonus or
torticollis / neck andd trunk posture troubles )
Signs and symptoms in older children include all of the above plus
heartburn and a history of vomiting, regurgitation, unhealthy teeth, and
halitosis / fowl breath.
some work up to see what the cause is behind this needs to be looked for by
Esophageal manometry
Esophagogastroduodenoscopy
Upper gastrointestinal imaging series
Gastric scintiscan study
Esophagography
Intraesophageal pH probe monitoring
Intraluminal esophageal electrical impedance
Get the baby to a paediatric gastroenterologist for detailed work up and follow the guidelines and tips mentioned below meanwhile.
Providing small, frequent feeds thickened with cereal
Upright positioning after feeding
Elevating the head of the bed
Prone positioning (infants >6 months)
Older children with gastroesophageal reflux may benefit from the following:
Diet that avoids tomato and citrus products, fruit juices, peppermint, chocolate, and caffeine-containing beverages
Smaller, more frequent feeds
Relatively lower fat diet (lipids retards gastric emptying)
Proper eating habits
Weight loss
It needs a detailed history and a thorough physical examination and a complete clinical correlation. Let it turn out to be in the best interest of the baby.
Take good care of the baby and please close the discussion.
Regards