Helping baby gaining weight with reflux

My son is 5 months old. He was 8-15.5 lbs at birth and now weighs 9.95 lbs. He has microcephaly (small brain) and spastic quadraparesis (tense,spastic arms/legs). He is breastfed and fed breast milk in a bottle. He has eaten Earths best cereal and Sweet Potato ok. He has reflux though and often has a difficult time keeping it down. We are starting to add formula to the breast milk to add calories. We are under regular care from a pediatrician and a home care nurse but I'm interested in your advice to provide something to help him gain weight and also to help with constipation (prune juice is a little to strong and he can't keep it down well). I'm interested in any feedback you may have.

Thanks,

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Sue Gilbert

Sue Gilbert works as a consulting nutritionist. For many years she worked with Earth's Best Organic Baby Food, integrating nutrition and... Read more

Dear Deb,

First, to help with the constipation, can you try diluting the prune juice? Give him about a 50/50 mix with a little warm water. Have him drink it on a relatively empty stomach early in the morning. If he can't tolerate that, than some apple juice may be helpful. Apple juice contains sorbitol which can act as a laxative.

To help him gain weight adding concentrated calories that are easy to swallow is what you need to do. Ask your pediatrician about using a formula that has a higher calorie count per ounce. These formulas are usually marketed for premature infants. Also, you may want to add a little sweetener to his cereal, such a brown sugar, or perhaps a little bit of butter. Both will increase the calorie content. Try using the more calorie dense formula when mixing his cereal.

He is still young to be introducing too many solids, particularly in light of his reflux problem. Offer him foods that are sensitive to the problem, yet still encourage him to swallow successfully. Foods that naturally flow to the back of his throat will help elicit the swallow reflex and help him get used to swallowing. Any single ingredient baby foods that are texture/consistency modified can be used for this purpose. For example, mix a little formula into the baby food if they need to be thinned.

When he gets older and you can include more foods in his diet, some calorie and nutrient dense foods that you can add are: puddings, whole milk yogurts, high quality frozen yogurts and ice cream, butter on toast and vegetables, peanut butter on bread or crackers. Adding a little peanut butter to whole milk vanilla yogurt makes a kid friendly, rich food. Avocados are a calorie rich vegetable also high in vitamins. Try pureeing meats and mixing with a rich broth to thin down to an acceptable consistency.

A pediatric dietitian may also be of help to you. Ask your home nurse for his opinion/recommendation of one in your area, or ask the American Dietetic Association. You can email them at hotline@eatright.org.

Thank you for writing.

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