My goal is to add one blog post every day during the work week; however, today is one of those days when I am tired and feel I don't "have it in me" to tackle a lengthy subject. Plus, spring feels like it is just around the corner, and I know my girls and I can use some play time together. So in lieu of "information," I am going to suggest an activity that is both fun and practical for GERD toddlers: baking gingerbread cookies.
Gingerbread cookies may sound like a Christmas treat or an old-fashioned old wives' tale, but they really are a fantastic food considering the random vomiting that sometimes occurs with GERD children. I've been baking gingerbread with the girls since they were old enough to eat solid foods. Not only do we have fun spending time and baking together, but when we're done the girls have a snack they enjoy eating and helps to settle their sensitive tummies in between meals. (Gingerbread and apples--or applesauce--makes a great snack for GERD toddlers.)
You don't even have to be a Betty Crocker and make the cookies from scratch. Just use a gingerbread cookie mix from the baking aisle, or use a box of gingerbread with a cookie recipe conversion on the package. Of course, regular gingerbread works just as well as gingerbread cookies, but my girls prefer the cookies. After all, it's so much more fun to roll and cut than simply mix and pour!
So bake a box of gingerbread cookies and spend some time having fun with your GERD baby!!!
Friday, January 22, 2010
Thursday, January 21, 2010
Physical Causes of GERD
Some people think I am obsessed with GERD. Maybe I am. My husband and I always said we wanted 3-4 children. Right now we have two, and both of them have "moderately severe" GERD. We are fortunate that they never had to be hospitalized or be given feeding tubes, but that didn't mean we didn't face challenges. We had challenges--lots of challenges--and the GERD is still there; it's just under control--for now. And since I couldn't find any support groups in my area or any other GERD parents to connect with at the time we were dealing with the "crisis" symptoms, I had to do a lot of reading on my own--especially when it became clear that the Prevacid was doing more harm than good.
Of course, one of my first questions was "Why do they have GERD in the first place? What caused it?" Believe it or not, some people told me they thought God was punishing me for something I had done by giving me two children with moderately severe GERD. To those people, I could only respond by saying my daughters were blessings--and that God had given them to me because He apparently trusted me to be able to handle their specific needs, even if I didn't trust myself!
Others told me that since my girls had every outward appearance of being healthy, I must be imagining their symptoms or (even worse) inflicting the symptoms upon them by my care of them. To those people, I could only watch my cries of "You're wrong! You're wrong! You're wrong!" fall upon deaf ears.
Because I was dealing with my own physical pain from pregnancy complications and follow-up surgeries as well as post-partum depression, there were times when I indeed wrestled with self-doubt, but that is another story.
For today's post, suffice it to say that GERD is a real disease. Some babies will outgrow their symptoms after 1-2 years; others will have to manage theirs throughout their lives. To keep GERD in balanced perspective, here are the current theories as to its cause in infants:
1. Genetics: One study links it to autoimmunity; another links it to a defect in Chromosome 13. Studies in both camps are ongoing. GERD with a genetic cause is most likely a chronic (long-term or lifelong) condition. For more information on the study relating GERD to Chromosome 13, please refer to the following link:
http://www.post-gazette.com/healthscience/20000719gerdstudy1.asp
2. Hiatal hernias: The presence of a hernia can be established through medical imaging and treated accordingly. This type of GERD may or may not be chronic.
3. Presence of labor-inducing drugs during birth: The natural health professionals I have consulted agree that the use of labor-inducing drugs seem to have a correlation with infant GERD. They believe the stronger contractions associated with labor-inducing drugs can cause injury to the baby such as hiatal hernias or vagus nerve damage. I have not found medical research to support this, and neither have the doctors whom I have consulted, whether pediatricians or OB/GYNs. That doesn't mean it can't be true, though, since homeopathic and medical research hardly ever cross. It certainly makes sense to me, so I offer it simply as something to consider. Genetics can't be changed: methods of childbirth can, so if you feel your child is already at risk of having GERD, an induced labor may be something you wish to avoid if at all possible.
Of course, one of my first questions was "Why do they have GERD in the first place? What caused it?" Believe it or not, some people told me they thought God was punishing me for something I had done by giving me two children with moderately severe GERD. To those people, I could only respond by saying my daughters were blessings--and that God had given them to me because He apparently trusted me to be able to handle their specific needs, even if I didn't trust myself!
Others told me that since my girls had every outward appearance of being healthy, I must be imagining their symptoms or (even worse) inflicting the symptoms upon them by my care of them. To those people, I could only watch my cries of "You're wrong! You're wrong! You're wrong!" fall upon deaf ears.
Because I was dealing with my own physical pain from pregnancy complications and follow-up surgeries as well as post-partum depression, there were times when I indeed wrestled with self-doubt, but that is another story.
For today's post, suffice it to say that GERD is a real disease. Some babies will outgrow their symptoms after 1-2 years; others will have to manage theirs throughout their lives. To keep GERD in balanced perspective, here are the current theories as to its cause in infants:
1. Genetics: One study links it to autoimmunity; another links it to a defect in Chromosome 13. Studies in both camps are ongoing. GERD with a genetic cause is most likely a chronic (long-term or lifelong) condition. For more information on the study relating GERD to Chromosome 13, please refer to the following link:
http://www.post-gazette.com/healthscience/20000719gerdstudy1.asp
2. Hiatal hernias: The presence of a hernia can be established through medical imaging and treated accordingly. This type of GERD may or may not be chronic.
3. Presence of labor-inducing drugs during birth: The natural health professionals I have consulted agree that the use of labor-inducing drugs seem to have a correlation with infant GERD. They believe the stronger contractions associated with labor-inducing drugs can cause injury to the baby such as hiatal hernias or vagus nerve damage. I have not found medical research to support this, and neither have the doctors whom I have consulted, whether pediatricians or OB/GYNs. That doesn't mean it can't be true, though, since homeopathic and medical research hardly ever cross. It certainly makes sense to me, so I offer it simply as something to consider. Genetics can't be changed: methods of childbirth can, so if you feel your child is already at risk of having GERD, an induced labor may be something you wish to avoid if at all possible.
Wednesday, January 20, 2010
Elderberry and the GERD Baby
I was recently introduced to elderberry juice by some friends of mine after my daughter struggled with back-to-back viral infections with severe nausea and high fever. Since she tested negative for flu both times, our pediatrician could not prescribe Tamiflu. But with swine flu still making its rounds in our area, we were concerned.
The discovery of elderberry has been a lifesaver to us--or at least, a sanity saver. Last year (during the 2008-2009 fall/winter season) both my girls were sick for four months straight of nonstop viral illness. Not fun! And when my daughter became so ill this past fall, I was determined to do whatever I could to prevent her from repeating last year's experience!
A weakened immune system can be a symptom of GERD as well as a side effect of long-term PPI use such as Prevacid, so I can not say if one or the other (or a combination) was the reason my girls typically got sick so drastically or remained sick for so long. I do know there was a period of time where I simply had to keep them away from other children. While I was glad they had each other, I longed for a time when I could get them "out of the house" and introduce them to a more normal toddler social life.
For the past six weeks, I have given my girls elderberry juice every day, and amazingly, they have not had a single illness despite being exposed to children in preschool and Bible study with runny noses, fevers, and even strep throat. What's more, my younger daughter had suffered from chronic croup and recurring stridor since she was an infant. She was being evaluated for acid-induced asthma when we began the elderberry. Recently, however, her croup has completely disappeared. The only thing I can attribute this remarkable recovery to is the introduction of elderberry juice, which reportedly is a natural remedy for asthma and bronchial irritation.
There is a variety of elderberry juices and syrups on the market. Syrups, which usually include some form of sugar, are typically sweeter and can be administered in higher doses. Juices or extracts, which typically do not contain sugar, are often mildly bitter and should be administered in smaller doses. I prefer the juice because you can begin giving it to a GERD baby as soon as he or she is old enough to drink juice, whereas the syrups with added sugars may cause diarrhea if administered too early. I mix 1/4 teaspoon of straight elderberry juice into a small cup of apple juice for my girls at breakfast. They love drinking their "purple juice!"
I am including a link to Wyldewood Cellars' recent newsletter, discussing the use of elderberry to prevent the swine flu. Wyldewood is a winery located in Kansas which sells elderberry juices (as well as wines). Their juice is my personal favorite (a Best Pick!), as it contains no added sugar and is very cost affordable. However, it is a local cellar, so I had to stock up the last time I visited my family in Missouri.
If you do not have a health store near you that sells elderberry (also known as sambucol or sambucus,) you can order online at Amazon.com. I have listed a few varieties in my GERD Mama store for you to peruse if you cannot find a provider near you.
To Read About Elderberry and H1N1 Swine Flu Protection (page 3 of the attached newsletter)
http://www.wyldewoodcellars.com/PDFs/NL%2009-09.pdf
The discovery of elderberry has been a lifesaver to us--or at least, a sanity saver. Last year (during the 2008-2009 fall/winter season) both my girls were sick for four months straight of nonstop viral illness. Not fun! And when my daughter became so ill this past fall, I was determined to do whatever I could to prevent her from repeating last year's experience!
A weakened immune system can be a symptom of GERD as well as a side effect of long-term PPI use such as Prevacid, so I can not say if one or the other (or a combination) was the reason my girls typically got sick so drastically or remained sick for so long. I do know there was a period of time where I simply had to keep them away from other children. While I was glad they had each other, I longed for a time when I could get them "out of the house" and introduce them to a more normal toddler social life.
For the past six weeks, I have given my girls elderberry juice every day, and amazingly, they have not had a single illness despite being exposed to children in preschool and Bible study with runny noses, fevers, and even strep throat. What's more, my younger daughter had suffered from chronic croup and recurring stridor since she was an infant. She was being evaluated for acid-induced asthma when we began the elderberry. Recently, however, her croup has completely disappeared. The only thing I can attribute this remarkable recovery to is the introduction of elderberry juice, which reportedly is a natural remedy for asthma and bronchial irritation.
There is a variety of elderberry juices and syrups on the market. Syrups, which usually include some form of sugar, are typically sweeter and can be administered in higher doses. Juices or extracts, which typically do not contain sugar, are often mildly bitter and should be administered in smaller doses. I prefer the juice because you can begin giving it to a GERD baby as soon as he or she is old enough to drink juice, whereas the syrups with added sugars may cause diarrhea if administered too early. I mix 1/4 teaspoon of straight elderberry juice into a small cup of apple juice for my girls at breakfast. They love drinking their "purple juice!"
I am including a link to Wyldewood Cellars' recent newsletter, discussing the use of elderberry to prevent the swine flu. Wyldewood is a winery located in Kansas which sells elderberry juices (as well as wines). Their juice is my personal favorite (a Best Pick!), as it contains no added sugar and is very cost affordable. However, it is a local cellar, so I had to stock up the last time I visited my family in Missouri.
If you do not have a health store near you that sells elderberry (also known as sambucol or sambucus,) you can order online at Amazon.com. I have listed a few varieties in my GERD Mama store for you to peruse if you cannot find a provider near you.
To Read About Elderberry and H1N1 Swine Flu Protection (page 3 of the attached newsletter)
http://www.wyldewoodcellars.com/PDFs/NL%2009-09.pdf
Tuesday, January 19, 2010
The 5S Model Revised
When my husband and I were expecting our first baby, we attended an 8-hour hospital class designed for new parents. One of the sessions gave us practice in the 5 S Model of quieting babies. Of course, we were given the typical line that "You have to do them exactly right, or they won't work." We swaddled and swung and vigorously shushed our model plastic babies under the hawk-like eyes of our nurse instructor. We were so naive! We actually thought the 5 S'es would work! Then our daughter was born and the truth hit us: when you've got a crying GERD baby, you're in it for the long haul.
So if your GERD baby is like ours and the typical 5 S'es don't work, give these modifications a try:
1. Sucking
Sucking is often last on the quieting list, but I am placing it first. It is of utmost importance for GERD babies.
First of all, many of them have difficulty sucking and swallowing. Allowing them the opportunity to suck on an orthodontically designed pacifier in between feedings gives them almost round-the-clock practice. And as we all know, practice makes perfect.
Secondly, their failure to thrive means they need more feeding sessions than babies without GERD. With our first baby, we were told to feed her every two hours during the day and every four hours at night. We were told not to deviate from this schedule, or we would be creating an obese child who relied on food for comfort. What a joke! Unfortunately, it was not very funny, and with her rapid dehydration and weight loss, we soon learned we had to feed her a little bit every 30-60 minutes during the day and every 90-120 minutes at night to keep her nourished and comfortable.
Sucking may not calm the GERD babies instantly--but it does have longterm benefits by providing them with the skills and nourishment they need to thrive.
2. Side vs. Stomach Position
Skip the infant side position and place the baby on her stomach, resting on your forearm. It's called the "colic hold" for a reason. We were taught to hold the baby's head in our hand and rest her bottom in the crook of our elbow. Reversing her position so her head was nestled on our forearm and her tummy was in our hand allowed us to apply gentle pressure to her tummy, which helped. We were also able to lower our hand to a natural position so that her head could still be elevated to aid with the reflux. Putting her on her tummy on the floor or bassinet during waking hours helped as well, particularly if a small burp cloth was rolled and placed under her tummy. I used to tell my husband that when our girls were older and didn't require so much round-the-clock care, I would design a stomach-positioner for GERD babies much like the head-positioner for premature babies. Of course, now there are stomach-positioners on the market! (More on those in another post.) How I wish we had some when our girls were infants!
3. "Shh-shh--shh" vs. The Darth Vader "Shhhhhhhhh"
I don't know why our nurse encouraged us to bounce the baby vigorously while breathing a fast-paced "Shh-shh-shh-shh." Not only does this quick-paced pattern not calm a GERD baby, it also makes you so dizzy you feel like you're going to pass out. I don't know anyone who would be calmed by this motion and noise. Newborns have the amazing potential to read our emotions, and since GERD babies are irritable and anxious to begin with, they don't need any extra tension to aggravate them.
Instead, think of Darth Vader. While holding your baby and gently patting her back, take a deep relaxing breath in...then let out a long "Shhhhhhhhhhh." Follow that repetition for as long as it takes. Deep breath. Darth Vader "Shhhhhhhhhh." Deep breath. Darth Vader "Shhhhhhhhhh."
It won't work instantly, but it will prevent you from passing out, and it will help to keep you calm and relaxed, which is essential for soothing a GERD baby.
4. The Swing vs. The Shoulder Snuggle
Everyone loves the mechanical swing. Parents can set the baby down, turn it on, and walk away. Instantly, the baby is soothed to sleep and the parents can do what they need to do, right? Not necessarily. The problem with the mechanical swing--and the car seat, for that matter--is that they create one of the worst positions for an acid reflux baby. Ever hear the stories of the colicky babies who were charmed by car rides, and if you could just keep your baby in the car seat all day long he would be happy? Ever wonder why your baby screams and cries in the car, so that even a five-minute drive across town becomes a harrowing nightmare, an accident waiting to happen for you, the driver?
Forcing the GERD baby into the seated position through car seats and mechanical swings creates pressure on the stomach and the lower esophageal sphincter, resulting in reflux. For this reason, one of the best places for a GERD baby to be is snuggled on someone's shoulder, for both physical and emotional reasons. Gently patting the baby's back or swaying from side to side may be all the vibration the baby needs. If white noise helps to calm the baby, turn on a fan or a white noise machine. One of my girls was calmed most effectively when she was snuggled over my shoulder and I was patting her in front of the dryer or the microwave vent. The pats, the position, the contact, and the noise all helped when nothing else would.
It's for this reason that a harness baby-carrier (like a Bjorn) is better for GERD babies than a shoulder sling. In the harness carrier, the baby's abdomen can be kept straight with gentle pressure from your body, whereas in a shoulder sling the baby's abdomen is scrunched up tight.
5. Swaddles vs. Stomach Bands
So if your GERD baby is like ours and the typical 5 S'es don't work, give these modifications a try:
1. Sucking
Sucking is often last on the quieting list, but I am placing it first. It is of utmost importance for GERD babies.
First of all, many of them have difficulty sucking and swallowing. Allowing them the opportunity to suck on an orthodontically designed pacifier in between feedings gives them almost round-the-clock practice. And as we all know, practice makes perfect.
Secondly, their failure to thrive means they need more feeding sessions than babies without GERD. With our first baby, we were told to feed her every two hours during the day and every four hours at night. We were told not to deviate from this schedule, or we would be creating an obese child who relied on food for comfort. What a joke! Unfortunately, it was not very funny, and with her rapid dehydration and weight loss, we soon learned we had to feed her a little bit every 30-60 minutes during the day and every 90-120 minutes at night to keep her nourished and comfortable.
Sucking may not calm the GERD babies instantly--but it does have longterm benefits by providing them with the skills and nourishment they need to thrive.
2. Side vs. Stomach Position
Skip the infant side position and place the baby on her stomach, resting on your forearm. It's called the "colic hold" for a reason. We were taught to hold the baby's head in our hand and rest her bottom in the crook of our elbow. Reversing her position so her head was nestled on our forearm and her tummy was in our hand allowed us to apply gentle pressure to her tummy, which helped. We were also able to lower our hand to a natural position so that her head could still be elevated to aid with the reflux. Putting her on her tummy on the floor or bassinet during waking hours helped as well, particularly if a small burp cloth was rolled and placed under her tummy. I used to tell my husband that when our girls were older and didn't require so much round-the-clock care, I would design a stomach-positioner for GERD babies much like the head-positioner for premature babies. Of course, now there are stomach-positioners on the market! (More on those in another post.) How I wish we had some when our girls were infants!
3. "Shh-shh--shh" vs. The Darth Vader "Shhhhhhhhh"
I don't know why our nurse encouraged us to bounce the baby vigorously while breathing a fast-paced "Shh-shh-shh-shh." Not only does this quick-paced pattern not calm a GERD baby, it also makes you so dizzy you feel like you're going to pass out. I don't know anyone who would be calmed by this motion and noise. Newborns have the amazing potential to read our emotions, and since GERD babies are irritable and anxious to begin with, they don't need any extra tension to aggravate them.
Instead, think of Darth Vader. While holding your baby and gently patting her back, take a deep relaxing breath in...then let out a long "Shhhhhhhhhhh." Follow that repetition for as long as it takes. Deep breath. Darth Vader "Shhhhhhhhhh." Deep breath. Darth Vader "Shhhhhhhhhh."
It won't work instantly, but it will prevent you from passing out, and it will help to keep you calm and relaxed, which is essential for soothing a GERD baby.
4. The Swing vs. The Shoulder Snuggle
Everyone loves the mechanical swing. Parents can set the baby down, turn it on, and walk away. Instantly, the baby is soothed to sleep and the parents can do what they need to do, right? Not necessarily. The problem with the mechanical swing--and the car seat, for that matter--is that they create one of the worst positions for an acid reflux baby. Ever hear the stories of the colicky babies who were charmed by car rides, and if you could just keep your baby in the car seat all day long he would be happy? Ever wonder why your baby screams and cries in the car, so that even a five-minute drive across town becomes a harrowing nightmare, an accident waiting to happen for you, the driver?
Forcing the GERD baby into the seated position through car seats and mechanical swings creates pressure on the stomach and the lower esophageal sphincter, resulting in reflux. For this reason, one of the best places for a GERD baby to be is snuggled on someone's shoulder, for both physical and emotional reasons. Gently patting the baby's back or swaying from side to side may be all the vibration the baby needs. If white noise helps to calm the baby, turn on a fan or a white noise machine. One of my girls was calmed most effectively when she was snuggled over my shoulder and I was patting her in front of the dryer or the microwave vent. The pats, the position, the contact, and the noise all helped when nothing else would.
It's for this reason that a harness baby-carrier (like a Bjorn) is better for GERD babies than a shoulder sling. In the harness carrier, the baby's abdomen can be kept straight with gentle pressure from your body, whereas in a shoulder sling the baby's abdomen is scrunched up tight.
5. Swaddles vs. Stomach Bands
Swaddling is great until the reflux starts and your baby starts arching her back. Then her whole body goes rigid and she breaks out of the swaddle like a baby Hulk breaking out of restraining bands. The best advice here is just to clothe or wrap your baby in whatever seems most comfortable to her. Usually, warmth and gentle pressure to the tummy are most effective. I am impressed by the new "stomach bands" that are on the market now designed especially for GERD babies. These stomach bands look very much like the hernia belt or the belly-band for pregnant women. Some include warming devices that can be microwaved. I would be a little hesitant to use the warming device on the baby, though. I will take a closer look at the stomach bands in a future post, but for now, know that they are out there and talk with your pediatrician to see if they might be of benefit to you.
Monday, January 18, 2010
That Special Touch: the Importance of Massage and Exercises
Infant massage and physical exercises are gaining popularity as natural ways to help infants deal with gas, colic, and reflux. While these exercises have been around for centuries, it seems they have recently resurfaced among women and health practitioners who want to do things "naturally." In addition, I have found that pediatric physical therapists are often encouraging activities such as these due to the growing number of GERD babies requiring their services.
Some homeopathic experts and physical therapists also assert that abdominal massage and exercises can stimulate the vagus nerve, an important nerve that runs from the brainstem to the colon. If injured or imbalanced, this nerve can trigger a variety of GERD symptoms, including reflux, damage to the esophagus and the lower esophageal sphincter (LES), dysphagia (difficulty swallowing), dysphonia (difficulty speaking), irritability, and asthma, in addition to a variety of other symptoms not usually associated with GERD. At one time, the primary surgical treatment of GERD was to remove the vagus nerve branches leading into the stomach. This procedure has since been replaced by other surgical options as well as non-invasive therapies such as medication and/or massage.
There is a number of massage techniques and exercises you can do with your infant. I found a few in particular seemed to work best with my girls: the clockwise massage circling the baby's belly button, the "I Love U" massage focusing gentle pressure on the left side of the baby's abdomen, and the "bicycling" exercise in which you gently pump your baby's legs. These exercises can be viewed in the following links.
I understand there are actual classes you can take not only to learn how to do these with your baby but also to become certified to teach them. I did not take an official class, and I am not certified to teach, so the only advice I am offering here is that of a mom who has seen the benefit these techniques have with GERD babies. Of course, they did not alleviate all of my girls' symptoms, but they did serve to lessen some of their discomfort, and if you are like me, you are willing to do anything to help your baby. I have recently re-implemented the massage with my girls at bedtime even though they are older because it seems to help them wind down and sleep through the night--two things with which they have always struggled.
Of course, these techniques may be used throughout the day as well. Because GERD infants sometimes have difficulty lying flat on their backs, you may want to place the baby in an inclined position for both the massage and exercises.
Herbalists often encourage using the essential oils of lavender and chamomile while doing infant massage. I have found any of the commercial baby lotions or oils with lavender and chamomile work equally well and save you a little pocket change, which may come in handy since having a GERD baby can run your bills up quickly. Recently, I discovered the Vick's Baby Rub with lavender and chamomile. This product is designed for babies 3 months and up. I wish it had been marketed when my girls were in the crucial period of their first 12 months of life, as I believe it may have helped not only with their massage, but also with the chronic congestion they encountered as the result of their reflux.
The four primary ways in which massage and exercises seem to help GERD babies are as follows:
1-They relax rigid muscles, strengthen the abdominal wall, and help expel gas which in turn reduces reflux.
2-The use of herbs such as chamomile and lavender during massage seem to have an "aromatherapy" effect, enabling the baby to calm and relax.
3-The bonding touch of parent-to-child is particularly important with GERD babies because they are so often irritable and fussy.
4-For babies who do better with added rice formulas, constipation can be a problem--and can worsen reflux. The massage and exercises can help to loosen their bowels. In fact, I found a sure-fire way to stimulate a bowel movement in my constipated baby was to do the infant massage while she was in a warm bath. (Inevitably, we would end up with a few floaters!)
Some homeopathic experts and physical therapists also assert that abdominal massage and exercises can stimulate the vagus nerve, an important nerve that runs from the brainstem to the colon. If injured or imbalanced, this nerve can trigger a variety of GERD symptoms, including reflux, damage to the esophagus and the lower esophageal sphincter (LES), dysphagia (difficulty swallowing), dysphonia (difficulty speaking), irritability, and asthma, in addition to a variety of other symptoms not usually associated with GERD. At one time, the primary surgical treatment of GERD was to remove the vagus nerve branches leading into the stomach. This procedure has since been replaced by other surgical options as well as non-invasive therapies such as medication and/or massage.
There is a number of massage techniques and exercises you can do with your infant. I found a few in particular seemed to work best with my girls: the clockwise massage circling the baby's belly button, the "I Love U" massage focusing gentle pressure on the left side of the baby's abdomen, and the "bicycling" exercise in which you gently pump your baby's legs. These exercises can be viewed in the following links.
Infant massage video from "The Pregnancy Show" (Clockwise massage and "I Love U")
Infant exercises for gas/colic/reflux (Bicycling)
I understand there are actual classes you can take not only to learn how to do these with your baby but also to become certified to teach them. I did not take an official class, and I am not certified to teach, so the only advice I am offering here is that of a mom who has seen the benefit these techniques have with GERD babies. Of course, they did not alleviate all of my girls' symptoms, but they did serve to lessen some of their discomfort, and if you are like me, you are willing to do anything to help your baby. I have recently re-implemented the massage with my girls at bedtime even though they are older because it seems to help them wind down and sleep through the night--two things with which they have always struggled.
Of course, these techniques may be used throughout the day as well. Because GERD infants sometimes have difficulty lying flat on their backs, you may want to place the baby in an inclined position for both the massage and exercises.
Herbalists often encourage using the essential oils of lavender and chamomile while doing infant massage. I have found any of the commercial baby lotions or oils with lavender and chamomile work equally well and save you a little pocket change, which may come in handy since having a GERD baby can run your bills up quickly. Recently, I discovered the Vick's Baby Rub with lavender and chamomile. This product is designed for babies 3 months and up. I wish it had been marketed when my girls were in the crucial period of their first 12 months of life, as I believe it may have helped not only with their massage, but also with the chronic congestion they encountered as the result of their reflux.
Friday, January 15, 2010
Mrs. Rabbit's Night-Night Tea
If your toddlers are like mine and struggle with "shutting down" for the night and going to sleep, or if they continue to have tummy troubles that keep them awake, here is an (almost) sure-fire way to calm and soothe them.
1/3 cup chamomile tea*
2/3 cup milk
1/2 tsp. Colic-Ease Gripe Water
Tips on making the tea:
1-Use straight chamomile tea with no other added herbs. (As for brands, Celestial Seasonings Chamomile is my favorite because it is simple, affordable, and easy to find.)
2-Make sure the tea leaves steep for at least 10 minutes
3-Serve it lukewarm during a calming night-time routine (reading books, listening to music, etc.)
4-You may substitute juice for children who don't like milk
5-If a new food has unsettled the child's stomach, you may increase the dosage of Colic-Ease gripe water according to the child's age and the label directions
*6-I vary the amount of tea according to age: 18 months use 1/4 cup; ages 2-4 use 1/3 cup; ages 5 and up use 1/2 cup, etc.
My girls love their night-night tea...and the story of naughty little Peter Rabbit whose mother loves him so much she sends him to bed with chamomile tea for his tummy ache!!
1/3 cup chamomile tea*
2/3 cup milk
1/2 tsp. Colic-Ease Gripe Water
Tips on making the tea:
1-Use straight chamomile tea with no other added herbs. (As for brands, Celestial Seasonings Chamomile is my favorite because it is simple, affordable, and easy to find.)
2-Make sure the tea leaves steep for at least 10 minutes
3-Serve it lukewarm during a calming night-time routine (reading books, listening to music, etc.)
4-You may substitute juice for children who don't like milk
5-If a new food has unsettled the child's stomach, you may increase the dosage of Colic-Ease gripe water according to the child's age and the label directions
*6-I vary the amount of tea according to age: 18 months use 1/4 cup; ages 2-4 use 1/3 cup; ages 5 and up use 1/2 cup, etc.
My girls love their night-night tea...and the story of naughty little Peter Rabbit whose mother loves him so much she sends him to bed with chamomile tea for his tummy ache!!
Thursday, January 14, 2010
Something Fishy: Two Sides to DHA
It seems that every time I turn around, I discover more products with added DHA. First it was prenatal supplements and infant formulas. Now it's added to toddler formulas, toddler foods, toddler multivitamins, fruit juices, and milk.
What is DHA?
DHA stands for docosahexaenoic acid, a fatty acid that occurs naturally in microalgae, which is typically eaten by fish. Once digested by the fish, it moves up the food chain, becoming more and more concentrated, until it is consumed by humans. In humans, DHA is known to have a variety of health benefits. The most commonly discussed benefits for adults are related to heart and cardiovascular health. For women, DHA can reduce symptoms of depression, specifically in the post-partum period. In infants and toddlers, DHA is known to be essential for brain and eye development.
So why is it added to infant formulas?
The current explanation for adding it to formulas maintains that in cultures where women eat a lot of fish during pregnancy and nursing, DHA is more available to the infants both in utero and through nursing. But in America, many women do not eat significant levels of fish--or are warned against eating fish for fear of mercury poisoning. American women also often rely on infant formulas instead of nursing for medical, professional, or personal reasons. Therefore, DHA has become the "superfood" additive, if you will, to infant dietary products.
A history of the addition of DHA to infant formulas, however, reveals a different aspect, too. As with healthy children and adults, healthy full-term infants are apparently able to create DHA from precursor fatty acids. Low-term and preterm infants, however, are not able to create as much as their body requires, so DHA was added to infant formulas. At first, it was tuna oil. Lately, it has been synthetic oil.
But is it safe?
The real question should not be "Is DHA safe?" rather, "Is synthetic DHA safe?"
Theoretically, the DHA manufactured in a laboratory directly from microalgae (also known as Crypthecodinium cohnii) and added to infant products should be completely harmless for all babies. After all, naturally occurring DHA begins in microalgae, too, so what is the difference between adding microalgal DHA to infant supplements instead of fish-oil DHA?
No one knows why, but there is a difference. Perhaps the difference lies in how the DHA is processed. No one knows exactly how a fish processes DHA; therefore, any laboratory processing of DHA must involve synthetic chemicals.
How does this difference impact infants?
First, according to an Australian study, the synthetic oils caused a significant increase in the liver and spleen weights of infants. While this weight increase apparently did not affect the organs' ability to function correctly at the time of research, the reason for this increase and the possible risks associated with it are still unclear.
Secondly, infants given synthetic DHA gained weight and grew faster than infants given natural (fish-oil) DHA. And in America, bigger is often better.
Or is it? For the vast majority of infants, no measurable difference between synthetic and natural DHA was established other than weight gain (over all and in regard to their livers and spleens). But for the GERD baby, the difference was monumental.
In a recent study published by the Cornucopia Institute, research drew a direct line between the presence of synthetic DHA in infant formulas and the presence of GERD in babies. GERD babies who were taken off formulas with synthetic DHA demonstrated a remarkable recovery from their symptoms, while GERD babies left on the synthetic formulas did not. In addition, other studies documenting the rise in the number of GERD babies diagnosed show an eerily similar pattern regarding the rise of GERD and the presence of synthetic DHA in infant formulas.
What is the solution?
One solution would be for parents of GERD babies using formula to feed their babies only the formulas that have added iron, not DHA. Unfortunately, within the past two years most of the major formula makers in America have discontinued making DHA-free formulas. (Ironically, some of these same companies still manufacture DHA-free formulas for other countries, Canada included.) And given the evidence that DHA is essential for infant brain and eye development, no formula company is interested in reversing their current trend of adding DHA.
The Case for Fish-Oil DHA
But there is hope. Other studies, and my own personal experience, indicate that pediatric GERD patients do well when taking natural DHA (fish oil) supplements. In other words, natural DHA does not seem to trigger GERD symptoms, and it provides GERD babies with all the important benefits of brain and eye development. Fish oil is already making an appearance as the DHA supplement in toddler formulas: it is perhaps not a far leap in logic until it appears in infant formulas, too.
And there is another benefit to fish oil DHA. Autoimmune research indicates that a high DHA fish-oil diet can actually slow or stop the production of cytokines--the chemicals recently tied to GERD symptoms by a research team in Dallas. In other words, not only does fish oil DHA not trigger GERD symptoms; it may actually prevent them from occurring.
Of course, all this information can be dizzying and confusing, particularly for moms who have to buy formula for one reason or another and cannot find synthetically-free DHA. From my personal experience and that of other parents, here are my recommendations:
1-Write to formula companies.
As far as I know, Similac is the only company that still makes a regular formula without DHA; however, I could only find it at Amazon.com. Similac also produces a hypoallergenic formula called Neocate, which you can purchase with or without DHA.
Enfamil no longer makes regular DHA-free formulas, but they are open to my concerns. Enfamil Pregestimil is a hypoallergenic formula which to my knowledge does not yet contain DHA, but reportedly will in the near future. In addition, Enfamil has already begun producing a toddler formula that uses tuna oil instead of synthetic DHA. (Enfagrow Vanilla is the formula without synthetic DHA.)
Nestle has also begun using tuna oil in their Juicy Juice DHA Grape juice, so perhaps they will be open to creating a formula with tuna oil DHA.
Be positive: encourage them and thank them for this switch and ask if they will consider creating a formula with fish oil for GERD infants, as well. Chances are, all it takes is for one formula company to make a change and the others will follow in the name of market competition.
Finally, be aware that the hypoallergenic formulas are high in price. Check with your insurance company if you need to use them: many insurances will cover the cost of specialized formulas as long as your pediatrician writes a prescription. (You can look at the GERD Mama Store/Amazon link on the right of this page to see what these formulas look like.)
2-If you cannot find a DHA-free formula, choose one that contains a lower percentage of DHA. In general, Enfamil contains the highest: generic brands such as Up and Up (Target) and Parent's Choice (Walmart) contain lower percentages. Mothers of GERD babies have asserted their babies do better on the generic brands although no one seems to know why. I wonder if it has to do with the lower percentage of synthetic oils.
3-If you use a lower DHA-formula and your infant still experiences GERD, you will need to try other treatments. Natural treatments that worked best for my girls included Colic-Ease Gripe Water, positioning, and massage. And, of course, a lot of prayer.
4-Take advantage of natural DHA fish oil supplements and foods for your toddler. The most obvious source for fish oil should be fish, but if your child is a picky eater, I have listed a few names and products below to guide you as you shop. Many of these can be found in the regular grocery store. Others can be purchased in health stores or online.
5-When choosing a toddler multivitamin, read the label and choose one that does not contain synthetic DHA. Look for the presence of fish oil listed in the ingredients. (The most common fish oils are tuna, cod, sardine, and anchovy.) My children love Nature's Plus Animal Parade Grape multivitamins, which do not contain DHA. Animal Parade also sells separate fish-oil based DHA or Omega supplements, which I have listed below.
6-Don't think that just because something is organic, it contains natural fish oil DHA. Many organic formulas with DHA have gone to using synthetic DHA. This is a controversy within the guidelines of organic certification. Honest or not, it happens, so read labels!
7-Unfortunately, for many infants, eliminating DHA does not eliminate GERD, but it does reduce the severity of some of their symptoms. And as a GERD mama, I know: every little bit counts!
Tuna Oil DHA food products for infants/toddlers:
What is DHA?
DHA stands for docosahexaenoic acid, a fatty acid that occurs naturally in microalgae, which is typically eaten by fish. Once digested by the fish, it moves up the food chain, becoming more and more concentrated, until it is consumed by humans. In humans, DHA is known to have a variety of health benefits. The most commonly discussed benefits for adults are related to heart and cardiovascular health. For women, DHA can reduce symptoms of depression, specifically in the post-partum period. In infants and toddlers, DHA is known to be essential for brain and eye development.
So why is it added to infant formulas?
The current explanation for adding it to formulas maintains that in cultures where women eat a lot of fish during pregnancy and nursing, DHA is more available to the infants both in utero and through nursing. But in America, many women do not eat significant levels of fish--or are warned against eating fish for fear of mercury poisoning. American women also often rely on infant formulas instead of nursing for medical, professional, or personal reasons. Therefore, DHA has become the "superfood" additive, if you will, to infant dietary products.
A history of the addition of DHA to infant formulas, however, reveals a different aspect, too. As with healthy children and adults, healthy full-term infants are apparently able to create DHA from precursor fatty acids. Low-term and preterm infants, however, are not able to create as much as their body requires, so DHA was added to infant formulas. At first, it was tuna oil. Lately, it has been synthetic oil.
But is it safe?
The real question should not be "Is DHA safe?" rather, "Is synthetic DHA safe?"
Theoretically, the DHA manufactured in a laboratory directly from microalgae (also known as Crypthecodinium cohnii) and added to infant products should be completely harmless for all babies. After all, naturally occurring DHA begins in microalgae, too, so what is the difference between adding microalgal DHA to infant supplements instead of fish-oil DHA?
No one knows why, but there is a difference. Perhaps the difference lies in how the DHA is processed. No one knows exactly how a fish processes DHA; therefore, any laboratory processing of DHA must involve synthetic chemicals.
How does this difference impact infants?
First, according to an Australian study, the synthetic oils caused a significant increase in the liver and spleen weights of infants. While this weight increase apparently did not affect the organs' ability to function correctly at the time of research, the reason for this increase and the possible risks associated with it are still unclear.
Secondly, infants given synthetic DHA gained weight and grew faster than infants given natural (fish-oil) DHA. And in America, bigger is often better.
Or is it? For the vast majority of infants, no measurable difference between synthetic and natural DHA was established other than weight gain (over all and in regard to their livers and spleens). But for the GERD baby, the difference was monumental.
In a recent study published by the Cornucopia Institute, research drew a direct line between the presence of synthetic DHA in infant formulas and the presence of GERD in babies. GERD babies who were taken off formulas with synthetic DHA demonstrated a remarkable recovery from their symptoms, while GERD babies left on the synthetic formulas did not. In addition, other studies documenting the rise in the number of GERD babies diagnosed show an eerily similar pattern regarding the rise of GERD and the presence of synthetic DHA in infant formulas.
What is the solution?
One solution would be for parents of GERD babies using formula to feed their babies only the formulas that have added iron, not DHA. Unfortunately, within the past two years most of the major formula makers in America have discontinued making DHA-free formulas. (Ironically, some of these same companies still manufacture DHA-free formulas for other countries, Canada included.) And given the evidence that DHA is essential for infant brain and eye development, no formula company is interested in reversing their current trend of adding DHA.
The Case for Fish-Oil DHA
But there is hope. Other studies, and my own personal experience, indicate that pediatric GERD patients do well when taking natural DHA (fish oil) supplements. In other words, natural DHA does not seem to trigger GERD symptoms, and it provides GERD babies with all the important benefits of brain and eye development. Fish oil is already making an appearance as the DHA supplement in toddler formulas: it is perhaps not a far leap in logic until it appears in infant formulas, too.
And there is another benefit to fish oil DHA. Autoimmune research indicates that a high DHA fish-oil diet can actually slow or stop the production of cytokines--the chemicals recently tied to GERD symptoms by a research team in Dallas. In other words, not only does fish oil DHA not trigger GERD symptoms; it may actually prevent them from occurring.
Of course, all this information can be dizzying and confusing, particularly for moms who have to buy formula for one reason or another and cannot find synthetically-free DHA. From my personal experience and that of other parents, here are my recommendations:
1-Write to formula companies.
As far as I know, Similac is the only company that still makes a regular formula without DHA; however, I could only find it at Amazon.com. Similac also produces a hypoallergenic formula called Neocate, which you can purchase with or without DHA.
Enfamil no longer makes regular DHA-free formulas, but they are open to my concerns. Enfamil Pregestimil is a hypoallergenic formula which to my knowledge does not yet contain DHA, but reportedly will in the near future. In addition, Enfamil has already begun producing a toddler formula that uses tuna oil instead of synthetic DHA. (Enfagrow Vanilla is the formula without synthetic DHA.)
Nestle has also begun using tuna oil in their Juicy Juice DHA Grape juice, so perhaps they will be open to creating a formula with tuna oil DHA.
Be positive: encourage them and thank them for this switch and ask if they will consider creating a formula with fish oil for GERD infants, as well. Chances are, all it takes is for one formula company to make a change and the others will follow in the name of market competition.
Finally, be aware that the hypoallergenic formulas are high in price. Check with your insurance company if you need to use them: many insurances will cover the cost of specialized formulas as long as your pediatrician writes a prescription. (You can look at the GERD Mama Store/Amazon link on the right of this page to see what these formulas look like.)
2-If you cannot find a DHA-free formula, choose one that contains a lower percentage of DHA. In general, Enfamil contains the highest: generic brands such as Up and Up (Target) and Parent's Choice (Walmart) contain lower percentages. Mothers of GERD babies have asserted their babies do better on the generic brands although no one seems to know why. I wonder if it has to do with the lower percentage of synthetic oils.
3-If you use a lower DHA-formula and your infant still experiences GERD, you will need to try other treatments. Natural treatments that worked best for my girls included Colic-Ease Gripe Water, positioning, and massage. And, of course, a lot of prayer.
4-Take advantage of natural DHA fish oil supplements and foods for your toddler. The most obvious source for fish oil should be fish, but if your child is a picky eater, I have listed a few names and products below to guide you as you shop. Many of these can be found in the regular grocery store. Others can be purchased in health stores or online.
5-When choosing a toddler multivitamin, read the label and choose one that does not contain synthetic DHA. Look for the presence of fish oil listed in the ingredients. (The most common fish oils are tuna, cod, sardine, and anchovy.) My children love Nature's Plus Animal Parade Grape multivitamins, which do not contain DHA. Animal Parade also sells separate fish-oil based DHA or Omega supplements, which I have listed below.
6-Don't think that just because something is organic, it contains natural fish oil DHA. Many organic formulas with DHA have gone to using synthetic DHA. This is a controversy within the guidelines of organic certification. Honest or not, it happens, so read labels!
7-Unfortunately, for many infants, eliminating DHA does not eliminate GERD, but it does reduce the severity of some of their symptoms. And as a GERD mama, I know: every little bit counts!
Tuna Oil DHA food products for infants/toddlers:
Gerber 2nd foods with DHA
Gerber DHA cereal
Gerber DHA cereal
Juicy Juice Grape DHA
Enfagrow Vanilla toddler formula
Enfagrow Vanilla toddler formula
Natural Fish Oil DHA/Omega Oil Supplements:
Nordic Naturals Children's DHA
Animal Parade DHA
Animal Parade Omega 3/6/9
Bluebonnet Omega 3
Child Life Cod Liver Oil
To read more about the Australian study regarding synthetic DHA (and ARA) and infant weight gain
http://findarticles.com/p/articles/mi_m0ISW/is_243/ai_109946504/
http://findarticles.com/p/articles/mi_m0ISW/is_243/ai_109946504/
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