> Can someone (maybe one if the good doctors) help me understand why my 
> online
> friend has been 'prescribed' rice cereal added to the supplemental bottle
> for her premie daughter (now two months old and 4 pounds or so, original 
> due
> date was 4th week of May).  I do not understand this.
> Karyn-grace Clarke, IBCLC, LLLL

Hi Karyn-grace

The information I've pasted below comes from 
<http://www.kellymom.com/babyconcerns/reflux.html>.

Kelly notes "that rice cereal will not effectively thicken breastmilk due to 
the amylase".  While rice cereal will not thicken breastmilk effectively 
there is one thickener that will thicken breastmilk but I have not heard of 
it being recommended for reflux episodes but it is used for babies that 
aspirate.  There are still lots of doctors in US & Australia recommending 
rice cereal for reflux either with or without the use of medication.  The 
youngest baby I've heard of the doctor suggesting rice cereal was three 
weeks old.

Very few doctors seem to be aware that managing the breastfeeding can make a 
substantial difference to the vomiting.  Many mothers find it very hard to 
get medical support while they look into food intolerances/allergies while 
they are breastfeeding, since many medical professionals view it as either 
unnecessary or too hard for the mother (even if the mother states it's what 
she wants to do).

There are at least a few studies about looking at the efficacy of thickening 
feeds for reflux.  I need to pull them out for another reason in the next 
few weeks and I'm happy to send the references to you if you'd like.

This came across my desk recently.
Starch thickening of human milk is ineffective in reducing the 
gastroesophageal reflux in preterm infants: A crossover study using 
intraluminal impedance" by Corvaglia and colleagues and comes from the 
Journal of Pediatrics Feb. 2006 vol. 148 no. 2 pp. 265-8


Regards
Suzie Heaton
Australia

From <http://www.kellymom.com/babyconcerns/reflux.html>
"What about thickened feeds?
Baby cereal, added to thicken breastmilk or formula, has been used as a 
treatment for GER for many years, but its use is controversial.

Does it work? Thickened feeds can reduce spitting up, but studies have not 
shown a decrease in reflux index scores (i.e., the "silent reflux" is still 
present). Per Donna Secker, MS, RD in Gastroesophageal Reflux Disease , "The 
effect of thickened feedings may be more cosmetic (decreased regurgitation 
and increased postprandial sleeping) than beneficial." Thickened feeds have 
been associated with increased coughing after feedings, and may also 
decrease gastric emptying time and increase reflux episodes and aspiration. 
Note that rice cereal will not effectively thicken breastmilk due to the 
amylase (an enzyme that digests carbohydrates) naturally present in the 
breastmilk.

Is it healthy for baby? If you do thicken feeds, monitor baby's intake since 
baby may take in less milk overall and thus decrease overall nutrient 
intake. There are a number of reasons to avoid introducing cereal and other 
solids early. There is evidence that the introduction of rice or 
gluten-containing cereals before 3 months of age increases baby's risk for 
type I diabetes. In addition, babies with GERD are more likely to need all 
their defenses against allergies, respiratory infections and ear 
infections - but studies show that early introduction of solids increases 
baby's risk for all of these conditions."


             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]