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Infant Formula Thickeners

Formula thickeners are usually used to help babies who suffer with reflux. Babies who have reflux will usually bring up their milk in the form of spit up. This isn’t vomiting, but an easy flow of milk up through the mouth. It’s very common, and most babies grow out of it by their first birthday.

Thickeners can help milk stay down in the stomach and reduce spit up, although it’s not always needed. For some babies, reflux isn’t a problem. It might be messy, but it doesn’t cause any distress and doesn’t stop them from getting the nutrition they need from their milk. 

For others, reflux can cause serious problems - including crying, pain and lack of weight gain. Some babies suffer from silent reflux, which means they don’t spit up, but swallow their regurgitated milk – often causing pain and unexplained crying. 

If your baby’s reflux symptoms are causing them distress or mean that they’re not getting the nutrition they need,  it might be worth considering using a thickener or a specialty thickened formula like HiPP Anti-Reflux – but always speak to your pediatrician first. 

Other reasons for using thickeners

As well as reflux, thickeners can help with:

  • Chronic aspiration. Aspiration is when anything – liquid or food – is inhaled into the lungs rather than the stomach. This happens occasionally to everyone, and is usually described as something ‘going down the wrong pipe’. In babies and young children, it can be a chronic condition, usually caused by reflux, or sometimes by a physical problem. Since it can be dangerous and lead to respiratory problems (including pneumonia), always speak to your pediatrician if you suspect aspiration.
  • Dysphagia means difficulty swallowing. In babies, this means that they’ll bring milk up, and might struggle to suck on the breast or bottle. It’s more common in premature babies whose muscles and coordination haven’t fully developed. Thickened formula is often used as a treatment for dysphagia, as thicker milk takes longer to swallow, giving your baby more time to swallow. 

It’s important to distinguish between spit up and vomiting. Vomiting is the forceful bringing up for milk, which shoots out of the mouth as a result of stomach contractions. It can be projectile, very messy and distressing for the baby as well as their parents. Regular vomiting might be a sign of a more serious problem, and shouldn’t be treated with thickeners.

What kind of thickeners are there?

Formula thickeners are either added to formula once it’s made up, or are included as part of a specialty anti-reflux formula. Some mild thickeners are also added to standard formula as a stabilizer. 

Common thickeners include:

  • Carob gum (also known as locust bean gum). This is a natural product extracted from the carob tree, and is generally safe for babies and unlikely to cause an allergic reaction. HiPP Anti-Reflux uses carb beans as a thickener. 
  • Rice or corn starch are often used in thickeners designed to be added to standard formula, and are considered to be safe for babies. 
  • Carrageenan is derived from seaweed, and can be used both in standard formula and thickening products. However, it is banned in European formulas as it’s been linked to intestinal inflammation and may be carcinogenic.
  • Maltodextrin is a starchy carb derived from rice, corn or potatoes. It’s often used to stabilize standard formulas, and as an extra thickening agent in specialty formulas or thickeners. Organic maltodextrin is used in some Holle and Loulouka formulas.  

You should never try to thicken formula by using a higher ratio of powder to water than usual. This can mean your baby doesn’t get enough water, potentially leading to dehydration and kidney problems.

Should I use a thickener in my baby’s formula?

Most babies, even if they suffer from reflux, don’t need a thickener in their formula. If your baby has reflux but isn’t distressed or failing to gain weight, then you shouldn’t need to thicken their milk. Spit up is messy, but it’s not harmful, and they’ll usually grow out of it by 6-12 months old. Starting solid food often helps reduce reflux significantly. 

If your little one is struggling with painful reflux (including silent reflux) and not gaining weight as they should, speak to your pediatrician about using a thickener or specialty formula. They may recommend that you try other solutions first – including feeding little and often, and more frequent burping.

It’s also worth noting that thickened formula can be more difficult to feed. You’ll usually need to use a bottle nipple with a larger flow than usual, as your baby might have trouble sucking thickened formula through their usual size nipple. 

Thickeners can be dangerous for some babies, especially premature babies – so it’s important to get medical advice before using them.

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