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    Management of Frequent Spit-Up

    Frequent spit-up is a concern for many parents. This feeding issue, otherwise known as gastroesophageal reflux (GER), is actually quite common—in fact, about ⅔ of otherwise healthy infants experience frequent spit-up1.

    Guidelines for GERD were developed by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition that can help you recognize clients who may benefit from these guidelines for GERD or referral to a specialist, as well as those parents who should simply be reassured that their baby’s GER is physiologic and not harmful1.

    GER vs. GERD—What’s the Difference?

    While GER is fairly common in infants, gastroesophageal reflux disease, or GERD, is not. The AAP defines GER as the passage of stomach contents into the esophagus, which leads to regurgitation/spit-up in otherwise healthy infants1. GERD is considered reflux with complications, and may include the following complications1:

    • Weight loss
    • Poor weight gain
    • Vomiting associated with irritability
    • Feeding refusal
    • Sleep disturbances
    • Respiratory issues

    Parents who notice any of the above in their infant should see their pediatrician.

    Guidelines for Managing Frequent Spit-Up (GER)

    The AAP recommends lifestyle changes as first-line management of frequent spit-up in infants rather than medication1. GERD medication reduces stomach acid, which plays an important role in a baby’s health. These medications should be reserved for infants with GERD and used only under the supervision of a doctor.

    Instead of medication, parents should try these feeding management changes1:

    • Switch to a thickened, added-rice formula or add rice cereal to formula
    • Reduce feeding volume and increase feeding frequency

    It is also recommended that parents try positioning and environment changes1:

    • Keep the baby upright when awake
    • Avoid semi-reclined positioning, as this can make reflux worse
    • Avoid second-hand smoke

    Enfamil A.R. is Clinically Proven to Manage Spit-Up

    Enfamil A.R. is a thickened, milk-based infant formula specifically designed to manage frequent spit-up. It is clinically proven to reduce frequency and volume of spit-up by 50%2,*—and it works in 1 week.

    Enfamil A.R. is Clinically Proven to Manage Spit-Up

    Enfamil A.R. provides balanced nutrition for infants, while adding rice cereal to formula can increase caloric density2:

    • Enfamil A.R. has 20 Cal/fl oz, the same caloric density as breast milk—formula with added rice cereal has 35 Cal/fl oz
    • Adding rice cereal to formula increases the carbohydrate content of formula, altering the macronutrient levels

    The #1 Brand Recommended by Pediatricians3,†

    Enfamil A.R. is the #1 spit-up formula brand recommended by pediatricians and is chosen most by parents3,†. In addition to clinically proven reduction in spit-up, Enfamil A.R. has complete nutrition for a baby’s first year, and has a prebiotic blend that supports digestive health and DHA to foster learning ability4,‡.

  • * Based on a clinical study of Enfamil A.R. with infants who spit up frequently (five or more spit-ups per day), comparing frequency and volume of spit-up after feeding Enfamil A.R. to the same infants at the beginning of the study.
    † Of pediatricians who recommend a specific brand; formula for spit-up is defined as rice-thickened formula.
    ‡ Shown in Enfamil® Infant with DHA and ARA.

    References: 1. Lightdale JR et al. Pediatrics. 2013;131:e1684-e1695. doi: 10.1542/peds.2013-0421. 2. Vanderhoof JA et al. Clin Pediatr (Phila). 2003;42:483-495. 3. Data on file, Mead Johnson Nutrition. 4. Colombo J et al. Am J Clin Nutr. 2013;98:403-412.

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