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When my son was born I was determined to breast feed him and fortunately, he decided that he quite liked the idea himself and took to it just a few hours after his birth. Everything seemed fine but after approximately a week it became apparent that he just wasn't satisfied enough - it's so difficult to tell just how much milk they're actually getting when you first begin to breastfeed.
Exhausted from the arrival of my little bundle and the subsequent sleepless nights, I decided (after a discussion with my midwife and health visitor) that we'd move onto formula milk. Disappointed, I went and bought some Cow & Gate powdered formula which had the desired effect. For a couple of months the feeding pattern was perfect - baby seemed to thoroughly enjoy his new milk and was much more satisfied. More importantly, he was steadily gaining weight. We were onto a winner! Until...
After slightly increasing the amount of formula one afternoon, he suddenly threw up after finishing the bottle. Regurgitating (or posseting) a small amount of milk after a feed is perfectly natural and not uncommon in babies but this wasn't just a bit of spitting up - it was as if the whole feed came pouring back out. This continued to happen after every bottle and I couldn't understand why. I knew he wasn't having too much or taking it too fast as we were still using slow flow teats at this stage. I tried sitting him upright more during each feed and even gave him cooler milk but nothing made a difference. Although it was worrying I just thought he'd caught a bug but after 4 days (I only left it this long due to the weekend) and no signs of improvement, I became much more concerned and took him to the doctors.
It didn't take our GP long to come to a conclusion and my baby was diagnosed with immature reflux.
And now for the science bit...the stomach lies just under the diaphragm muscle. The diaphragm works with the gullet (also known as the oesophagus - the tube between the mouth and stomach) and acts as a valve to keep the stomach contents actually in the stomach. Sometimes this valve action isn't as strong as it should be and in babies, it just isn't fully developed. This is what causes the vomiting.
Sachets of infant Gaviscon were prescribed to mix in with the normal milk formula and we were sent on our way with hopes that it would work...but it didn't. The condition was exactly the same. Plastic backed bibs weren't enough to keep him dry and he'd end up soaked after every feed. This was obviously very awkward and inconvenient, particularly when it came to night time bottles as it meant a full change of clothing was required in the middle of the night. He was also still hungry all the time as his stomach wasn't staying full.
Another trip to the doctors surgery was definitely needed so off we went. After a discussion with my health visitor and GP, it was decided that we should try a special prescribed milk formula called Enfamil A.R which has only been used by a couple of babies from our surgery. I did feel like we were being used as a 'test' but thought it was worth a go if it helped my poor little cherub!
~ ENFAMIL A.R ~
Produced by an American company called Mead Johnson Nutritionals, Enfamil A.R is an infant formula that is suitable from birth onwards and is specifically formulated for the dietary management of spitting up, relieving the symptoms of reflux problems.
Here's a brief overview of the product features which I will then go on to explain in more detail....
~ Milk based formula
~ Greater viscosity - contains rice starch
~ Nutritionally balanced
~ Includes LIPIL
~ MILK BASED FORMULA ~
Enfamil A.R is a milk based powered formula with added ingredients to help reflux. The powder comes in 400g tins and looks just like any other milk formula. You even make it up in just the same way with the provided scoop, adding 1 level scoop of powder per 2 fluid oz. of previously boiled water that has been allowed to cool. All the other normal preparation and storage instructions also apply - proper hygiene, preparation, dilution, use and storage are important when preparing any infant formula. For example, if a bottle has been warmed you should discard it after 1 hour due to the growth of bacteria and any pre-prepared bottles should be kept in the fridge for no longer than 24 hours for the same reason.
~ GREATER VISCOSITY - CONTAINS RICE STARCH ~
The milk formula is pre-thickened with the addition of rice starch which is considered to be easy to digest and also hypo allergenic. When made up the milk does appear to be slightly thicker in the bottle than a regular formula. Small 'globules' are visible as they cling to the inside of the bottle but it is designed to still flow freely through normal teats - which in my experience, it does.
The viscosity of the milk increases dramatically when it is exposed to an acidic environment (ie: the stomach) so this is basically how it works. As soon as it is swallowed, contact with the stomach acid causes it to thicken, helping to keep the formula down gently and effectively.
~ NUTRITIONALLY BALANCED ~
Importantly, Enfamil A.R is formulated to be nutritionally balanced for your baby's first 12 months and provides all the nutrients needed for healthy growth and development. It has a nutrient profile similar to that of regular infant formula and is designed to be a sole source of nutrition (obviously before the weaning stage begins) containing....
~ Nutrients - for example the necessary proteins, fats and carbohydrates that are required, and also DHA and AA (which are explained in more detail later on)
~ Vitamins - a wide range of vitamins including Vitamins A, C, D, E, B6, B12, Thiamin, Riboflavin, Niacin and Pantothenic Acid to name a few.
~ Minerals - these are also added to the formula and include Calcium (which we all know is necessary for strong bones), Magnesium, Zinc, Copper, Sodium and Potassium.
In addition, Enfamil A.R is also Iron Fortified and contains antioxidants to support baby's immune system.
~ INCLUDES LIPIL ~
Enfamil A.R was first developed nearly 50 years ago but since it's introduction in 1959 there have been many refinements and reformulations to make it much more nutritional and to bring its content even closer to breast milk.
The levels of total fat and saturated, monounsaturated and polyunsaturated fatty acids are patterned after levels found in breast milk and it now also contains LIPIL which is a special blend of important nutrients called LCP's (long chain polyunsaturated fatty acids) which consist of DHA (Docosahexaenoic) and AA (Arachidonic Acid). These are found in breast milk and support brain and eye development.
The fact that this fatty acid pattern is so similar to breast milk makes Enfamil A.R a more than satisfactory alternative.
~ DOES IT WORK? ~
This milk formula has been clinically proven to be effective in reducing frequent posseting by over 40 percent and I've got to agree...it does work.
I saw an immediate improvement after each bottle which gradually got better and better over the first couple of weeks. My son thoroughly enjoyed his new feeds and we didn't have to experience the distressing vomiting and subsequent soaking any longer!
During the first year of a baby's life the sphincter action gradually gets stronger by itself and the symptoms of reflux will naturally decrease. The use of Enfamil A.R certainly helps to combat these symptoms in the meantime, making baby much more comfortable...and mum and dad a lot less stressed!
~ AND THE COST? ~
Absolutely nothing! In America, Enfamil A.R has to be purchased like any other milk formula but at a higher price (6 tins cost 84 dollars which works out at approximately £8 per tin). Over here in the UK it isn't readily available and can only be prescribed by your GP. It is therefore completely free which is a great bonus as over the weeks you can spend quite a lot of money on milk formula, especially when you get to the 12 fluid oz. bottle stage.
My son was prescribed Enfamil A.R for virtually a full year (8 tins per prescription so we weren't backwards and forwards to the doctors all the time). In fact the last tin finished on the milestone of his first birthday when I decided to move him onto 'grown up' full fat cow's milk...with great success I might add!
~ CONCLUSION ~
I have been more than happy to use Enfamil A.R as a subsitute milk for my child. So, if you are concerned about your baby's feeding because some of the symptoms I've mentioned sound familiar then perhaps this milk formula is the way to go. I'd recommend that you ask your GP about it.
As a company with more than 100 years experience, Mead Johnson Nutritionals is a world leader in infant nutrition. With more than 70 products in over 60 countries, its products are trusted by health care professionals (and parents) around the world. They certainly get a thumbs up from this mum!
With Enfamil A.R, what goes down is much more likely to stay down!
Full details about Enfamil A.R can be found at www.enfamil.com. This is an American website (the UK version is currently under construction) but offers all ingredients and relevant information about the product.
Enfamil AR Powder Formula: All babiesspit-up from time to time, but frequent spit-up after feeding can beinconvenient / Enfamil AR Powder Formula is clinically proven tosignificantly reduce frequent spit-up, giving moms the assurance thattheir baby is getting and keeping all the nourishment they need to growhealthy.