Rice cereal thickener for feeding issues? - Mothering Forums

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#1 of 13 Old 07-28-2009, 11:51 AM - Thread Starter
 
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Our ST and doctor has put Emaline on rice cereal in her breastmilk bottles to help with her feeding issues. She seems to do much better on thickened feeds, but I'm just not sure about it. I mean, it's really working. Her reflux is 100 times better than it was and she's actually using the suck-swallow-breathe sequence instead of letting the food drip into her mouth, attempting to swallow and choking.

But I'm just not sure about the rice cereal. She's 5 months old, 3 months adjusted. It's really early to have anything in her diet except breastmilk.

What do you think? It is helping a lot, but it just doesn't sit right.

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#2 of 13 Old 07-28-2009, 12:14 PM
 
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i think a little rice for thickening is pretty benign (and in this case it's obviously very helpful!). we just started giving small amounts of avacado puree to my boys (5 months) and i was surprised at how much it has helped with reflux. makes for much happier babies that are no doubt having an easier time with digesting.

glad it's working for you guys!

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#3 of 13 Old 07-28-2009, 12:20 PM
 
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You could consider using Thick-It instead of rice cereal. That way you avoid any of the potential allergy issues of introducing a grain a bit early.

Mommy to BigBoy Ian (3-17-05) ; LittleBoy Connor (3-3-07) (DiGeorge/VCFS):; BabyBoy Gavin (10-3-09) x3 AngelBaby (1-7-06)
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#4 of 13 Old 07-28-2009, 03:51 PM
 
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Originally Posted by skybluepink02 View Post
Our ST and doctor has put Emaline on rice cereal in her breastmilk bottles to help with her feeding issues. She seems to do much better on thickened feeds, but I'm just not sure about it. I mean, it's really working. Her reflux is 100 times better than it was and she's actually using the suck-swallow-breathe sequence instead of letting the food drip into her mouth, attempting to swallow and choking.

But I'm just not sure about the rice cereal. She's 5 months old, 3 months adjusted. It's really early to have anything in her diet except breastmilk.

What do you think? It is helping a lot, but it just doesn't sit right.
Don't worry about doing it "right." Worry about what works for THIS child. Keep doing what works.
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#5 of 13 Old 07-28-2009, 06:53 PM
 
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Her reflux is 100 times better than it was and she's actually using the suck-swallow-breathe sequence instead of letting the food drip into her mouth, attempting to swallow and choking.
No, rice cereal (or any additive) is not optimal, but it sounds like it is what is needed for this situation. You have to weigh the risks of "early" introduction of a "solid" food vs the risks of aspiration due to severe reflux and suck dysfunction.

As a pp said, you could use Thick It instead, if you wanted to avoid the grains and have something that doesn't get broken down as quickly by the enzymes in breastmilk.

I'm sorry you are having to make the decision to go with something that goes against what is generally best for babies, but very glad that it is making a difference for your little one.
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#6 of 13 Old 07-28-2009, 08:39 PM
 
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I agree w/ the thick-it versus rice. We used rice for a bit, but had HORRIBLE constipation and it was a big deal---but w/o anything the reflux was awful. Thick-it worked better---though not completely.

We also did meds (previcaid) though one of my DDs still has reflux at almost 4 yrs old (still takes meds, but no dietary supplements, avoid high acid foods)---she was also born 2 months early. FWIW- we did do rice for about 3 weeks before switching to Thick-it and she has had no food allergies at this point- 3 years later.

Have given you a list of yes/no foods for you to eat if you are BF? Your diet can also help a bit, though not 'fix' the reflux.

KC
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#7 of 13 Old 07-29-2009, 12:07 AM
 
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I would do what works for baby. In my experience, thick it does not work well in breastmilk. There are not a lot of other options for thickening breastmilk. There is a gel that is marketed as something to thicken breastmilk, but the FDA just came out with a statement to not use it (I just went to a fragile infants feeding course). If breastmilk needs to be thickened, they (at the conference) recommended rice cereal.

I understand your concerns. It sounds like your babe is doing better and enjoying eating more with the thickened feedings perhaps due to both the reflux reduction and the better handled flow rate. I am assuming that you tried a slower flow nipple first??? If you didn't, some bottles have nipples that go slower than others, so that may be beneficial rather than thickening (although "slow" flow on the label doesn't necessarily mean that). It really depends on your babe. Slowing the flow down wouldn't necessarily decrease the reflux and it sounds like that has improved. Sorry, I just started working in our NICU and doing lots of feeding stuff with babes at work. Didn't mean to get all technical on you. PM me if you have any other questions.

It's a challenge to balance what feels right to us and what seems to work for our kids. I hope that you are able to find a balance.

Nena, Wife to S since 1995, mom to G (my wonderkid) since 2000 and R since 2006 (my snuggley boy who was diagnosed with mitochondrial disease in 2007)
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#8 of 13 Old 07-29-2009, 01:38 PM - Thread Starter
 
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Originally Posted by gsmom View Post
I would do what works for baby. In my experience, thick it does not work well in breastmilk. There are not a lot of other options for thickening breastmilk. There is a gel that is marketed as something to thicken breastmilk, but the FDA just came out with a statement to not use it (I just went to a fragile infants feeding course). If breastmilk needs to be thickened, they (at the conference) recommended rice cereal.

I understand your concerns. It sounds like your babe is doing better and enjoying eating more with the thickened feedings perhaps due to both the reflux reduction and the better handled flow rate. I am assuming that you tried a slower flow nipple first??? If you didn't, some bottles have nipples that go slower than others, so that may be beneficial rather than thickening (although "slow" flow on the label doesn't necessarily mean that). It really depends on your babe. Slowing the flow down wouldn't necessarily decrease the reflux and it sounds like that has improved. Sorry, I just started working in our NICU and doing lots of feeding stuff with babes at work. Didn't mean to get all technical on you. PM me if you have any other questions.

It's a challenge to balance what feels right to us and what seems to work for our kids. I hope that you are able to find a balance.
We've tried slower flow nipples, even preemie nipples, but she still chokes. Her speech therapist recommened thickening her feeds to help her sort it out in the front of her mouth before she swallows. She was on thickened feeds in the NICU, but off of them when she came home. She can eat somewhat in the side lying position, but not even the least bit inclined.

I guess we'll stick with rice cereal. I researched after I saw this, and by all indications, thick-it doesn't work with breastmilk. Lesser of two evils, I suppose. I mostly just worry about introducing a grain this early because her Daddy is celiac and there are a lot of food allergies in the family. She's gotta be able to eat though.

Thanks for your advice. I appreciate it, as well as the advice of everyone else who answered.

Welcoming our twins :: born February 21, 2009 at 33 weeks! :
C-section due to pre-eclampsia and HELLP:
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#9 of 13 Old 07-30-2009, 11:24 AM
 
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We used simply thick.

I think it may work with breastmilk. I am not seeing anything that says it wont.

According to their site it gives these 2 answers.

What can SimplyThick™ thicken?
SimplyThick™ can thicken any liquid, whether hot or cold. This includes water, juice, soda, milk, coffee, tea, soups, purees, beer, wine and mixed drinks

Are there any occasions where using SimplyThick™ is a problem?
On occasion certain dry beverage mixes do not appear to be properly thickened on the first try with SimplyThick™. In this case, change the order of addition and add SimplyThick™ to the water and thicken the water first. Then add the beverage mix. The most common example where this is necessary is with hot chocolate

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#10 of 13 Old 07-30-2009, 05:18 PM
 
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We used Thick-It with breastmilk for a long time. It worked fine. I would be interested to know why it wouldn't work? At the hospital, they told me not to use rice cereal because the enzymes in breastmilk would break down the rice cereal and make it not thicken properly.

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#11 of 13 Old 07-30-2009, 10:07 PM
 
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We used Thick-It with breastmilk for a long time. It worked fine. I would be interested to know why it wouldn't work? At the hospital, they told me not to use rice cereal because the enzymes in breastmilk would break down the rice cereal and make it not thicken properly.

moongazer
I had always heard the same thing...that rice cereal doesn't work well to thicken breastmilk. And Thick-It was what the SLPs used for all of his swallow studies, so it must have worked for at least a short period (maybe it thins out the longer it's in the breastmilk?) We didn't thicken at home, we used positional methods at the breast to minimize his aspirating, but that only worked with fluids at the breast. By the time he started taking fluids from other sources, we found a combination of bottle/nipple that helped him.

Mommy to BigBoy Ian (3-17-05) ; LittleBoy Connor (3-3-07) (DiGeorge/VCFS):; BabyBoy Gavin (10-3-09) x3 AngelBaby (1-7-06)
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#12 of 13 Old 07-30-2009, 10:30 PM - Thread Starter
 
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From what I can tell, both thick it and rice cereal break down in breastmilk. I am currently making two small bottles for her feeds and adding the cereal right before so it's the right consistancy. It's a pain not being able to make them beforehand, but what are you going to do?

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#13 of 13 Old 07-31-2009, 06:38 AM
 
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Thick It is corn based, which we were told was potentially more allergenic than rice cereal.

Both Thick It and rice cereal are starches which will break down in breastmilk over time. Thickening small amounts at a time is what worked for us.

Simply Thick is a xanthum gel based thickener which does not break down in breast milk. It makes for very nice consistently thick bottles. It is also extremely gluey and AC had one of his worst pneumonias when we were using it. I am not sure if it was coincidence or not, but we went back to rice cereal after that.
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