Anti-colic, anti-reflux and anti-constipation formula

Formula for colic, anti-reflux and constipation. There are many occasions when babies don't tolerate regular milk , and that's nothing unusual. That's why almost every manufacturer of infant formula offers special formulas .

Finding the right one for your baby can be quite a challenge, and understanding what this special formula milk for your baby is, its indications, or the poos it produces will be very interesting for you. That's why our midwives have put together the following post with all the useful information on the subject.

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Anti-reflux or anti-regurgitation formulas

Special anti-reflux or anti-regurgitation formulas are first infant formulas and follow-on formulas to which thickening agents have been added to increase viscosity, such as locust bean gum or rice or corn starch, in order to control or minimise vomiting and excessive regurgitation in the infant. They are also used as dietary therapy in uncomplicated gastro-oesophageal reflux.

The main protein source of these formulas is casein, with a casein/serum albumin ratio similar to that of cow's milk. The high proportion of casein is justified in order to increase the density of the curd, thereby reducing regurgitation. However, the precipitation of casein in the stomach with a greater viscosity can delay gastric emptying and may exert a buffering effect on gastric acidity. That is why some of these formulas contain less long-chain fatty acids in order to speed up gastric emptying.

Poos of a baby fed on anti-reflux formula

Babies who use this type of anti-reflux formula may have poos that are looser, since the locust bean gum used in their manufacture is a non-digestible glucogalactomannan, which affects their fermentation process in the colon and speeds up the bowel transit. This will sometimes cause diarrhoea, wind (farts) and colicky pain in the infant.

Indications for anti-reflux formulas

When looking at the indications for these formulas, it should be noted that physiological regurgitation in the infant is common in the first months of life and resolves spontaneously by around 12-18 months of age without any need for treatment. This type of anti-reflux formula should not be indicated as the only measure in children with moderate gastro-oesophageal reflux or reflux oesophagitis.

ESPGHAN considers these milks to be indicated in those infants with failure to thrive (delayed weight gain and physical growth) due to excessive nutrient losses associated with regurgitation, together with appropriate medical treatment and under medical supervision.

We should be aware that, at present, no evidence has been found that the use of these formulas provides any benefit for children with reflux oesophagitis, since the time the refluxed material remains in the oesophagus is increased. On the other hand, the effects of thickeners on the bioavailability of other nutrients in the diet are not known.

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Anti-constipation formulas

This type of anti-constipation formula is an adapted formula in which the proportion of β-palmitate is similar to that of breast milk. In breast milk, 70% of fatty acids are in the beta position and are properly hydrolysed by lipase. In adapted formulas, the fatty acids are mostly in the alpha position and, as they are not hydrolysed, free fatty acids remain which are poorly absorbed and bind to calcium to form insoluble calcium soaps.

Modifying the triglycerides in these formulas leads to a greater number of fatty acids in the beta position. As well as softening the stools, these milks allow better absorption of the fat fraction of the milk, calcium and magnesium, and an enrichment of bone mineral content.

In some cases they may contain a higher amount of magnesium because of its laxative effect and its stimulating effect on bowel motility through the stimulation of cholecystokinin (a gut hormone involved in digestion and appetite). In infant formulas, oligosaccharides with a prebiotic effect have been developed, the most relevant being galacto-oligosaccharides (GOS) and fructo-oligosaccharides (FOS), which in recent years have been added to some infant formulas. They regulate bowel transit thanks to the increase in the volume of the digestive bolus.

Poos of a baby fed on anti-constipation formulas

The stools of babies or children fed on these formulas will be less hard and contain fewer calcium soaps (a bond of two fatty acid molecules with one of sodium hydroxide).

Indication for anti-constipation formula milk

These anti-constipation formulas are indicated for infants fed on formula who are prone to constipation. A reminder for you: if your baby is exclusively breastfed, it can be normal for them to go up to 15 days without doing a poo , because there are cases in which breast milk is absorbed in full by babies, and it is not recommended to stimulate the anus of a baby to make them do a poo.

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Anti-colic formulas

This type of special anti-colic formula is used to relieve the possible triggers of infant colic. In these formulas, the whey proteins are partially hydrolysed to make them easier to digest and some of them contain less lactose, which is replaced by maltodextrin to reduce excess abdominal gas.

They also contain fructo-oligosaccharides in order to achieve a prebiotic effect, and a higher proportion of β-palmitate. The way the fat content is modified is in the form of MCTs. All these changes are aimed at solving minor digestive discomfort.

As well as the type of formula, the way a baby feeds also influences their digestive wellbeing. Using an anti-colic bottle, designed to reduce the intake of air during the feed, can help to minimise the appearance of wind and discomfort, especially in infants prone to colic.

Conclusion on anti-reflux, anti-colic and anti-constipation formula milk

As we always say, every baby is unique, and finding the best milk for your baby sometimes takes time. Be patient, because in motherhood it is your best ally, and trust your paediatrician, who will offer you the best solution. Also remember one detail: every brand has its own anti-reflux, anti-colic and anti-constipation formula, with its own taste and its own composition, and if your baby doesn't like one or doesn't get on well with it, another brand may be your solution.

So, as we mentioned in the post “the best infant formula”, there are pharmacies that have trial doses available, so ask about them to try first, so you don't have to spend more money than you need to before finding yours; if that isn't the case, buy the smallest tin in case it isn't the formula that your baby tolerates best.