Choosing the Right Formula for Your Baby's Vomiting and Constipation Issues

If a baby is experiencing vomiting, how should the formula be changed?

Hello, Dr.
Hsiao.
My baby is over two months old and used to drink S26 but would often vomit in a projectile manner.
Sometimes, he only has a bowel movement every three to four days, and he cries each time.
A doctor previously suggested that we might try switching formulas.
Recently, I heard from a store that we should buy Anqi Er H1+, but since we switched, he has gone from drinking 90cc to only 40 or 50cc.
He used to feed every three hours, but now he only wants to feed every six hours.
When changing his diaper, I see the color of his stool, but he hasn't actually had a proper bowel movement, and I want to return the formula.
The store advised us to observe for a few more days, saying that switching from S26 is difficult, so they suggested adding enzyme powder to the hydrolyzed protein formula to improve his feeding issues.
However, can a baby over two months old have enzyme powder? My baby has been growing slowly and was born weighing less than 2000 grams.
I am at a loss about what to do because many non-medical people are recommending different formulas, but I don't know which one is suitable for him.
Some suggest Anbu, others suggest New Anqi Er or Anqi Er H1+, and some recommend New Aisjia hydrolyzed protein or Baby Cass, which is all very confusing.
I don't know how to truly improve his issues with vomiting, spitting up, and having a bowel movement only every four days.
How should I choose the right formula?

danxin, 20~29 year old female. Ask Date: 2010/01/04

Dr. Xiao Kaiwen reply Pediatrics

If you are unsure whether your baby’s weight gain is adequate, and if there is poor weight gain accompanied by projectile vomiting, it is advisable to first visit a pediatric gastroenterologist at a major hospital for an evaluation.
This will help determine if there are any gastrointestinal structural issues (such as pyloric stenosis or intestinal obstruction) or congenital metabolic disorders.
Changing the formula should only be considered after ruling out other pathological issues, and it is recommended to consult with a neonatologist as well.
For a baby over two months old, the gastrointestinal system is still immature, and it is not advisable to introduce anything other than infant formula (such as enzyme powders).

Reply Date: 2010/01/04

More Info

Choosing the right formula for your baby, especially when dealing with issues like vomiting and constipation, can be quite challenging. It’s essential to approach this situation with careful consideration and ideally under the guidance of a pediatrician. Here’s a comprehensive overview of the factors to consider and some recommendations based on your baby’s symptoms.

Understanding Your Baby's Symptoms
1. Vomiting: The fact that your baby experiences projectile vomiting after feeding can be concerning. This could be due to several reasons, including:
- Overfeeding: Babies have small stomachs, and feeding them too much can lead to vomiting.

- Reflux: Gastroesophageal reflux (GER) is common in infants and can cause vomiting.

- Formula Intolerance: Some babies may not tolerate certain formulas well, leading to gastrointestinal distress.

2. Constipation: If your baby is having bowel movements every three to four days and seems to be in pain while doing so, this could indicate constipation. In infants, constipation can be caused by:
- Dehydration: Not enough fluid intake can lead to hard stools.

- Formula Composition: Some formulas can be harder for babies to digest, leading to constipation.

Choosing the Right Formula
Given your baby’s symptoms and the challenges you’ve faced with different formulas, here are some steps to consider:
1. Consult Your Pediatrician: Before making any changes to your baby’s diet, it’s crucial to consult with your pediatrician. They can provide personalized advice based on your baby’s health history and current symptoms.

2. Consider Hypoallergenic Formulas: If your baby has shown signs of intolerance to standard formulas (like S26), you might want to consider hypoallergenic formulas or those designed for sensitive tummies. These formulas are often easier to digest and can help reduce vomiting and constipation.

3. Hydrolyzed Protein Formulas: These formulas break down proteins into smaller pieces, making them easier for babies to digest. They are often recommended for babies with feeding issues or allergies.

4. Probiotics and Prebiotics: Some formulas contain added probiotics and prebiotics, which can help support digestive health and may alleviate constipation.

5. Gradual Transition: If you decide to switch formulas, do so gradually. Mix the new formula with the old one over several days to help your baby adjust. This can also help minimize gastrointestinal upset.

6. Monitor Feeding Patterns: Since you mentioned that your baby has reduced their intake after switching formulas, it’s important to monitor their feeding patterns closely. Babies should generally feed every 2-4 hours, and a significant increase in the time between feedings could indicate that they are not getting enough nutrition.

7. Hydration: Ensure that your baby is adequately hydrated. Sometimes, adding a small amount of water (if recommended by your pediatrician) can help with constipation.

8. Avoid Non-Medical Recommendations: While it can be tempting to follow advice from non-medical sources, it’s best to rely on your pediatrician’s guidance. They can help you navigate the myriad of formulas available and find one that suits your baby’s specific needs.

Conclusion
Navigating feeding issues in infants can be overwhelming, especially with the plethora of formulas available on the market. Your baby’s health and comfort should always come first. By consulting with your pediatrician and considering hypoallergenic or hydrolyzed formulas, you can find a solution that helps alleviate your baby’s vomiting and constipation. Remember, every baby is unique, and what works for one may not work for another, so patience and careful observation are key.

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