The umbilical cord delivers all the nutrients babies needs before birth. Once a baby is born it is cut, the outside part of the cord falls off. The skin on the baby heals up and becomes the umbilicus (belly button). In most cases, the muscle around the umbilicus closes up soon after the baby is born.
What is an umbilical hernia?
In about 1 in 5 newborns, the muscle around the belly button doesn’t close. The small opening that remains in the baby’s abdominal wall under the belly button is called an umbilical hernia. Because of this, a portion of intestine can pop out into a hernia sac that is covered only by skin.
How do I know if my child has an umbilical hernia?
The most common sign of an umbilical hernia is a bulging of the belly button. The bulge will typically come and go. It may be large when your child is straining or crying. When your child relaxes, the bulge may go away. At times, the bulge may stretch the skin as the hernia becomes bigger.
Is an umbilical hernia harmful?
Most of the time, umbilical hernias do not cause any problems. In very rare cases, the organs from inside the belly are trapped (“incarcerated”) inside the hernia sac. This results in the bulge being present even when your child is calm.
It is even more rare for the organs trapped inside the hernia sac to have their blood flow reduced (“strangulated”). If this happens, your child will likely have severe pain. The belly button may be very sensitive to the touch. The belly button bulge may also be red. Your child may have a fever, throw up, or refuse to eat. If this happens, your child needs to be seen right away. Call your doctor’s office or go to the emergency room.
Will any tests need to be done to see if my child has an umbilical hernia?
Most of the time, your child’s doctor can diagnose an umbilical hernia by examining your child. Rarely, they may order an ultrasound to see if there is a hernia or to see if belly organs are trapped inside the hernia.
An ultrasound is a test used to look at organs underneath the skin and will not hurt your child. A jelly-like liquid will be placed on the belly button and a probe will be used on the skin to see the organs underneath.
How is an umbilical hernia treated?
Most umbilical hernias (about 90%) will close on their own by the time children are 4 years old and nothing needs to be done. The size of the hole in the muscle (and not how far the hernia sticks out) is a better predictor of whether the hernia will close on its own. Since most umbilical hernias do not cause problems, it is safe to wait until your child is closer to 4 years old before thinking about having surgery. Surgery is the only thing that will fix an umbilical hernia if it does not close on its own. Binders and other things done to hold the hernia in do not work and may make the hernia worse or harm the skin.
What problems might my child have from an umbilical hernia?
After surgery, most children do not have problems. Rarely, a hernia can come back and you may see a bulge in the belly button again. If that happens, you will need to see your child’s surgeon again.
In most cases, vomiting will stop without specific medical treatment. The majority of cases are caused by a virus and will get better on their own. You should never use over-the-counter or prescription remedies unless they’ve been specifically prescribed by your pediatrician for your child and for this particular illness.
When your infant or young child is vomiting, keep her lying on her stomach or side as much as possible. Doing this will minimize the chances of her inhaling vomit into her upper airway and lungs.
Watch for Dehydration
When there is continued vomiting, you need to make certain that dehydration doesn’t occur. Dehydration is a term used when the body loses so much water that it can no longer function efficiently. If allowed to reach a severe degree, it can be serious and life-threatening. To prevent this from happening, make sure your child consumes enough extra fluids to restore what has been lost through throwing up. If she vomits these fluids, notify your pediatrician.
Modify Your Child’s Diet
For the first twenty-four hours or so of any illness that causes vomiting, keep your child off solid foods, and encourage her to suck or drink small amounts of electrolyte solution (ask your pediatrician which one), clear fluids such as water, sugar water (1/2 teaspoon [2.5 ml] sugar in 4 ounces [120 ml] of water), Popsicles, gelatin water (1 teaspoon [5 ml] of flavored gelatin in 4 ounces of water) instead of eating. Liquids not only help to prevent dehydration, but also are less likely than solid foods to stimulate further vomiting.
Be sure to follow your pediatrician’s guidelines for giving your child fluids. Your doctor will adhere to requirements like those descibed below.
Estimated Oral Fluid and Electrolyte Requirements by Body Weight
Body Weight (in pounds)
Minimum Daily Fluid Requirements (in ounces)*
Electrolyte Solution Requirements for Mild Diarrhea (in ounces for 24 hours)
6–7
10
16
11
15
23
22
25
40
26
28
44
33
32
51
40
38
61
1 pound = 0.45 kilograms 1 ounce = 30 ml *NOTE: This is the smallest amount of fluid that a normal child requires. Most children drink more than this.
In most cases, your child will just need to stay at home and receive a liquid diet for twelve to twenty-four hours. Your pediatrician usually won’t prescribe a drug to treat the vomiting, but some doctors will prescribe antinausea medications to children.
If your child also has diarrhea, ask your pediatrician for instructions on giving liquids and restoring solids to her diet.
When to Call the Pediatrician
If she can’t retain any clear liquids or if the symptoms become more severe, notify your pediatrician. She will examine your child and may order blood and urine tests or X-rays to make a diagnosis. Occasionally hospital care may be necessary.
Until your child feels better, remember to keep her hydrated, and call your pediatrician right away if she shows signs of dehydration. If your child looks sick, the symptoms aren’t improving with time, or your pediatrician suspects a bacterial infection, he may perform a culture of the stool, and treat appropriately.
For severe dehydration, hospitalization is sometimes necessary so that your child can be rehydrated intravenously. In milder cases, all that may be necessary is to give your child an electrolyte replacement solution according to your pediatrician’s directions. The table below indicates the approximate amount of this solution to be used.
Body Weight (lbs)
Minimum Daily Fluid Requirements (oz)*
Electrolyte Solution Requirements for Mild Diarrhea (oz/24 hrs)
6-7
10
16
11
15
23
22
25
40
26
28
44
33
32
51
40
38
61
Exclusively breastfed babies are less likely to develop severe diarrhea. If a breastfed infant does develop diarrhea, generally you can continue breastfeeding, giving additional electrolyte solution only if your doctor feels this is necessary. Many breastfed babies can continue to stay hydrated with frequent breastfeeding alone.
Once your child has been on an electrolyte solution for twelve to twenty-four hours and the diarrhea is decreasing, you gradually may expand the diet to include foods such as applesauce, pears, bananas, and flavored gelatin, with a goal of returning to his usual diet over the next few days as he tolerates. In children over age one, milk can be withheld for one to two days until the diarrhea begins improving. In infants on formula, you can mix the formula with twice as much water as usual to make half-strength formula for a few feeds until the diarrhea seems to be improving and then you can mix it as usual. (Add an equal volume of water to your child’s usual full-strength formula.) As the vomiting and diarrhea improve, an older child may be able to eat small quantities of bland foods such as rice, toast, potatoes, and cereal, and should be moved to an age-appropriate diet as soon as possible. You can continue to give the electrolyte replacement solution if your child likes it or they are not taking usual amounts of their regular fluids.
It is usually unnecessary to withhold food for longer than twenty-four hours, as your child will need some normal nutrition to start to regain lost strength. After you have started giving him food again, his stools may remain loose, but that does not necessarily mean that things are not going well. Look for increased activity, better appetite, more frequent urination, and the disappearance of any of the signs of dehydration. When you see these, you will know your child is getting better.
Diarrhea that lasts longer than two weeks (chronic diarrhea) may signify a more serious type of intestinal problem. When diarrhea persists this long, your pediatrician will want to do further tests to determine the cause and to make sure your child is not becoming malnourished. If malnutrition is becoming a problem, the pediatrician may recommend a special diet or special type of formula.
If your child drinks too much fluid, especially too much juice or sweetened beverages as mentioned earlier, a condition commonly referred to as toddler’s diarrhea could develop. This causes ongoing loose stools but shouldn’t affect appetite or growth or cause dehydration. Although toddler’s diarrhea is not a dangerous condition, the pediatrician may suggest that you limit the amounts of juice and sweetened fluids your child drinks (limiting fruit juice is always a good idea). You can give plain water to children whose thirst does not seem to be satisfied by their normal dietary and milk intake.
When diarrhea occurs in combination with other symptoms, it could mean that there is a more serious medical problem. Notify your pediatrician immediately if the diarrhea is accompanied by any of the following:
Fever that lasts longer than twenty-four to forty-eight hours
Bloody stools
Vomiting that lasts more than twelve to twenty-four hours
Vomited material that is green-colored, blood-tinged, or like coffee grounds in appearance
A distended (swollen-appearing) abdomen
Refusal to eat or drink
Severe abdominal pain
Rash or jaundice (yellow color of skin and eyes)
If your child has another medical condition or is taking medication routinely, it is best to tell your pediatrician about any diarrheal illness that lasts more than twenty-four hours without improvement, or anything else that really worries you.
What we eat can have a big impact on our overall health. If you have a child with irritable bowel syndrome (IBS), you know that certain foods seem to trigger their digestive symptoms. Your pediatrician may have recommended that your child try a low-FODMAP diet. But what are FODMAPs? And what is this diet all about?
Understanding FODMAPs
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are sugars (carbohydrates) that are found in a wide variety of foods we eat often. FODMAP sugars include:
Oligosaccharides: Fructans and galacto-oligosaccharides (GOS)
Disaccharides: Lactose
Monosaccharides: Fructose
Polyols: Sorbitol and mannitol
FODMAPs can cause digestive problems in some people, especially those with IBS. That’s because scientists have found that our small intestines don’t absorb or digest FODMAPs very well. This leads to more water entering the gut. Then when FODMAP sugars reach the colon, they create more gas.
All this excess fluid and gas can lead to symptoms such as:
Abdominal Discomfort
Abdominal Pain
Cramping
Flatulence
Bloating
Diarrhea
Constipation
FODMAPs aren’t unhealthy or bad. They just have the potential to make symptoms worse in people with sensitive digestive systems, such as those with IBS.
FODMAP content in foods
There are many foods that are high in FODMAPs. This table gives a list of some common ones, as well as alternatives that kids can eat while on the diet. However, it’s not by any means a complete list. We recommend kids work with a registered dietitian when possible.
FODMAP Type
High-FODMAP Foods
Low-FODMAP Alternatives
Fructose
High fructose corn syrup (used in many foods/beverages), molasses, honey, apples, pears, boysenberry, mango, fruit juices, agave syrup
Peanut butter, canned lentils (limited), some nuts in restricted quantities
The low-FODMAP diet
This diet is often referred to as simply the FODMAP diet. But technically, it’s a low-FODMAP diet. That’s because it focuses on limiting the intake of high-FODMAP foods. The diet includes three phases and was created in Australia specifically for people with IBS, a common issue in both children and adults. Your pediatrician may recommend a low-FODMAP diet if your child has IBS. Research has shown that this diet has helped many adults and kids with IBS manage their symptoms.
Because the low-FODMAP diet is so restrictive, it’s not for people who are otherwise healthy. Your child should only be on this diet if it has been recommended by your doctor. We recommend working with a registered dietitian while your child is on this diet. Your pediatrician can suggest one or you can find one at the Academy of Nutrition and Dietetics website.
Here’s what you can expect in the three phases of this diet.
Phase 1: Elimination
In the first phase, your child stops eating foods that are high in FODMAPs for 2–6 weeks. We often recommend 2 weeks because it can be hard to follow such a restrictive diet. You should know by the end of this phase whether the diet is helping your child’s symptoms.
Keep in mind that not everyone that tries the low-FODMAP diet has symptom relief. You may need to work with your child’s pediatrician on finding other options if the diet doesn’t help.
Phase 2: Reintroduction
You’ll move on to the second phase if your child’s symptoms have improved. In this phase, you’ll introduce high-FODMAP foods back into your child’s diet. We recommend reintroducing one FODMAP at a time—for example, lactose—typically over three days. This allows your child to tell which of the FODMAPs are causing symptoms. If the digestive issues (pain, gas, etc.) start again after a FODMAP type is reintroduced, take it back out of their diet.
You may want to take a break if your child’s symptoms get worse with one FODMAP before reintroducing another one. It’s also a good idea to keep a food diary during this time to track what your child is eating and how they react.
The goal of this phase is to help you pinpoint which foods your child can tolerate and which ones cause digestive distress. If you need to take breaks in between reintroducing FODMAP types, this phase can take up to a month.
Phase 3: Personalization
Once you’ve figured out which foods cause digestive symptoms, you can personalize the diet to your child’s needs. In this phase, you’ll have your child limit or completely avoid the FODMAP types that give them problems. Your child can enjoy the others without worrying about their symptoms coming back.
Risks of FODMAP diet
The risks of a low-FODMAP diet are not getting enough nutrients or enough calories. For growing kids, this is a concern. That’s why it’s a good idea to work with a registered dietitian to come up with a healthy diet for your child during the three phases. This will help reduce these nutritional risks.
Interestingly, our initial research suggests that children with IBS often typically eat a poor diet, similar actually to what healthy kids eat. But kids with IBS who work with a registered dietitian to follow a low-FODMAP diet have some initial improvement, even in the first phase, in their overall diet quality.
Your child shouldn’t try a low-FODMAP diet if they have an eating disorder or if they’re already following a specialized diet.
You can learn more about the low-FODMAP diet, take online courses, and find recipes at the Monash University site, where the diet was created. They also have an app that gives you low-FODMAP food recommendations and lets you look up foods.
Remember
Talk with your pediatrician if you have any concerns about your child’s digestive health.
Children complain of stomachaches for all sorts of reasons—not uncommonly, to stall at bedtime. Or perhaps they’re trying to avoid school. Or maybe their “eyes were bigger than their stomach” and they ate too much for dinner. Recurrent abdominal pain(often simply called stomachache) is common but luckily usually not serious in children. In some cases, no physical cause can be found, and the pain is termed functional or nonspecific pain, possibly related to emotional stress. At times, spasms in the digestive tract may cause pain. A crying child may swallow gas, which can cause abdominal discomfort. What’s essential to remember is that the pain can be real, even though there is no obvious cause.
Other Causes of Stomachaches Include the Following:
Constipation, although rarely a problem in younger babies, is more common in older children.
Urinary tract infections are more common in 1- to 5-year-old girls than in younger children and cause discomfort in the abdomen and bladder area.
Strep throat is a throat infection caused by bacteria (streptococci), with symptoms that include a sore throat, fever, and abdominal pain.
Appendicitis is very uncommon in children younger than 5 years; the first sign is a complaint of constant stomachache in the center of the abdomen, which later moves down and over to the right side.
Milk allergy, a reaction to the protein in milk, produces cramping abdominal pain.
Lactose intolerance is when the body lacks the enzyme needed to break down lactose in milk and other milk products. Lactose intolerance is different from a milk allergy and is more common in African American and Asian children. Symptoms of lactose intolerance include diarrhea or constipation, increased gassiness, and cramping abdominal pain.
Emotional upset, particularly in school-aged children, may cause recurrent abdominal pain that seems to have no other cause.
When to Call Your Pediatrician:
Abdominal pain that comes on suddenly or persists may require prompt attention, especially if your child has additional symptoms, such as a change in his bowel pattern, vomiting, fever (temperature of 100.4°F or higher), sore throat, or headache. Even when no physical cause can be found, the child’s distress is genuine and should receive appropriate attention. Call your pediatrician promptly if your baby is younger than 1 year and shows signs of stomach pain (for example, legs pulled up toward the abdomen, unusual crying); if your child aged 4 years or younger has recurrent stomachache; or if abdominal pain awakes him or stops him from getting to sleep.
Shigella bacteria cause a diarrheal illness that can occur in children. Four species of Shigella bacteria (S boydii, S dysenteriae, S flexneri, and S sonnei) have been identified as infecting the lining of the intestines. These bacterial illnesses are highly contagious. They are spread through the feces of people with the infection, particularly in close contact environments such as within families and in child care centers. They can also be contracted by consuming contaminated food or water or by touching an object on which the bacteria may be present. Children aged 2 to 4 years are particularly vulnerable to developing the disease. The incubation period is usually 2 to 4 days.
Signs and Symptoms
A Shigella infection can cause mild watery or loose stools with no other symptoms, or it can be more serious, with fever, abdominal cramps or tenderness, crampy rectal pain (tenesmus), and mucous-filled and sometimes bloody stools.
When to Call Your Pediatrician
Call your pediatrician if you notice blood in your child’s stool, there’s no improvement in her diarrhea, or she is showing signs of dehydration.
How Is the Diagnosis Made?
A pediatrician may order laboratory tests in which a culture of the child’s feces is examined for evidence of Shigella bacteria.
Treatment
If your child’s symptoms are mild, your pediatrician may decide that it’s not necessary to prescribe medicine to treat the infection. These children generally get better rapidly without any medicine. However, antibiotics such as cefixime, ampicillin, or trimethoprim sulfamethoxazole may be prescribed in more severe cases. These drugs can kill Shigella bacteria in the child’s stools, shorten the duration of the diarrhea, and lower the chances of spreading the illness.
If your child is having lots of watery diarrhea, be sure to give her extra fluids to avoid dehydration. It is important that the fluids contain salt because salts are lost in the diarrhea. Rehydration fluids are sold over the counter, but you can also make these at home. Talk to your pediatrician to be sure you have the correct amount of salt and water. In severe cases, intravenous fluids may be required.
Do not self-prescribe antidiarrheal medicines, which can actually make your child worse.
What Is the Prognosis?
In most cases, Shigella infections run their course in 2 to 3 days. Occasionally, complications may develop, including bacteremia (bacteria in the blood), hemolytic uremic syndrome (a disorder characterized by kidney failure and anemia), and Reiter syndrome (painful urination, joint achiness).
Prevention
If your child attends a child care facility, make sure staff members practice good hygiene, including frequent hand washing, particularly before food preparation and after diaper changes, and regularly disinfect toys. At home as well as at these child care settings, food should be stored, handled, and prepared according to good sanitation guidelines. People with a diarrheal illness should not be involved in preparing food for others.
Reye syndrome (often referred to as Reye’s syndrome) is a rare but very serious illness that usually occurs in children younger than fifteen years of age. It can affect all organs of the body, but most often injures the brain and the liver.
Reye syndrome is preceded by a viral infection, most commonly chickenpox or influenza. Although no one knows precisely what causes Reye syndrome, it affects only a small number of children, and is strongly associated with aspirin or aspirin-containing medication during the viral infection.
Signs and Symptoms
Whenever your child has a viral illness, be alert for the following pattern typical of Reye syndrome: Your child may develop a viral infection, such as influenza, an upper respiratory illness, or chickenpox, and then seem to be improving. However, then he abruptly starts to vomit repeatedly and frequently every one or two hours over a twenty-four to thirty-six-hour period, becoming lethargic or sleepy, which then turns into agitation, delirium, or anger. Then he may become confused or even become unresponsive. If the disease progresses, there is a strong chance he will have seizures and go into a deep coma.
Call your pediatrician as soon as you suspect that your child’s illness is following this pattern. If your doctor is not available, take your child to the nearest emergency department. It is very important to diagnose this illness as early as possible.
Prevention
Since the medical community issued a public warning against the use of aspirin during viral illnesses, the number of cases of Reye syndrome has decreased greatly. Therefore, we strongly recommend that you do not give aspirin or any medications containing aspirin to your child or teenager when he has any viral illness, particularly chickenpox or influenza. If he needs medication for mild fever or discomfort, give him acetaminophen or ibuprofen. Ibuprofen is approved for use in children six months of age or older; however, it should never be given to children who are dehydrated or who are vomiting continuously.
Yersinia enterocolitica and Yersinia pseudotuberculosis are bacterial infections that are uncommon, but can cause problems when they occur. Y enterocolitica causes a condition called enterocolitis, which is an inflammation of the small intestine and colon that occurs, and often recurs, mostly in young children.
These infections appear to be acquired by eating contaminated food, particularly raw or inadequately cooked pork products, and drinking unpasteurized milk. They might also be contracted by touching an infected animal, drinking contaminated well water, or on rare occasions, from contaminated transfusions. The infections are increasing in frequency among children whose immune system is weakened. The incubation period is around 4 to 6 days.
Signs and Symptoms
When a Y enterocolitica infection is present, it not only causes an inflamed small intestine and colon, but also symptoms such as diarrhea and a fever. A child with this infection may have stools that contain blood and mucus. These symptoms may last for 1 to 3 weeks, sometimes longer.
Along with these more common symptoms, very young children who have too much iron stored in their bodies, such as those who receive blood transfusions, or whose immune system is already suppressed or weakened because of another illness, may be susceptible to bacteremia (the spread of bacteria to the blood). Older youngsters may also have symptoms that mimic appendicitis (a pseudoappendicitis syndrome), with right-sided abdominal pain and tenderness. On rare occasions, this infection may be associated with conditions such as a sore throat, eye inflammation, meningitis, and pneumonia. In older youngsters, joint pain or a red skin lump (erythema nodosum) on the lower legs may develop after the infection itself has gone away.
Children with Y pseudotuberculosis will likely develop a fever, a rash, and abdominal pain, including the pseudoappendicitis syndrome. Some children may also have diarrhea, a rash, and excess fluid in the chest region or spaces around the joints.
When to Call Your Pediatrician
Contact your pediatrician if your child’s stool is streaked with blood. Look for signs of dehydration that could be caused by your youngster’s diarrhea, including dry mouth, unusual thirst, and a decline in the frequency of urination.
How Is the Diagnosis Made?
Your pediatrician can order tests to detect the presence of Yersinia organisms in your child’s stool. Evidence of the infection may also be seen by taking throat swabs and evaluating them in the laboratory, examining the urine, or testing the blood for antibodies to the bacteria.
Because these are relatively rare infections, most laboratories do not routinely perform tests looking for Yersinia organisms in feces.
Treatment
In most children, the infection will go away on its own. In some cases, Yersinia infections need to be treated with antibiotics. As with all cases of diarrhea, fluids are given to prevent or treat dehydration.
Prevention
Make sure your child does not consume raw or undercooked pork, unpasteurized milk, and contaminated water.Wash your hands thoroughly with soap and water after handling raw pork intestines (chitterlings).
No vaccine is available to prevent Yersinia infections.
The highly acidic digestive juices in the stomach and bowel can erode the delicate lining of the gastrointestinal tract, causing sores known as ulcers. The most common site is the duodenum: the portion of the small intestine that receives the soupy mixture of semidigested food from the stomach. Both duodenal ulcers and gastric (stomach) ulcers are referred to as “peptic” ulcers. The name alludes to pepsin, the digestive enzyme responsible for breaking down the protein in food.
Doctors used to believe that all ulcers were caused by diet and stress. We now know that a bacterium known as Helicobacter pylori is behind many adult ulcers. The percentage of adolescent ulcer patients infected with H. pylori may be in the neighborhood of 25 percent. Scientists believe that this common microorganism enters our bodies via food and water, and possibly through kissing. Half of all men and women over sixty carry the bacteria. Why the majority of them never develop peptic ulcer disease is a question still in search of an answer.
Symptoms that Suggest Peptic Ulcers may Include:
Sharp, burning or gnawing pain in the upper abdomen that lasts anywhere from thirty minutes to three hours and comes and goes
Appetite loss
Weight loss
Weight gain
Nausea and vomiting
Blood-tinged vomit
Bloody stool
Bloating
Belching
Anemia
How Ulcers Are Diagnosed
Physical examination and thorough medical history, plus one or more of the following procedures:
Endoscopic exam of the stomach (gastroscopy) or the upper bowel (esophagogastroduodenoscopy), including tissue biopsy, to detect H. pylori bacteria
To locate the source of gastrointestinal bleeding, the doctor may order one or more of the following:
Stool blood test
Complete blood count
Prothrombin time blood test
Angiogram
Sigmoidoscopy or colonoscopy
Scintigraphic studies
CAT (CT) scan
Magnetic resonance imaging (MRI) scan
How Ulcers Are Treated
Drug therapy: “When I started in gastroenterology in the 1970s,” says Dr. Alan Lake, a pediatrician and pediatric gastroenterologist at Baltimore’s Johns Hopkins University School of Medicine, “I was subjecting six to eight patients a year to partial removal of their stomachs to treat chronic peptic ulcer disease. But since the mid 1980s, I haven’t sent a single patient to surgery. The medication options that are now available have virtually eliminated the need for an operation.”
Several types of drugs are typically incorporated into treatment:
Nonprescription antacids, taken intermittently to neutralize excess stomach acid and relieve abdominal pain.
H2 blockers (cimetidine, rantidine, famotidine), which reduce acid production in the digestive tract.
Antibiotics, if diagnostic tests reveal the presence of H. pylori.
Youngsters taking H2 blockers should begin to feel significantly better after several weeks. The medication can then be discontinued. Your child can also resume eating normally; the bland diet of old has not been found to help treat or prevent ulcers. Should the disease recur—as happens in half to four-fifths of all cases—most pediatricians would recommend staying on the drug for six months to two years.
Certain diet textures are often prescribed to help infants and children with special needs eat more safely and easily. Children with dysphagia or gastroesophageal reflux, for example, may need their food to be thicker in order to swallow safely or reduce reflux.
In response to concerns over arsenic in rice, the American Academy of Pediatrics (AAP) now recommends parents of children with these conditions use oatmeal instead of rice cereal.
Why Oatmeal?
Children with these conditions were exposed to more rice cereal (and, therefore, more arsenic) for a longer period of time. For infants, this increased exposure also comes at a time when they are developing most rapidly and may be at the greatest risk for side effects of arsenic. Therefore, a safer alternative was needed.
Oatmeal is not a member of the wheat family (i.e. oatmeal is gluten-free), so it’s also safe for kids with celiac disease.
Tips for Parents:
Talk with your child’s pediatrician or feeding specialist about the different types of oatmeal cereals on the market and how to arrive at a just-right consistency. The amount of oatmeal to add to the liquid (formula, breast milk, etc.) is dependent on your child’s condition. It is important to follow the recommendations of your pediatrician or feeding therapist.
If you are mixing oatmeal cereal in pumped breast milk: It is best to do it right before your infant will feed. If you mix it too early, the enzymes in the breast milk will break down the oatmeal—making it ineffective.
If you are mixing oatmeal cereal in formula: It is most effective if done no more than 20 to 30 minutes before your infant will feed.
If your child is drinking it from a bottle, you may need to go up to a larger nipple size in order for the oatmeal to flow. Most feeding specialists now recommend either a faster flow nipple or commercially precut, cross-cut nipples provided by the hospital.
Be certain that your child is sitting in an appropriate position, as it can affect his or her ease and enjoyment with the meal.
Make sure you are not over feeding your child. If he or she is gaining weight rapidly, but spitting up a lot, try decreasing the amount at each feeding. Infants with reflux, for example, tend to do better with smaller, more frequent meals.
The commercial thickening agent, Simply Thick, should not be used in any infant. It increases the risk of developing a life-threatening condition called necrotizing enterocolitis.
