Does the formula cause vomiting in my baby with tongue-tie?

Question

Hello doctor,

My baby is three weeks old and has a tongue tie and reflux. He was started on Nexium (Esomeprazole). As he sometimes struggles to latch, the doctor also prescribed Alula AR formula. However, I feel that this formula is causing vomiting, especially after three weeks of feeding, and he seems sensitive to it. I have also noticed a rash with fine red pimples on his face, neck, and arms.

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I have read the query and understand the concern.

At three weeks of age, reflux is common, and a tongue tie can worsen the swallowing of air, which may lead to more spit-ups and discomfort. Esomeprazole may take a few days to show its full effect, so symptoms can persist initially. If vomiting has increased soon after starting formula milk, it may not be suitable for the baby, as thickened formulas can sometimes worsen intolerance in certain infants.

The rash with fine red pimples could be neonatal acne, which is common. However, if it appeared after introducing the formula, a possibility of milk protein sensitivity or allergy should also be considered.

It is important to watch for warning signs such as persistent vomiting, poor weight gain, blood or mucus in stools, worsening rash, or excessive irritability. In the meantime, feeding smaller amounts more frequently, keeping the baby upright for 20 to 30 minutes after feeding, burping frequently, and ensuring proper latch during feeding may help reduce symptoms.

It is advisable not to continue the new formula if symptoms worsen. A review with a pediatrician is recommended to consider switching to a different formula, such as a hydrolyzed formula, and to evaluate the tongue tie further if feeding difficulties persist.

A consultation for lactation support can also help in establishing proper feeding techniques. If possible, sharing images of the rash and tongue tie during consultation can help guide further management.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.