To follow up on Mallory’s post on Dysphagia, GERD, and Silent Aspiration in children, I wanted to use this post to discuss the use of thickeners to help with the treatment of GERD/GER, dysphagia and aspiration. I'll also share some commercially available thickeners.
If your little one is showing signs of GERD/GER, dysphagia or aspiration, you should always see a doctor to determine exactly what condition needs to be treated. One thing to remember is that children with Eosinophilic Esophagitis (EoE) can also have symptoms of dysphagia and often have symptoms very similar to that of GERD.
EoE is caused by food allergies and can be managed effectively by eliminating the allergens in your child’s diet. Thickening their food or formula may not be needed once the allergens are removed if the reflux also comes under control. Be sure to check with your child's doctor and/or speech pathologist to see if a food thickener is appropriate for your little one before trying one.
Thickening Foods and Liquids
If your child does have GERD/GER, dysphagia or aspiration, the healthcare team may recommend altering the thickness of food and liquids to help make them easier to swallow. When fluids are too thin, some children have trouble using their tongues and the muscles that help to swallow correctly, causing liquid to get caught in the airway passage and then get into their lungs. Thickening the formula and other fluids can help the liquids stay together during swallowing, decreasing the risk of aspiration, which is when fluid or food getting into the lungs (where it should not be!).
For infants with reflux symptoms, adding dry rice cereal or oat cereal to their formula or expressed breast milk to thicken it may be suggested by some healthcare professionals. It's important to note that there is not consensus on this, and not all healthcare teams agree that this is an acceptable approach. If your team suggests this, you should ask them what amount of cereal they recommended you add to your little one's bottle to help with reflux. You can read more about adding thickeners to Neocate here.
There are also some commercial thickeners on the market that may be options, depending on your child's age. It is important to read labels and call the company that makes the thickener if your child has food allergies to ensure the thickener doesn't contain any of their allergens. A few options in the market, and the manufacturer recommendations on who can use the product, include:
- GelMix (not for use with infants under 42 weeks gestational age or with infants under six pounds)
- ThickenUp (only appropriate for use in individuals greater than 3 years old)
- Thick-It (not appropriate for use with premature infants, consult your physician before using with any infant)
- SimplyThick (NOT intended for use with children under 12 years with a history of NEC, with preterm infants, or term infants under 12 months)
We do not have any specific commercial thickeners that we recommend for Neocate products. Any should work, and if your healthcare team recommends that the Neocate you use should be thickened, ask them what they recommend.
We hope this helped! What other questions do you have about thickeners?
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