12 of 12 people found the following review helpful
Helpful for the right type of reflux,
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This review is from: COW & GATE INSTANT CAROBEL - 135G (Misc.)
To be fair from the start, my baby boy has really severe reflux. He is on massive amounts of strong medications and may be looking at an operation. So I was never expecting this to be a cure in itself, but part of a supportive regime.
Initially we tried it when he was 2 or 3 months old and learned he was suffering from reflux and oesophagitis. Together with keeping him upright after feeds, feeding small regular amounts, infant Gaviscon and changing his formula. At that stage - NO help at all from any of these things either separately or in combination.
Scroll forwards several months. My baby is now 6 months old and has had a lot of trips to paediatric specialists. He is on large doses of Lanzoprazole several times a day (the strongest prescription anti-reflux medication usually only for adults), and is no longer drinking milk of any sort. There is a 50% improvement, but still a lot of pain and distress.
I notice he still vomits small amounts pretty frequently. About as often as a newborn, perhaps more, and he is now nearly 7 months. So I try adding in Carobel at the maximum possible dose to each feed of non-milk drink.
Within 48 hours he is vomiting a lot less, and more importantly, is now about 60 - 70% of normal. We are continuing to use it as part of a broad protocol to get the little boy back to happy, good health.
(Note: we tried several thickeners including Aptimil Comfort. We found Carobel to be the best because a) it thickened more completely and b) we could control the amount added. I makes no real difference to the taste. It does however make a difference to thickness/viscosity of bottle so please see `'NOTES ON USE'' below).
MY CONCLUSION: This WORKS to reduce the amount and frequency of vomiting. By thickening the milk, less comes back up the oesophagus and therefore less acid burns the oesophagus meaning it has time to heal. But it is not suitable at all for severe reflux (which admittedly is not most babies' problem.)
MY FURTHER THOUGHTS: It is ONLY useful for milder reflux, OR as part of more comprehensive (medicine) based approach in treating severe and difficult reflux.
Therefore; try it, along with other simple interventions (holding upright after feeds, sleeping more upright, smaller feeds etc) initially. It is much better if Carobel + little feeding changes are helpful, rather than needing pharmaceuticals. If you don't see benefit within a week or so, move on to more serious help such as Rinatidine (which switches off acid pumps partially.). If that doesn't help, try even more serious medicine i.e. proton pump inhibitors (which switch off nearly all acid pumps in the stomach). If that doesn't help, add in all those things that didn't work first off, as now they may have a chance of being the missing piece of the puzzle.
(The logic here is that Carobel and infant Gaviscon are for milder reflux. As too are behavioral interventions such as upright after feeding. If you baby has severe reflux you need serious medicine. But not all babies are fully helped. However, at this stage, Severe Reflux has effectively been reduced to Mild reflux by turning off most of the acid pumps with medicine. So the treatments for mild reflux have a real chance of being an added benefit.
NOTES ON USE; We found that more was better. We kept adding it until the milk became like thick double cream. At this stage we had to buy size 3, super fast flow nipples, and used a sharp knife (Stanley best) to make the star shaped hole even bigger.
NOTES ON REFLUX IN GENERAL;.
Start with the easy stuff as follows in order (I have found):
1) Keep upright after feeds for 1/2 hour min. Including night feeds.
2) Raise one end of cot up at least 9". (cot looks odd but is safe enough)
3) Add Carobel to milk to thicken it. We found Carobel more effective than other thickeners including so called "comfort" milks e.g. Aptimil Comfort.
4) Add 2 sachets of infant Gaviscon to each feed. The Gaviscon doesn't thicken much, but it does form a type of '' sieve'' on top of the milk in the stomach to prevent acid and pepsin rising up. If 1) - 4) no luck even in combination:
5) Get Rinatidine from your GP. This turns off about 30% of all the acid pumps in the stomach. If not enough improvement after 3 weeks:
6) Get a PPI (proton pump inhibitor) from a GP or paediatrician. This turns off 85% of all the acid pumps in the stomach.
7) Keep going up on the dose of the PPI at 2 -3 week intervals until your baby is not regularly screaming in pain. For us it has taken a staggeringly large dose to get to this stage.
AT ALL TIMES: work with combinations of the above for better results.
UPDATE: My little baby boy is now 16 months old. We used Carobel as part of our regime all the way up until 14 months. We are slowly weaning him off all his medications and he is starting to thrive. We are expecting another little one in a few months. If s/he has similar difficulties (and reflux can run in families as my husband had terrible reflux for the first two years of his life - back in the days when nothing much could be done) - I will be glad to try Carobel again.