What is thickened formula and what is a thickener?

I was recently involved in a discussion with my fellow mommies and one of them asked the question: “Do any of you know why Nestargel has been discontinued?”

To which a cacophony of answers came forth, as they do at these mommy gatherings. As we at BabyYumYum are all about supplying credible and factual information, we went straight to the source to get some facts about why it has been discontinued in South Africa. We also did some research into what exactly thickened formula is and what the different alternatives available are.


What is Nestargel?

Nestargel is a thickener that comes in a powder form and is added to baby’s formula (or breast-milk) to help thicken the feed to reduce reflux and regurgitation, which is a very common problem that both breast-milk and formula fed babies suffer from.


Why has it been discontinued?

This is the official response received from Nestle’s consumer Care Adviser:
“Kindly be advised that the above product has been discontinued. We were importing it, unfortunately, Nestlé South Africa will not be importing it anymore. We recommend that our consumers discuss further with a Healthcare Professional (HCP) for a suitable alternative from the thickeners available on the market.”


Oh No – What can I use now?

Using a thickener or thickened formula is only advised after consulting with your healthcare practitioner and then again the options of which brand and what are a total minefield. Not even to mention the medicinal options (anti-acids, proton-pump inhibitors, prokinetics) that your healthcare practitioner could also recommend, which should only be used for short-term treatment by the way!

List of what else you can use

So if you have been advised to use a thickener or thickened formula here is a rundown of what is on the market:

AR Formulas: (AR =Anti Reflux)

  • S26 AR (lowest price of R99.00 for 400g)
  • NAN AR ( lowest price of R189.00 for 800g)
  • Novalac AR (lowest price of R171.00 for 800g)
  • Novalac AR Digest (for severe reflux) ( lowest price of R249.00 for 800g)

For more info on the above products take a look at our post: http://babyyumyum.co.za/all-your-need-to-know-about-regurgitation-and-reflux/

From this list, the majority of the products are only thickened with one thickener and is only sufficient to address mild-moderate reflux. However, if you have been advised to use a medicinal product and you feel sceptical of giving something so potent to your little baby, then Novalac AR Digest Formula is the way to go since this is the only formula indicated for severe reflux. According to a study I read on this product (Vandenplas et al., 2008 – reference can be provided on request) the combination of a partially hydrolysed whey based protein portfolio along with a combination of thickeners (locust bean gum and specially processed tapioca starch), allowed to effectively alleviate the symptoms whereas other thickened and extensively hydrolysed formulas, as well as prokinetics and acid-blocking medicinal options, were unsuccessful.


Some tips and tricks for using thickened formulas:

Get a bigger teat size or look for variable flow teats. Try to picture custard through a needle eye, when you think of thickened formulas. Having said that, there are anti-reflux formulas on the market that do not thicken in the bottle, but in the stomach, such as Novalac AR – which makes life so much easier for mommy and baby!
Make sure that the water you mix the formula with is clean and warm as opposed to cold, sterile water as this causes it to “clump”.
Constipation is common with thickened formulas. If this is the case and your baby’s poo is thicker than Nutella then look at some anti constipation information on our site: http://babyyumyum.co.za/from-constipation-to-diarrhoea-what-to-do/

Have you tried any AR Formulas? Let us know your experiences or any tips and tricks you have.