The usefulness of thickeners in reflux and antacids in baby food

The use of thickeners in baby food is widespread, both in commercial formula and in additives added by parents themselves, such as starch or locust bean gum. However, there is little scientific research into their effectiveness, safety and correct use. A new study led by Prof. Eline Tommelein, from the experimental pharmacology research group at the VUB, is changing that.

Many parents experience regurgitation and reflux in their babies as problematic, while to a certain extent this is a physiologically normal phenomenon. Manufacturers are responding strongly to this with thickened milk products. ‘The problem is that we don't really know how viscous milk needs to be to be clinically effective, and how different thickeners behave in different situations,’ says Prof. Tommelein.

"Our study shows, among other things, that thickeners vary greatly in terms of preparation and effectiveness. Certain thickeners (such as starch) even lose their effect in the acidic environment of the stomach, while others function better in an acidic environment. Some thickeners need to be prepared 12 to 24 hours in advance, while others can only be used immediately."

This means that healthcare providers such as doctors, pharmacists and dieticians must adapt their recommendations to the thickening agent used. A “one size fits all” recommendation is not possible. ​
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​Some agents also carry risks: “With sodium carboxymethylcellulose (‘Gelilact’), babies consume up to three times the recommended amount of salt. When starch is used, the calorie content of the food increases significantly, which can lead to rapid weight gain,” says Prof. Tommelein.
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​Breastfeeding is always the best option, but if this is not possible, the results emphasise the importance of expert advice. "Our message is that healthcare professionals need to have a thorough understanding of the composition and effects of these products. Parents need clear, accurate and product-specific guidance," says Prof. Tommelein.

Reference:

The research was conducted in collaboration with the Laboratory for Pharmaceutical Technology at Ghent University, led by Prof. Valérie Vanhoorne. The findings were published in:

Tommelein, E., Baert, K., Ombecq, M., Henry, S., & Vanhoorne, V. (2025). Anti-regurgitation infant formulas and antacid medication: match or mismatch? European Journal of Pediatrics, 184(6), 1-9. Article 336. https://doi.org/10.1007/s00431-025-06161-1

Baert K, Ombecq M, Van Winckel M, Henry S, Tommelein E, Vanhoorne V. The viscosity-enhancing effect of carob bean gum and sodium carboxymethylcellulose when added to infant formula. Food Sci Nutr. 2024 Jan 11;12(4):2661-2670. doi: 10.1002/fsn3.3947.

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Koen Stein

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