Multiple measures that should be used to minimize reflux include small feedings (1-3 oz) every 2 to 3 hours, use of breast milk or predigested formulas that are thickened with rice cereal (1-3 tsp/oz), frequent burping, and medications. Bottle nipples are cross-cut to enlarge the opening for thickened formula. The infant with frequent reflux and vomiting must be thoroughly assessed for signs of fluid volume deficit (dehydration), including sunken fontanel, no tears when crying, dry mucous membranes (mouth), poor skin turgor. Low urine output (fewer wet diapers).