Your baby is spitting up? Join the club! Most babies spit up. In fact, mild reflux occurs in at least 50 percent of infants and usually doesn’t cause them any discomfort, stress or complications. Reflux improves with age. Many babies get better once they learn to sit well.
What defines “normal” spit up?
Involuntary spit up (reflux) consists of approximately one or two mouthfuls of stomach contents. “Wet burps” happen when a smaller amount of spit up accompanies the burp. Larger spit ups may occur if the baby is overfed.
When is spit up most common?
It begins in the first few weeks after birth and may continue up to about 1 year old. It usually occurs during or shortly after feedings.
What can I do to decrease my baby’s spit up?
Feeding:
- Give your baby smaller amounts per feeding (provided baby is over 1 month old). Filling baby’s stomach to capacity makes spitting up worse. It takes two or more hours for the stomach to empty.
- Breastfeeding moms can try nursing on one side per feeding and pumping the other side. Extend the times between feedings to at least two hours.
- Bottle-feeding moms can give baby one ounce less per feeding and keep the total time to less than 20 minutes. Wait at least 2 1/2 hours between feedings
Burping:
- Burp baby two or three times during each feeding. Try not to interrupt the baby’s rhythm but wait until he or she looks around or pauses during feeding and then burp baby. If no burp occurs within one minute, stop. Some babies don’t need to burp often.
Positioning:
- After feeding, hold your baby in an upright or vertical position for 15 to 30 minutes. If you can’t hold baby upright that long, use a front-pack, infant seat, swing or jump seat, depending on your baby’s age and ability.
- Reduce sucking time. Using a pacifier constantly can fill the stomach with swallowed air. Likewise, a bottle with a nipple hole that is too small can do the same. When held upside down, formula in the bottle should drip out at a rate of one drop per second. If it doesn’t, clean out the nipple and/or enlarge the hole.
Diapering:
- Avoid making diapers too tight because this adds pressure on the stomach.
Playing:
- Avoid playing vigorously with your baby immediately after meals.
When is spit up of concern?
Serious complications related to spit up occur in less than 1% of infants. Talk to your doctor if your baby seems to be choking when spitting up milk. If your baby cries frequently and is often unhappy and/or seems to be in constant discomfort, talk to your doctor. This can be evidence of heartburn from acid on the lower esophagus. If your baby isn’t gaining weight, it’s also possible that the valve on the stomach’s upper end isn’t closing properly
What is the difference between spit up and vomit?
If your baby appears to have no discomfort, no diarrhea and is generally happy, hungry and looks good, he or she just has reflux. If your baby’s spit up is forceful or projectile and your baby is uncomfortable when it happens, vomiting is the likely answer. If your baby looks or acts sick, he or she is vomiting.
Call your doctor if:
- Your child is under 1 month old, looks or acts abnormal in any way and/or vomits.
- Your baby looks or acts very sick.
- You see blood in the spit up.
- There is bile (bright yellow or green) in the spit up.
- Your baby isn’t gaining weight, has frequent unexplained fussiness or is spitting up more and more.
- You can’t tell if your child is spitting up or vomiting.
- You are worried and think your child needs to be evaluated.
- Your baby isn’t improving or becomes worse even when you have implemented changes to decrease the spitting up.
Sanford Health offers support for every mom, whether you’re breastfeeding, pumping or formula feeding. Learn more about lactation services.
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Posted In Children's, Health Information
