Reflux

A baby spitting up occasionally is usually looked at as “something babies do.” According to the late Dr. Gregory White, husband of the late LLLI Founder, Mary White, “In a healthy baby, spitting up is a laundry problem, not a medical problem.”

A baby may spit up for lots of reasons:

  • Baby is not be able to swallow quickly enough when milk ejects forcefully during a feeding, resulting in swallowing excess air.
  • Mother has an oversupply of milk that can result in baby taking too much too fast for the stomach to handle. Either can result in additional air swallowed with the large volumes of milk. Read our post on oversupply.
  • Less common reasons are:
    • Immature muscle control
    • Allergy to foods and/or dietary supplements mother may consume
    • Disease

If the spitting up is frequent and obviously uncomfortable for baby, it may be that your baby is experiencing gastroesophogeal reflux disease, or GERD.

  • GERD occurs when the band of voluntary muscle fibers within the esophagus where it enters the stomach fails to keep the stomach contents in the stomach.
  • Milk or food, along with acid from the stomach, backs up into the lower esophagus and irritates the tissues there.
  • Adults recognize this feeling as heartburn. Read our post on GERD.

If your baby is overall a pleasant and healthy baby with good output and normal growth patterns, be assured that he will likely outgrow this stage by 6-12  months.  In the meantime, here are some general tips to keeping spit up episodes to a minimum:

  • Use positions for feeding that keep baby’s head higher than her tummy, such as a laid-back position or having baby diagonally across your chest in a cradle hold. Avoid positions that have baby bending at the waist, putting more pressure on her tummy.  See Positioning.
  • Keep baby upright for 15-20 minutes or so after feedings to allow for digestion to begin. This is a nice time to just lean back with baby on your chest to soothe, talk, sing, or hum to him or to just snuggle.
  • Burp gently between sides and at the end of the feeding.
  • Try shorter, frequent feedings, if baby is agreeable, to reduce the load in her tummy.
  • Try nursing at one breast only each feeding to avoid two strong milk ejections and, therefore, reducing overfeeding and excess swallowing of air.

Occasionally, some older babies will start to spit up when they hadn’t typically been spitting up. If your baby doesn’t seem ill, other reasons might include:

  • Something new to his diet – solids, adding or changing vitamins for you or baby, medications for either of you.
  • Growth spurt – when babies start feeding more frequently with a growth spurt, they can be bringing in larger volumes of milk and/or more air.
  • Teething – the discomfort of the gums may cause baby to be less efficient with her sucking and take in more air. Teething can also result in increased saliva production and swallowing, adding to the volume of fluid and air in her tummy. See Teething.