By Sr Teresa Hayward (RN, RM, Lactation consultant, Infant & Paediatric Nutritionist, Baby Sleep Consultant)
For many babies, spitting up or bringing up milk is totally normal.
You will often find that you have just fed your baby, whether its breast or formula, only for them to bring up what seems like the whole feed again.
What causes spitting up?
Spitting up or bringing up milk is common in healthy babies. In the first 3months, nearly half of all babies experience their milk coming back up into the oesophagus, and this is known as reflux.
There is a muscle between the oesophagus and stomach that keeps the stomach contents where they belong. This muscle usually only matures around 3months of age and until then spitting up and reflux may be an issue, especially if the tummy is overfull
What is the difference between spitting up and vomiting?
Spitting up is the easy flow of milk through the baby’s mouth, possibly with a burp, but not always. Vomiting occurs when the flow is forceful and shoots out rather than dribbling out.
It seems like my baby is spitting up a lot. Can spitting up affect my baby's growth?
Normal spitting up doesn’t affect the weight of baby. In fact most are gaining more than the normal, due to spitting up being an excess of milk. As long as baby is happy, eating and gaining weight, we are not concerned. We will often call these babies “happy spitters”. However if baby is not happy, then we should assess feeding.
Always keep in mind that it is very easy to overestimate the amount you baby is spitting up based on the size of stain.
Will my baby outgrow spitting up?
Most babies stop spitting up by age 12 months.
What can you do to reduce spitting up?
Consider these tips:
Keep your baby upright. Feed your baby in a more upright position. Follow each feeding with 10 minutes in an upright position. Avoid immediate active play or use of an infant swing.
Avoid overfeeding. Ensure you are feeding your baby the correct amount for their weight if you are formula feeding and only feeding 4hrly.
Take time to burp your baby. Frequent burping after each feeding can keep air from building up in your baby's stomach. But at the same time, be careful to not burp longer than 2min as you will be pushing the contents back up the oesophagus
Put baby to sleep on his or her back. To reduce the risk of sudden infant death syndrome (SIDS), it's important to place your baby to sleep on his or her back. Placing a baby to sleep on his or her tummy to prevent spitting up isn't recommended.
What does the spit up look like. If it is mainly curdled milk, then this is usually a sign that baby was fed when they weren't actually hungry, and there was still milk in tummy from previous feed. If it fresh spit up, it means that baby is overfeeding. It is very watery, then your baby is probably drooling too, and baby is swallowing saliva.
Can spitting up be a sign of a problem?
Certain signs and symptoms might indicate an underlying condition or something more serious than run-of-the-mill spitting up. Contact your baby's doctor if your baby:
Isn't gaining weight
Spits up forcefully
Spits up green or yellow fluid
Spits up blood or a material that looks like coffee grounds
Refuses feedings repeatedly
Has blood in his or her stool
Has difficulty breathing or other signs of illness
Begins spitting up at age 6 months or older
Cries for more than three hours a day and is more irritable than normal
Has fewer wet diapers than usual
Treatment depends on what's causing the problem. Special feeding techniques might be helpful. In other cases, the doctor might prescribe medication to treat reflux.
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