I cannot tell you how often I hear this question. Almost all babies spit up at one time or another and parents worry how much is too much and whether or not we need to do something about it.
So, here’s the lowdown on babies and spit up.
The first thing to know is we pediatricians refer to baby spit up as reflux. When parents first hear that term (reflux) they automatically think acid reflux and are confused because isn’t that an adult condition?
Let’s talk about reflux in babies
Reflux in babies is physiologic and presents as spit up. It is extremely common in newborns, particularly in premature infants. About half of all newborns up to the age of 4 months will have reflux and the numbers are higher in premature babies. This is simply a “mechanical” issue in babies where the lower muscle of the esophagus is “relaxed” and allows a backflow of breastmilk and/or formula. Most babies will grow and thrive throughout it all and will outgrow this “spitting up” phase by the time they reach 1 year (it’s much sooner for most babies).
We refer to babies who grow, thrive, and are otherwise unruffled by this spitting up as “happy spitters”.
Taking some “reflux precautions” such as keeping baby upright for 20-30 minutes after feeding, offering baby smaller and more frequent feeds, and burping often will ease this reflux. Ultimately, time is the best treatment for these happy spitters as the muscles of the lower esophagus strengthen and mature.
When it’s more than just spit up
Some babies will have more severe reflux. They may cry and grimace with the spit up and/or they may not be gaining weight. In these babies, an evaluation of the degree of reflux and/or a trial of anti-reflux medication may be in order. If your baby is formula feeding, her pediatrician may even recommend thickened formula to reduce the amount of spit-up.
Another red flag is if your baby’s spit-up is projectile or forceful. If this forceful spit-up (vomiting) occurs frequently after feeding, your baby’s pediatrician will want to rule out a condition known as pyloric stenosis.
Although rare, pyloric stenosis will not go away on its own. If your baby’s pediatrician suspects this, an abdominal ultrasound will be ordered. If present, surgery is needed to correct this thickened muscle at the junction of the stomach and small intestine.
A word on colic and reflux
Oftentimes an infant who presents with symptoms of colic may also have significant reflux exacerbating those crying jags. Be sure to mention any spit-up to your child’s doctor if you’re in the throes of colic. Treating and relieving moderate to severe reflux may improve the symptoms of colic greatly.
Bottom line: Most babies will have some degree of reflux. The good news is, most of them are happy and thrive throughout it all. For these babies, time is the best treatment.
Did or does your baby spit up frequently? What questions do you have about babies and reflux?Pin It