Is your baby spitting up a lot after feedings? There's usually no need to stress. "70% of infants under 3 months will spit up three times a day, and it's even perfectly normal for them to be spitting up as often as 10 or 12 times," says William Byrne, M.D., chief of pediatric gastroenterology at Doernbecher Children's Hospital, in Portland, Oregon.
Keep reading to learn what causes babies to spit up and how to handle it.
Why Do Babies Spit Up?
If your baby keeps spitting up within two hours of feeding and yet seems perfectly happy, they probably have gastroesophageal reflux (GER). By age 2 months, 70% to 85% of infants have have daily regurgitation, according to the National Institutes of Health. The condition peaks around 4 months old, when two-thirds of infants have symptoms. The ring of muscle separating the bottom of a baby's esophagus from the stomach is still developing, allowing stomach contents to slosh back up.
Babies need to consume a lot of calories to support their rapid growth—three to four times as many as an adult per pound of body weight. Plus, they have a tendency to swallow air while sucking. As a result, their stomach becomes very full, and their immature sphincter muscle, which separates the stomach from the esophagus, makes them prone to spitting up some of that milk back up (they can also spit up after crying or coughing forcefully).
Causes, Symptoms, and Remedies for Acid Reflux in Babies
Is My Baby Eating Enough?
Even if your baby spits up after every feeding, they're probably still taking in enough. Your pediatrician will evaluate your infant's weight gain at their well-baby checkups. If everything's on track, they're getting the calories they need despite the spit-ups.
It may seem like their whole meal is coming back up, but it's likely less than a tablespoon, says Dr. Byrne. So don't "top off" your baby with more milk if they spit up after eating. In fact, overfeeding can lead to even more reflux.
When Do Babies Stop Spitting Up?
Don't worry, the day will come when you won't need to do laundry after every feeding. GER symptoms tend to decrease around 6 months, once your baby's digestive system has matured and they start sitting upright and eating solid foods.
The problem usually goes away entirely by your baby's first birthday, when the muscles at the bottom of the esophagus become stronger. (There are, however, some babies who continue spitting up until around their second birthday.) Don't be surprised if GER gets worse before it gets better; some children's symptoms reappear when they learn to crawl and their stomach contents shift around, causing them to spit up more than usual.
Tips for Dealing With Your Baby's Spit-Up
Even though you can't really prevent GER, you can minimize the mess by investing in extra bibs and following these tips.
Avoid overfeeding
An overly full belly is a major cause of reflux, so avoid overfeeding your baby, says Aeri Moon, M.D., a pediatric gastroenterologist in New York City. Follow your baby's lead and look for cues that they're full—even if that means they don't finish their bottle or nurse for equal amounts of time on each breast.
Burp your baby
Swallowing too much air while eating leads to gas bubbles in the stomach that can trap some food. When the air comes back up as a burp, so does the remaining breast milk or formula. Ensuring that your baby is latched on correctly and burping them before, during, and after each feeding can help reduce this problem.
Use anti-gas bottles
If your baby spits up after bottle feeding, consider using a bottle that is specifically designed to reduce gas. These bottles are sometimes referred to as anti-gas or anti-colic bottles and are designed with special vents and valves to help reduce the amount of air your baby takes in during feeding. You'll also want to ensure that the nipple size has an appropriate flow for your baby. If the flow is too fast, they can take in excess air.
Keep your baby upright after feedings
Gravity is on your side when it comes to reflux, and it can make a big difference in helping food stay down. Position your little spitter at roughly a 30-degree angle while feeding. Then keep your baby upright for at least 20 minutes afterward, either in your arms or in a carrier, so that the food can travel out of the stomach and into the small intestine.
Does My Baby Have GERD?
Gastroesophageal reflux (GER) isn't something to worry about—even the healthiest babies have it. But for about 2% of full-term babies and a higher percentage of preemies, reflux causes pain and medical problems. In these cases, a doctor may diagnose gastroesophageal reflux disease (GERD). Telltale signs include:
Lack of interest in eatingExtreme fussiness during feedingWheezingCoughingHoarsenessFailure to gain weight
GERD is reflux to the extreme: So much acid splashes back up from the stomach that it irritates the lining of your baby's esophagus. Your baby might try to relieve the discomfort by coughing, arching their back, or pulling their legs up to their tummy. If your baby has these symptoms, contact their pediatrician. The doctor may recommend smaller, more frequent meals, additional burping, or in some cases, medication.
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