Our Frisco pediatric office receives a lot of calls from Dallas-area parents about their new baby’s spit-up. What is normal? What is not? Let’s talk about some spitting-up facts.

The first thing new parents should know is that spitting up is normal and quite common. Roughly half of all babies occasionally experience gastroesophageal reflux, also known as infant reflux or infant acid reflux. After your baby swallows breast milk or formula, it passes down their esophagus to their stomach. The lower esophageal sphincter, a ring of muscles between the esophagus and the stomach, is designed to prevent the stomach’s contents from coming back up. However, the lower esophageal sphincter may not be mature enough to function as it should. Newborns have tiny stomachs that fill up easily, and when this ring of muscles does not tighten up after the milk has passed into the stomach, the milk can come back up.

The size of a spit-up stain can be misleading and cause you to overestimate the amount of milk that your baby has actually lost. While it may seem like a lot, spit up is usually only a small amount of the liquid your baby has ingested. By the age of four to five months, your baby’s body may have matured enough to handle ingestion better and as a result, they may stop spitting up. Most babies have stopped entirely by the age of 12 months.

Is my baby spitting up or vomiting?

Spit-up is a quick and easy flow of liquids up and out of the mouth during or after a feeding. It is occasionally accompanied by a burp! Vomiting, on the other hand, is a forceful flow of liquid. The contents of your baby’s stomach will come up fast and shoot out of their mouth rather than coming up smoothly and dribbling out.

In healthy babies, spitting up – even on a regular basis – does not lead to weight loss or a failure to thrive. Does your baby seem comfortable? If so, and if they are eating well and gaining weight, then the loss of calories from spitting up is not affecting him or her adversely.

When should I worry about my baby’s spitting up?

Most of the time, spitting up is no cause for concern. However, there are a few symptoms that can indicate a problem or underlying condition that should be addressed quickly. Contact our office at Entirely Kids Pediatrics immediately if your baby:

• Has poor appetite or refuses feedings repeatedly
• Has green or yellow spit-up
• Is more irritable than usual and crying for long periods of time
• Has fewer wet diapers than usual
• Begins spitting up at age 6 months or older
• Spits up blood or material that looks like coffee grounds
• Has blood in his or her stool
• Is vomiting
• Seems to have difficulty breathing or other signs of illness

GERD

A condition called gastroesophageal reflux disease (GERD) can develop in some babies. The following are some indications that your baby is experiencing GERD, not normal spitting up:

• Your baby will seem irritable and uncomfortable throughout the day (as a result of apparent heartburn or painful reflux)
• Your baby may choke on the spit-up as it comes out
• Your baby may experience poor weight gain and fail to thrive

Call our office for an appointment as soon as possible if you see any of the signs of GERD.

Pyloric Stenosis

Intense muscle contractions after feedings during the first few months of a baby’s life can be caused by pyloric stenosis. This typically results in projectile vomiting and your baby would experience renewed hunger immediately following vomiting. This condition can sometimes be controlled with medication or be corrected with a surgical procedure.

Feeding Tips That Can Reduce Spitting Up

• Feed your baby in an upright position
• Follow each feeding with 30 minutes in an upright position
• Avoid the use of an infant swing immediately following a feeding
• Avoid overfeeding your baby
• If you’re breastfeeding, eliminating certain items from your diet could help. Ask us for recommendations.
• Try feeding your baby smaller amounts more frequently
• Make sure to burp your baby during and after each feeding, as this can prevent air from building up in the stomach
• Put baby to sleep on his or her back. Putting a baby to sleep on their stomach to prevent spitting up is not recommended. Sleeping on the back helps to reduce the risk of sudden infant death syndrome (SIDS)

Other issues that can cause spitting up issues are aerophagia and overstimulation. Aerophagia is the consumption of air in greater quantities than normal. Bouncing, extended tummy time, or vigorous play can cause your baby to be overstimulated and result in spitting up.

Our office is happy to see your baby and discuss any concerns you may have about spitting up or feeding issues. We're conveniently located off of Warren Parkway in Frisco. Please contact us for an appointment today!