Most babies spit up now and then – in fact, half of all do at least once a day in the early months of life. Spitting is very likely when you have oversupply or overactive letdown, but can happen for any baby. While it may look like baby is spitting out most of a feeding, keep in mind it’s not just milk, but also mucous and saliva.
If your baby is growing well, having plenty of wet and dirty diapers every day and doesn’t seem especially uncomfortable, then this spitting is unlikely to be a health problem (though it may be laundry problem!). These ‘happy spitters’ don’t have any symptoms of allergy or reflux disease. But they typically do require more bibs, burp cloths, and clothing changes.
You may be able to minimize spitting by:
- Feeding your baby frequently (small feedings given often instead of large feedings spaced farther apart)
- Feeding your baby in a more upright position
- Burping your baby often
- Handling your baby gently after feedings
- Keeping your baby upright for 20 minutes after feedings
All spitting in babies is actually classified as reflux. But, Ii your baby has the following symptoms, he may have GERD or gastroeophageal reflux disease:
- Spits up large volumes after most feedings
- Is fussy, unhappy, restless and seems to be in pain between feedings
- Refuses the breast, arches his back often during or after feedings, or fusses and cries inconsolably at feeding times
- Isn’t gaining weight appropriately
- Has frequent hiccoughs, burping, gagging, or choking, or has bad breath.
- Has respiratory problems
GERD occurs in about one in 20 babies, and is sometimes mistaken for colic. Imagine yourself with heartburn – that’s likely what your baby’s feeling and just can’t tell you. If you suspect GERD, you should seek help from your baby’s healthcare provider.
Your baby’s doctor will help you come up with a treatment plan, but working with a lactation consultant is helpful during this time, too. The doctor may recommend medications (prescription acid reducers) or sleep positions that will improve your baby’s comfort level. The doctor can also rule out a more serious related condition called pyloric stenosis. Your lactation consultant can assess whether oversupply or a forceful letdown are contributing to your baby’s discomfort, and will help you come up with a feeding plan that should make your baby feel better.
As your baby’s immature digestive system grows, spitting should slow down. Reflux peaks around two to four months of age, and typically disappears after one year. In the meantime, expect to do lots of comforting (and lots of laundry!).