1. Why babies spit up.
Babies spit up because they are just being babies. They gulp milk and air, and the air settles beneath the milk in the
stomach. When baby's stomach contracts, like an air gun, the stomach shoots some
milk back up the esophagus, and you have sour, curdled milk on your shoulder.
Some ravenous eaters gulp too much milk
too fast, and the overloaded
tummy sends some back. Jostling babies after eating may also trigger
regurgitation. Spitting up can sometimes become more than a laundry problem and
reflects a medical problem, such as a formula allergy , pyloric stenosis, or
SPIT UP TIP
Try what we call the fist test: Tiny babies have tiny tummies, about the size of
their fists. Place a full bottle next to baby's fist, notice the size mismatch,
and you'll see why the overloaded tummy rebels.
2. When not to worry
The spots of dried milk on your clothing are
telltale signs that you are the parent of a spitter. Most babies regurgitate, or
spit up, their milk or formula several times a day during the early months. This
is more of a laundry problem than a medical problem and seldom bothers baby.
Dress for the occasion. If you are blessed with a baby who shares a bit of each
meal with your clothing, wear prints and avoid dark-colored clothing. Keep a
cloth diaper handy as a burp cloth. Don't worry if:
- Baby is gaining weight optimally
- Baby is not in colicky abdominal pain
- The spit-up doesn't always shoot out (projectile) a couple feet
- The spitting up is getting less frequent and less volume
- Baby is thriving and acting well
3. Not much lost
When baby spits up, you may feel she has lost all
the milk your body worked so hard to produce, or wasted the expensive formula
you bought. But you are likely to vastly overestimate the volume of regurgitated
milk. Pour a tablespoon of milk or formula on the countertop and watch the huge
puddle it makes. Now, does that amount match the spot on your dress? Most spit-
up measures only a teaspoonful.
4. When to worry
Spitting up becomes a problem and needs medical
attention if any of the following occur:
- Baby is losing weight or not gaining weight sufficiently.
- The vomiting increases in frequency and volume and becomes projectile
(the spit-up flies across your lap and onto the floor).
- The vomitus is consistently green (bile stained).
- Painful colicky behaviors accompany the vomiting
- Baby gags and coughs during every feeding.
BLOOD IN SPIT-UP
Don't panic at baby's first bleed. If you breastfeed, most often this is your
blood, not baby's. It usually comes from cracked nipples during breastfeeding
and subsides when your nipples heal. Occasionally, baby may retch or spit up
forcefully and tear a tiny blood vessel at the end of the esophagus. This also
heals quickly. If neither of these causes seems likely and the bleeding
continues, notify your doctor.
5. Five Ways to settle the spitter
- Slow the feedings. Respect that tiny babies have tiny tummies. If
formula feeding, give your baby smaller-volume, more frequent feedings.
- Burp baby during and after the feedings. Formula-fed
spitters should be burped every three ounces (ninety milliliters) of milk, and
breastfed spitters should be burped when switching sides or during a pause in
baby's sucking if baby lingers on one side.
- Feed upright and keep baby upright twenty to thirty minutes after a
feeding. If you do not have time simply to sit and hold your baby upright, wear
your baby in the upright position in a baby sling as you go about your work.
Gravity is the spitter's best friend.
- Avoid jostling or bouncing baby for at least a half hour after a
- If bottlefeeding, be sure the nipple hole is
neither too large nor too small.
When to expect the last spat. Most spitting up subsides around six
to seven months when baby sits upright and gravity holds down the milk.