How Can I Prevent Baby from Spitting Up After Feedings?
My 4.5-month-old has been spitting up after feedings quite often for the past few weeks. In no way does she seem to have an upset tummy just constantly spits up. A little background on us—she is our firstborn and we practice attachment parenting. I have unfortunately not been able to exclusively breastfeed her due to a massive hemorrhage post-delivery. This has caused me to not have an adequate milk supply (at least according to my midwife and lactation consultant). I’m still pumping and giving her as much as I can produce. However, since we started to bottlefeed she doesn’t seem to be interested in the breast at all. We supplement with Holle organic goat milk formula and she’s been on that since she was 6 weeks old. She seems to really like it. We recently started adding 1 ml of infant DHA from Nordic Naturals to one of her feedings also about a couple weeks ago.
Tips to Reduce Volume and Frequency of Spitting Up
First, I want to congratulate you for doing the best you can to provide your baby with as much of your breastmilk as you’re able to produce. Also, your choice of formula and the DHA supplementation seems to be wise, if your baby’s pediatrician agrees. Try these suggestions to lessen your baby’s volume and frequency of spitting up.
- Identify the trigger. Keep a journal as to what may be triggering the spit-ups, such as the milk you’re feeding her, the volume of feeding, how fast she feeds, the position you’re holding her in, and whether it is accompanied by pain. Once you have identified the trigger, then you lessen that trigger.
- Feed according to “the rule of twos.” Feed your baby twice as often, half as much, and take twice as long to feed her. Feeding a smaller volume more frequently eases digestion and minimizes reflux. Gastroesophageal reflux (GER) is the most common reason for spitting up, yet it is usually accompanied by painful spit-ups and an acidic odor to her spit-ups.
- Keep her upright. Elevate your baby to a 30-35-degree angle during and for 20-30 minutes after a feeding. This allows gravity to help the milk go down instead of back up.
- Estimate the volume of the spit-ups. You may be surprised that she is spitting up less volume than you think.
- Choose the right milk. If she seems to spit-up less when feeding on your milk, then it could be you need a change of formula. One of the newest ways to supplement little spitters is to use donor breastmilk as an alternative to formula. If you have a friend who says, “Oh, I leak so much…” or “I produce too much milk,” or any clue like that, ask if she would mind pumping 4 to 8 ounces a day extra for you.
- Try nap-nursing. Yes, it must be frustrating that your baby will take your milk from a bottle but not your breast, but that is usually because babies don’t have to work as hard getting milk from a bottle as they do from sucking from your breast, which requires more vigorous suck and ideal latch-on. Bottle-feeders can become lazy suckers and still get the milk they need. As often as you are able, lie down with her and nap-nurse. Snuggle cheek-to-breast, express a few drops of your precious milk onto your nipple and let her lick a little to entice her to suck a lot. The whole atmosphere of nap-nursing and snuggling is likely to prompt her to resume sucking from you instead of the bottle.
- Try a supplementary nursing system (available from a lactation consultant). This allows you to put pumped milk or formula in the supplementary system, with thin tubing that is placed alongside your nipple, so baby sucks from your nipple yet gets milk from the tube.
There are babies who spit-up a lot for the first six months and then it usually stops between six and eight months when they begin spending much of their day in an upright position. If your baby is growing optimally, doesn’t seem to have pain during and after feedings, doesn’t seem constipated, and is otherwise generally well then within a couple months this spitting-up is likely to pass.
I wish you well!
Martha Sears, RN
Martha is the mother of Dr. Bill’s eight children, a registered nurse, a former childbirth educator, a La Leche League leader, and a lactation consultant. Martha is the co-author of 25 parenting books and is a popular lecturer and media guest drawing on her 18 years of breastfeeding experience with her eight children (including Stephen with Down Syndrome and Lauren, her adopted daughter). Martha speaks frequently at national parenting conferences and is noted for her advice on how to handle the most common problems facing today’s mothers with their changing lifestyles. Martha is able to connect with both full-time, stay-at-home mothers and working mothers because she herself has experienced both styles of parenting. Martha takes great pride in referring to herself as a “professional mother” and one of her favorite quips when someone voices their concern about her having eight children in an already populated world is: “The world needs my children.”