Baby spitting up: Is it reflux?
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Baby spitting up: Is it reflux?

Nearly all babies will spit up after some feedings, whether they are breastfed or bottle-fed. In a healthy baby who is gaining weight well and has good urine output (6-8 wet cloth diapers or 5-6 disposable) and at least 3 bowel movements in 24 hours, then spitting up is more of a laundry problem than a medical problem.

Babies spit up for lots of reasons, including gagging when the milk lets down quickly and forcefully, oversupply of milk, immature muscle control, allergy, and disease. Many times the reason for the spitting up can’t be determined. Most healthy babies will outgrow the spitting up stage within 4-6 months.

If your baby seems happy and is growing normally, try these tips for minimizing spitting up:

  • Handle him gently and burp him often.
  • Try to keep him in an upright position during and after feedings. Nurse frequently. Smaller, more frequent feedings are easier to digest.
  • Keep clean up supplies (a cloth diaper to throw over your shoulder is a necessity) and a change of clothes nearby.
  • If you have tons and tons of milk, and your baby chokes or gags when the milk lets down, then spits up afterward, try offering one breast per feeding. You may also try taking him off the breast when the milk first lets down and catching the forceful spray in a towel, then putting him back on the breast after the initial flow of milk has subsided. For more suggestions on handling an overabundant milk supply, see the article Oversupply: Too Much Milk.
  • If your baby wants to nurse constantly, and seems to spit up every time he eats, try offering a pacifier -that may keep him from overfilling his stomach and spitting up the excess. If he isn’t gaining weight well and getting him to nurse is a struggle, forget the pacifier. He needs to spend all his sucking time at the breast.
  • If you are giving him supplemental vitamins, iron, or fluoride, try discontinuing them. Most breastfed babies don’t need vitamin supplements. If you are taking herbal or vitamin supplements, try stopping and see if it makes a difference. If your baby is receiving supplemental formula or has just started eating a new food, stop offering it. If you are eating a lot of dairy products, or if you have a family history of allergies, try cutting back or eliminating allergenic foods like milk, eggs, or wheat. It takes up to two weeks to completely eliminate milk protein from your milk, so allow that much time before you decide if it has made a difference.

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