Is your baby just spitting up or is it reflux?
This is a common question. How can you tell the difference between just “spitting up” and a sign of something more serious like reflux or reflux disease?
Let’s look at a few definitions and facts.
GER (Gastroesophageal Reflux) Statistics and Facts
Spitting up and reflux (gastroesophageal reflux) are actually the same thing. It is caused when the muscle at the entrance of the stomach is not strong enough to keep stomach contents in the stomach. When the stomach goes to let off air (burp), the muscles allow food and stomach acid back into the esophagus, which can come up through baby’s mouth. These muscles become stronger and usually the baby can control this muscle better once he or she learn to sit up. Some babies spit up more at a time than others.
- More than half of all babies spit up regularly during the first months of life.
- Reflux is usually worse between 1 and 4 months and usually stops by 12 to 18 months.
Breastfed babies can experience reflux as well as formula-fed babies. In breastfed babies reflux can be caused by ingestion of too much foremilk or food allergies to something the mother ate (e.g., tomatoes, citrus, spicy or high-fat foods). “Foremilk is the milk that is lying in the front of your breasts, this is the first milk that baby drinks with a breastfeeding session and this milk is watery compared to hind milk and is usually bluish in color. Foremilk is also abundant in carbohydrates, protein and vitamins.”(Breast-feeding-problems.com)
However, “acid reflux in babies that are breastfed is less severe and painful … Breastfeeding triggers a movement in the gastrointestinal tract that help move food into the intestines, also breast milk digests much easier than formula which reduces the chance of acid reflux occurring.” (Breastfeeding-problems.com)
Growth spurts or swallowing too much air can also be contributing factors whether breastfeeding or formula feeding, as well as genetics.
It is considered normal and okay if the baby doesn’t seem bothered or in discomfort by spitting up. If they are laughing and growing and gaining weight, then it should not be a concern.
However, if a baby refuses to feed, does not gain weight or experiences coughing, irritability, blood in the stool or breathing problems in association with the spitting up, then it’s time for a more serious look at GERD or gastroesophageal reflux disease.
Also watch out for fewer wet diapers or a sunken fontanelle (the soft spot in the middle of baby’s skull just behind the forehead under the hair line) which are signs of dehydration, bad breath, difficulty sleeping, spitting up of blood or green liquid. Call your pediatrician immediately.
Tips to Prevent GER and GERD in Babies
In many cases, acid reflux and reflux disease can be addressed through relatively simple lifestyle or eating habit changes. Some tips to prevent acid reflux in babies include:
- Decrease the amount you feed your baby at a time (may be done in conjunction with adding rice cereal, though it is important to avoid overfeeding which can aggravate symptoms). Smaller amounts might be easier to digest.
- Burp more frequently throughout each feeding (I found using a round motion more effective than the traditional whomping or patting on the back).
- Massage your baby. Massage is known to relieve uncomfortable tummy cramping and aid in the process of food moving into the intestines.
- Babies with reflux sleep better on their tummies and propped at a 30 degree angle. Acid reflux is more painful if laid on their back.
- If formula feeding, trying changing to a different formula that contains different proteins to see if a protein sensitivity is to blame.
- Avoid tight diapers and waistbands or pressing down on baby’s tummy after eating.
- Avoid activity with baby immediately after feeding.
- Avoid exposure to tobacco smoke.
If breastfeeding …
- Ensure your baby is latching on well to prevent him/her from swallowing air bubbles.
- “Allow baby to suck for comfort as this speeds up digestion and therefore [lessens] the chances of acid reflux. A pacifier can be used too … only if baby is drinking enough.” (Breastfeeing-problems.com)
- Reduce caffeine intak
- “Always let baby finish a breast before offering the other, even if you need to pump the other side. Doing this will ensure that baby drinks the essential hind milk in your breast too. Hindmilk is the milk further at the back of your breasts that is calorie loaded and much higher in fat percentage …” (Breastfeeding-problems.com)
For more information about digestive issues in infants and children, and to find out what you can do about them, visit the Children’s Digestive Health and Nutrition Foundation. They have podcasts and instructional videos to help.
Darlene Oakley is a freelance writer for EmpowHER.com.
Related Links:
The Difference Between Reflux and GERD in Kids. Children’s Digestive Health and Nutrition Foundation. Web. Apr 2, 2012.
https://www.cdhnf.org/wmspage.cfm?parm1=42
Pediatric GERD in Infants. Children’s Digestive Health and Nutrition Foundation. Web. Apr 2, 2012.
https://www.cdhnf.org/wmspage.cfm?parm1=43
Parent’s Checklist for Reflux in infants 0-12 months old. Children’s Digestive Health and Nutrition foundation. Web. Apr 2, 2012.
https://www.cdhnf.org/user-assets/documents/pdf/GERD_Checklist.pdf
Baby Spitting Up. Breastfeeding-problems.com. Web. Apr 2, 2012.
http://www.breastfeeding-problems.com/baby-spitting-up.html
Acid Reflux in Babies. Breastfeeding-problems.com. Web. Apr 2, 2012.
http://www.breastfeeding-problems.com/acid-reflux-in-babies.html
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