Though it can be concerning for a parent, almost all babies spit up. As long as the baby is otherwise healthy and gaining weight normally, spitting up -- known medically as reflux -- is not a problem, except for those extra loads of laundry. Uncommonly, reflux in babies may indicate a condition called gastroesophageal reflux disease, or GERD. This condition can be uncomfortable and possibly dangerous for your little one. Whether you are breast- or bottle-feeding, simple home interventions can help reduce the frequency of reflux and its messy symptoms in most cases. Discuss your concerns with your pediatrician before trying any home remedies.
Don’t Overfeed and Burp the Baby
If your baby's spitting up frequently, one possibility is overfeeding. Overfeeding stretches the stomach, which can cause the muscular band between the esophagus and stomach to open and allow reflux. American Academy of Pediatrics guidelines recommend feeding your baby smaller, more frequent meals to minimize stomach pressure and reduce spitting up. Ask your pediatrician for personalized guidance in modifying feedings.
The time-honored act of burping can also be of benefit. Burping your baby periodically throughout feeding allows the release of swallowed air, reducing pressure in the stomach. If you're bottle-feeding, burping after 1 to 2 oz. is generally sufficient. If you're nursing your baby, you can try burping when switching between breasts.
Keep the Baby Upright
Keeping your baby in an upright position after feeding helps limit stomach pressure until the food passes into the intestines, thereby reducing bouts of spitting up. The American Academy of Pediatrics recommends keeping your baby upright for at least 30 minutes after feeding. Holding the baby against your chest with the baby's head on your shoulder while you're sitting or standing will keep him in an upright but relaxed position. Laying your baby down right after eating is not recommended as this position can lead to the food flowing right back up and out of the stomach. Putting your baby in an infant carrier, car or baby seat after eating can also increase stomach pressure and trigger reflux.
Thickening Fluid Feedings
Adding a thickening agent to your baby's fluid feedings is a common recommendation for treating reflux. Rice cereal can be mixed into infant formula or breast milk. Though a common recommendation, it's not totally clear if this approach actually helps reduce reflux, and it may not be appropriate for some babies. Also, be aware that it might not be healthy to add calories to your baby's diet by using cereal or another thickening agent in his fluid feedings. Due to concerns surrounding use of thickening agents, do not try the remedy unless recommended by your pediatrician.
Warnings and Precautions
While most reflux issues are just a normal part of being a baby, some babies who spit up may have GERD or another potentially serious medical condition. Signs and symptoms to look out for that may indicate something more serious than normal spitting up include:
-- Failure to gain weight as expected.
-- Frequent refusal or lack of interest in feeding.
-- Forceful vomiting or onset of vomiting after 6 months of age.
-- Abdominal tenderness or bloating.
-- Wheezing, coughing or noisy breathing.
If any of these symptoms occur, call your doctor right away. Seek emergency medical care if your baby has difficulty breathing or vomits blood or foul-smelling material. Talk with your doctor about whether home remedies are the right choice or if you should consider other treatments if your baby is experiencing mild symptoms of reflux.
Medical advisor: Jonathan E. Aviv, M.D., FACS