Spit-up is a common problem for many newborn babies. The lower esophageal sphincter is responsible for keeping stomach contents in the stomach and not back-flowing, also known as refluxing, into the esophagus. This sphincter is immature at birth and takes time to begin working properly. Breast-feeding babies may spit up for many reasons, and spitting up with every feeding doesn't necessarily signify a problem. Speak with your pediatrician or health-care provider if you are concerned about your baby spitting up for diagnosis and treatment recommendations.
Prevalence and Severity
According to Kelly Bonyata, who oversees the breast-feeding and parenting website Kellymom.com, approximately one-half of all babies from birth to 3 months old spit up daily. Spitting up after feedings typically peaks around 4 months of age and usually resolves itself by the baby's first birthday. Breast-fed babies may spit up with varying severity, from minimal spit-up after feedings to much larger amounts that seem to be equal to an entire feeding. Minimal spit-up isn't a health risk if the baby is gaining weight and has six to eight wet diapers and three dirty diapers per day.
One of the most common reasons that breast-fed babies spit up after feedings is due to an oversupply or forceful let-down. Let-down is a reflex that occurs so that the milk can be easily withdrawn from the breast. In some women, this occurs too hard and too fast, releasing milk much faster than a baby can nurse and keep up. Other causes of frequent spitting up are food sensitivities, gastroesophageal reflux disease, or GERD.
Treating a baby who spits up frequently isn't necessary unless the baby experiences weight loss or other health problems. However, if spit-up results from over-supply or forceful let-down, pumping for a few minutes prior to breast-feeding can help decrease the amount of milk or force of the milk during the nursing session. Handle your baby gently to minimize jostling and keep your baby upright for 30 minutes after each feeding. If a food sensitivity is causing your baby to spit up, work with your doctor or midwife to help identify the culprit. Cow's milk frequently causes problems for newborns that have difficulty digesting the casein protein in the milk.
When to Seek Help
If your baby spits up large amounts of milk after every feeding, appears to be losing weight, or doesn't seem satisfied because so much milk is spit up, contact your child's pediatrician. Some babies do have GERD and require medication to help reduce reflux in order for the baby to thrive. If you have any questions related to your baby's care and overall health, do not hesitate to contact your doctor immediately.