Spit Up versus Acid Reflux
Baby spit up and acid reflux (gastroesophageal reflux) are actually the same thing.
A baby spits up when the muscle at the entrance of the stomach (lower esophageal sphincter) is not strong enough to keep stomach contents in the stomach and allows them back into the esophagus. (5)
These muscles become stronger and the baby can usually control this muscle better around 4 to 5 months of age. (6)
Both breastfed and formula-fed babies can experience reflux. Breastfed babies can experience reflux if:
• They get too much foremilk
• They have food allergies or sensivities to something the mother ate or drank (e.g., caffeine, tomatoes, citrus, spicy or high-fat foods)
• They are experiencing a growth spurt
• They swallow too much air
However, breastfed babies experience less severe and less painful acid reflux.
As long as he/she is not bothered or in discomfort, is laughing and growing and gaining weight, then it should not be a concern. (6)
If, however, your baby experiences any of the following, you should see your family doctor immediately:
• Refusing to feed
• Not gaining weight
• Coughing
• Irritability
• Blood in the stool
• Breathing problems in association with the spitting up (1)
These are all signs of gastroesophageal reflux disease (GERD) which is something more serious.
How to Prevent Acid Reflux in Babies
For most babies, simple lifestyle changes may be all that are needed to manage both reflux and reflux disease:
If formula feeding:
• Decrease the amount you feed your baby at a time. (3) Smaller amounts might be easier to digest and prevent the stomach from becoming distended. (4, 6)
• Burp your baby more frequently throughout each feeding. (3)
• Baby massage relieves tummy cramps and helps food move into the intestines. (5)
• Trying changing to a formula with different proteins to rule out a protein sensitivity. (3)
• Keep diapers and pant waistbands loose so they don’t press down on baby’s tummy after eating. (3, 4)
• Avoid activity with baby immediately after feeding. (4)
• Avoid exposure to tobacco smoke. (3)
If breastfeeding (5):
• Ensure your baby is latching on well. Good latching prevents swallowing of air bubbles.
• Sucking for comfort speeds up baby’s digestion, therefore, reducing the chances of reflux.
• Reduce caffeine intake.
• Make sure baby finishes one breast before offering the other. This will ensure that baby gets the essential hind milk.
Visit the Children’s Digestive Health and Nutrition Foundation for more information about digestive issues in infants and children. They have helpful podcasts and instructional videos.
Sources:
1) The Difference Between Reflux and GERD in Kids. Children’s Digestive Health and Nutrition Foundation. Web. Dec 4, 2012.
https://www.cdhnf.org/wmspage.cfm?parm1=42
2) Pediatric GERD in Infants. Children’s Digestive Health and Nutrition Foundation. Web. Dec 4, 2012.
https://www.cdhnf.org/wmspage.cfm?parm1=43
3) Parent’s Checklist for Reflux in infants 0-12 months old. Children’s Digestive Health and Nutrition foundation. Web. Dec 4, 2012.
https://www.cdhnf.org/user-assets/documents/pdf/GERD_Checklist.pdf
4) Baby Spitting Up. Breastfeeding-problems.com. Web. Dec 4, 2012.
http://www.breastfeeding-problems.com/baby-spitting-up.html
5) Acid Reflux in Babies. Breastfeeding-problems.com. Web. Dec 4, 2012.
http://www.breastfeeding-problems.com/acid-reflux-in-babies.html
6) Your Guide to Bottle Feeding: Spitting UP and Vomiting in Babies. WebMD. Web. Dec 4, 2012.
http://www.webmd.com/parenting/baby/bottle-feeding-9/spitting-up
Reviewed December 4, 2012
by Michele Blacksberg RN
Edited by Jody Smith