All babies spit up. Due to an immature digestive system, liquids often rise back up, especially during burping. Spitting up is generally not something to raise concern, but in some cases, it may signify something more.
Spitting Up and Vomiting
There is a difference between spitting up and vomiting, although many parents aren’t aware of it. Spitting up doesn’t usually involve any heaving, and the liquid that comes up is usually a small amount that doesn’t yet show much sign of digestion. Because spitting up happens most commonly after a feeding, what comes it is generally the food that was just ingested and is thus still undigested.
Vomiting, on the other hand, generally involves a more violent reaction; you may see heaving, and the regurgitated food will often be in a larger amount. Vomited baby food usually shows more sign of digestion; curdling and a more sour smell than spit up. Because the more intense action causes the stomach to empty more thoroughly, you may see food well on its way in the digestion process.
Spitting up generally doesn’t upset a baby, but vomiting may because it can be more painful. Vomiting may be a cause for concern especially if accompanied by fever, diarrhea, and lethargy or if it continues for more than 24 hours. If your young baby is vomiting, watch for any signs of dehydration and contact your pediatrician if the vomiting persists.
More Than a Little Spit-up: Reflux
Reflux is a fairly common problem in babies, and in its mildest form will simply go away with time. It occurs when the immature opening between the stomach and the esophagus allows stomach acid to rise up, causing pain. It is especially common in preemies whose digestive systems are not yet ready to handle food. Most babies will outgrow reflux without requiring any treatment; however, more serious forms of reflux can require intervention.
Signs of reflux include arching of the back and crying, excessive spit up that may be projectile, appearing hungry and then refusing the breast or bottle, and sleep disruptions. In some babies these symptoms will become so severe that medication is required to treat the problem. Prescription antacids that are safe for use in babies are available – don’t try any over the counter antacid medications as they are not meant for children so young.
In addition to medication, there are some actions you can take to prevent and alleviate reflux issues in your child. After a feeding, keep the baby upright for at least 15 minutes, to allow gravity to help keep the recently ingested food down where it belongs. Make sure to burp the baby thoroughly after feedings. If reflux is affecting your baby’s sleep, try elevating the mattress using a crib wedge. Keeping your baby’s head elevated as much as possible will reduce symptoms of reflux. If your child seems to be miserable in a car seat, you might want to consider switching from an infant bucket seat to a convertible style seat that doesn’t cause the baby’s abdomen to be scrunched down.
Luckily, with or without treatment, most babies outgrow reflux by 6-12 months of age. If your baby’s reflux continues beyond a year old, your pediatrician may suggest further testing or treatment.
If you suspect your baby’s spitting up means something more, call your pediatrician. Not all spit-up is normal, so if you think there is a problem, follow your gut and get it checked out by a medical professional.