Most
babies spit up. It is just a fact of life. Of course some of them do it
more than others. I would still crown my daughter Alana the queen of
spitting up. I often didn't bother changing my shirt unless there were
15 splots of spit up all over it; it simply wasn't worth it. Sandy, the
clean freak in our family, would follow after her with a spray bottle of
Resolve carpet cleaner and a scrub brush, so that she didn't completely
stain the carpets with the constant regurgitation. (No, he isn't for
sale.) Lauren rarely spit up. Kids do things differently.
Lani was a happy spitter. It didn't bother her in the least and she grew in leaps and bounds.
With
large babies like Alana, sometimes the spit up is simply the overflow.
I know that it is very hard to estimate how much milk your baby is
actually spitting out. I have parents calling all the time reporting
that the baby seems to spit up the entire meal. If you aren't sure about
a steady weight gain, we are going to want to have the baby officially
weighed to make sure they are doing okay, but do relax; the spit ups are
not nearly as much volume as you think they are. When we weigh them,
most of the time they are still gaining weight beautifully.
When
babies spit up it is not unusual for it to also come out of the nose.
This can be scary. Having a Nose Frida or aspirator handy will help you
clear them if they seem to be having a moment of difficulty when this
happens. (I find the Nose Frida to be more effective for this.)
Once
in a while you might note some blood in the spit up. To no surprise
this tends to freak many parents out, but take a deep breath. Most of
the time this is simply a symptom of mom's sore nipples. There is a good
chance that if the nipples are cracked at all, the baby might get a
little blood when they are sucking. There is a way for a lab to check
the blood to see if it from the baby or the mom. If the baby is
swallowing some blood during nursing it is also possible that you may
see some show up in the poop. It will no longer look like fresh blood by
the time it makes its way through the system but would more likely look
very dark and tarry. If the baby seems perfectly fine, it is very
unlikely that they have any type of active bleeding going on.
While most spitting up is fairly benign, projectile vomiting
is something that warrants attention. There is a fairly uncommon
condition called pyloric stenosis that usually shows up between 2-6
weeks of age. For some reason it is more common in little boys. I am
fine with the occasional more forceful spit up, but with pyloric
stenosis think exorcist. The spit up literally flies out of your baby
and this happens multiple times a day. Of course you never want to have
anything wrong with your baby, but on the scale of things, this finding
is relatively benign with a simple surgical fix.
We rarely see this, but I have had two cases so far this year and things always happen in threes, just saying....
If
you have a baby who is a big spitter and is also fussy, it might be
some reflux. These babies tend to arch their backs a lot. They seem more
uncomfortable when they are lying flat. With reflux, the spitting up
seems uncomfortable. If you suspect reflux , consider the following:
*Smaller more frequent feedings
*Keep your baby upright as much as possible, but especially the first 20 minutes after the feeding
*There are some wedge pillows available that some parents find helpful.
*Breast feeding moms should see if there are any dietary factors that impact the spitting.
*Babies getting formula might consider using one of the sensitive formulas
*Some
babies are very burp dependent. You will notice that if you aren't
patient enough to get a good burp, part of that meal is going to come
back up. Other babies never seem to burp and have no issues.
*Probiotics may be useful
If
nothing is helping, the doctor may prescribe Zantac; make sure you
bring this up at your next well child exam. If the baby is really
miserable call for a sooner evaluation. More often than not, the copious
spitting slows down significantly by the time they are seven months or
so.
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