Newborns spitting up is a common experience for many parents. Understanding the reasons behind this frequent occurrence and recognizing signs that might warrant medical attention can provide reassurance and guidance. While it can be messy, spitting up is typically a benign part of a baby’s early development.
Common Reasons Newborns Spit Up
Newborns commonly spit up due to the immaturity of their digestive systems. A primary factor is the underdeveloped lower esophageal sphincter (LES), a muscle at the top of the stomach that acts like a valve. This muscle is not yet strong enough in infants to consistently keep food in the stomach, allowing milk to flow back up into the esophagus and out of the mouth.
Additionally, the small size of a newborn’s stomach contributes to frequent spitting up. A baby’s stomach is quite small, about the size of their fist, making it easy to overfill. Babies can also swallow air during feeding, which creates air bubbles in the stomach. As these air bubbles rise to be burped out, they can bring milk along with them, resulting in a “wet burp” or spit-up. The position of the baby during or after feeding can also influence spitting up; lying flat can increase pressure on the stomach and make reflux more likely.
When Spitting Up Might Indicate More
While spitting up is often normal, certain underlying conditions can contribute to more frequent or problematic episodes. Gastroesophageal Reflux Disease (GERD) is a more severe form of reflux where the stomach contents cause significant discomfort or health concerns for the infant. Unlike typical spitting up, GERD often involves symptoms beyond simple regurgitation.
Food allergies or sensitivities can also manifest as increased spitting up. For instance, an allergy to cow’s milk protein in formula or even transferred through breast milk from the mother’s diet can sometimes lead to digestive inflammation and increased spitting up. In extremely rare cases, structural issues within the digestive system, such as pyloric stenosis, can be the cause. Pyloric stenosis involves a thickening of the muscle between the stomach and the small intestine, which obstructs the passage of food and results in forceful vomiting.
Signs to Watch For
It is important for parents to recognize specific signs that suggest spitting up might be more than normal infant reflux and warrants medical evaluation. One significant indicator is forceful or projectile vomiting, where the stomach contents are expelled with considerable force. This differs markedly from the gentle flow characteristic of typical spitting up.
Another concerning sign is poor weight gain or weight loss, as persistent spitting up that prevents the baby from retaining enough nutrients can affect their growth. Signs of pain or discomfort during or after feeding, such as excessive crying or arching of the back, can also signal a problem. The presence of unusual colors or textures in the spit-up should also prompt concern, including green or yellow bile or streaks of blood. Breathing difficulties, such as choking, gagging, or wheezing related to spitting up, are also red flags. Finally, signs of dehydration, including fewer wet diapers, sunken eyes, dry mouth, or lethargy, indicate that the baby is not retaining enough fluids and requires immediate attention.
Ways to Help Reduce Spitting Up
Several practical adjustments to feeding routines and infant care can help minimize spitting up. Feeding smaller amounts more frequently can prevent the baby’s small stomach from becoming overfilled. During bottle feeding, ensuring the nipple flow is appropriate helps prevent gulping too much air. For both breast and bottle-fed infants, regular burping during and after feeds helps expel swallowed air. Gentle pats on the back while holding the baby upright can facilitate burping.
Keeping the baby in an upright position for at least 20 to 30 minutes after feeding allows gravity to assist in keeping milk down. This means avoiding immediate active play or placing the baby in positions that compress their abdomen, such as tight clothing or diapers. While elevating the head of the crib might seem helpful, this should only be considered with specific guidance from a pediatrician. In some cases, if breastfeeding, a healthcare professional might suggest the mother temporarily adjust her diet, such as eliminating dairy. For formula-fed babies, a doctor might recommend trying a different formula.