Spit Up Explained

By Jenna Armstrong

April 8, 2020

My name is Jenna and I am am The Mama Coach in Winnipeg, MB. I am a Registered Nurse, lactation counselor, sleep coach, prenatal educator, CPR instructor, and a mom of 3 little ones! I am here to help!

You have scrubbed the carpet 10 times this week…you just fed your baby and you hear the noise!! Now you’re worried everything you just fed your baby is coming back up on your clean carpet!

Or maybe you are on your third outfit of the day; you’re just getting back from the grocery store and you realize that not only is your shirt inside out but there is spit up all over your shoulder. This was me with my first baby!! Of course, this is when we could go to the grocery store for an outing and the only reason people would stay 2 meters back is if they noticed the spit up! Never thought I would say this, but those were the days!!

Does either of these scenarios sound familiar?!

Spitting up is usually completely normal and is really common, especially in the first 3 months! Usually by 4 months it peaks, around 7 months little ones start outgrowing it, and most often spitting up settles by 12 months.

A happy spitter
12 months…I know, that seems like a long time!! And once your little one starts solids, the spit up can become a little colorful! When babies spit up it can be alarming, as it can come up through their nose as well as their mouth. Babies who spit up and don’t seem phased by it, they don’t cry or seem uncomfortable when it happens are who we call “happy spitters”. Spitting up is completely normal for these babies, they are healthy thriving infants. It is really more of a laundry and social problem than anything! I remember taking my little guy to friend’s houses and having to bring a big blanket to cover their carpet and anytime anyone wanted to hold him I warned them about the spitting up possibility!

Why does spitting up happen?
Spitting up is normal and common as our little one’s digestive systems are immature. The muscle between the esophagus and the stomach is weak, making it easier for stomach contents to flow back up.

When it is a problem?
For some little ones it is not normal and they need to be seen by their health care provider. These are the babies who scream when they spit up (as the acid is burning) and are not gaining the appropriate amount of weight. They are not happy babies and the spitting up is often forceful, more projectile like.

It can be attributed to a few different problems. If the baby is breastfeeding it could be associated with milk supply. If mom has an oversupply of milk or a forceful letdown these babies have to gulp down the milk to keep up with the flow and end up swallowing lots of air causing them to spit up. Babies to moms with oversupply issues get a lot more of the foremilk than the hindmilk during a breastfed. The foremilk is higher in lactose which is harder for their little bodies to breakdown and digest leading again to the spitting up.

Spitting up could be linked to a food allergy sensitivity. If you are a breastfeeding mom you may have to do an elimination diet, starting with cows’ milk as it is the most common sensitivity for babies. If you are formula feeding you may have to switch the type of formula.

Some babies get diagnosed with GERD (gastroesophageal reflex disease) and need prescription medications to control the spitting up.

Pyloric stenosis is rare but should be mentioned as it presents similarly. These babies have that forceful/projectile type vomiting, are cranky and are not gaining weight appropriately. Surgery is required in these cases.

What can I do?

  • Burp, burp, BURP!! If you are breastfeeding feed at one breast until they are done, take them off and burp, then offer the other breast and burp again at the end of the feed. If you are bottle-feeding, use the paced bottle-feeding technique. It is similar to feeding at the breast, as you pause and burp during the feed.
  • Try sitting baby more upright for 30 minutes after a feed.
  • Avoid overfeeding.
  • Get your baby the sleep they need.

Do I have to refeed?

Spit ups can look like everything your baby just ate but not to worry the amount of milk in the spit up is always less than it appears. Spit up is mixed with saliva which is why it looks like more than what there actually is. This is why parents notice their little ones spitting up more during teething because of the increased saliva/drooling involved!

If you need help with feeding your baby or getting your baby the sleep, he or she needs reach out to the local mama coach in your area, we are happy to help!

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