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Spitting Up

Regurgitation or “spitting up” is the non-forceful return of a small amount of milk during or shortly after feeding. The nipple holes may be too small or too large causing the milk to flow too slowly or too rapidly, the bottle may be held at the wrong angle or the infant may be upset because of nervous excitement or over handling. Sometimes spitting up means the baby has eaten more than her stomach can hold; sometimes she spits up while burping or drooling. Although it may be a bit messy, it’s no cause for concern. It almost never involves choking, coughing, discomfort, or danger to your child, even if it occurs while she’s sleeping.

Spitting up may be considerably reduced or even eliminated by burping Baby during and after feeding by gentle handling and by avoiding the other possible causes. But as long as the weekly weight gain is attained, there is no need to be concerned about occasional spitting up or “cheesing.” This condition usually stops when the baby starts taking solid food. Some babies spit up more than others, but most are out of this phase by the time they are sitting. A few “heavy spitters” will continue until they start to walk or are weaned to a cup. Some may continue throughout their first year.

You should be able to tell the difference easily between normal spitting up and true vomiting. Unlike spitting up, which most babies don’t even seem to notice, vomiting is forceful and usually causes great distress and discomfort for your child. It generally occurs soon after a meal and produces a much greater volume than spitting up. If your baby vomits on a regular basis (one or more times a day), consult your pediatrician.

Preventing Spitting Up

While it is practically impossible to prevent all spitting up, the following steps will help you decrease the frequency of these episodes and the amount of spit up.

  • Make each feeding calm, quiet and leisurely.
  • Avoid interruptions, sudden noises, bright lights and other distractions during feedings.
  • Burp your bottle-fed baby at least every 3 to 5 minutes during feedings
  • Avoid feeding while your infant is lying down.
  • Place the baby in an upright position in an infant seat or stroller immediately after feeding.
  • Do not jostle or play vigorously with the baby immediately after feeding
  • Try to feed her before she gets frantically hungry.
  • If bottle-feeding, make sure the hole in the nipple is neither too big (which lets the formula flow too fast) nor too small (which frustrates your baby and causes her to gulp air). To test, if the hole is the proper size, a few drops should come out when you invert the bottle and then stop.

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