04/19/2025
Good info about spitting up in infants!
Most infant reflux ("spitting up") is a laundry problem, NOT a medical problem. It can soil lots of clothing without actually posing a threat to your baby's health. 😅
Almost all babies have some degree of reflux, which cases them to spit up. It tends to peak around the age of 4 months and usually gets a lot better by 1 year of age.
Why do babies spit up? A baby’s esophagus is not yet strong enough to hold down all of the milk or formula that fills their belly during a feed, which is why they often spit up a good portion of it. 🤦♀️ There is nothing to worry about as long as your baby is overall happy, healthy, making good wet diapers (6+ per day), and growing appropriately.
Two ounces of milk can look like a LOT when it splatters on a flat surface. Parents often worry that their baby is spitting up “everything.” Is he making good wet diapers roughly every 3-4 hours? Gaining weight and following the growth chart? 📈 If so, you likely have a happy spitter on your hands!
Red flags to look out for include when it comes to reflux include poor weight gain, refusing to eat, and screaming or arching of the back during feeds. 🚩These are the babies that may actually benefit from treatment.
Please understand that antacid medications only reduce the acidity of the stomach contents to make the reflux less painful. They do NOT decrease the volume of spit-up! ‼️ Furthermore, it doesn't make much sense to put a baby on antacid medication AND a spit-up formula at the same time because spit-up formula actually relies on the acidity of the stomach to form clumps, so you're wasting your money when you pair the two together.
Beware of spit-up that is bright green or persistently forceful. Normal reflux does NOT come with dehydration, fever, difficulty breathing, chronic cough, or turning blue due to lack of air during feeds. These are all signs of a more worrisome problem that deserves medical attention.
To reduce reflux, avoid overfeeding! While an adult stomach can hold up to 4 liters of fluid at a time, a newborn’s stomach is only about the size of ping-pong ball. 🏓 An average 1-month old isn't able to hold down more than about 3-4 ounces at a time. There’s typically no need to re-feed your baby after he or she has spit up unless instructed otherwise.
Other useful tips: Burp your baby after every 2-3 ounces or when they naturally pause at the breast. Hold them upright for at least 20 minutes after feeds. Try to avoid car seats, tummy time, tight diapers, and snug waistbands shortly after feeds, as these can all put added pressure on the stomach.
I don’t typically encourage parents to switch formulas since infant reflux is normal and gets better with time, but there’s no harm in trying a hypoallergenic formula if your formula-fed baby is having other digestive issues (notable gas, bloating, explosive watery stools) in addition to the spitting up. 🍼 It's best to give a new formula at least 3-4 WEEKS for the body to adjust so that you can truly tell if it's helping or not.
