Baby reflux – Start for Life

1. Colic

2. Constipation

3. Mastitis

4. Milk supply

5. Reflux

6. Sore nipples

7. Thrush

8. Tongue-tie

If your baby brings up milk, or is sick during or after feeding, this is know as reflux – although it’s also called posseting or spitting up.

It’s quite common and your baby should grow out of it, usually by the time they are 12 months old.

What causes baby reflux?

The muscle at the bottom of the food pipe acts as a kind of door into the stomach – so when food or milk travels down, the muscle opens allowing the food into the stomach.

However, while this muscle is still developing in the first year, it can open when it should not (usually when your baby’s tummy is full). This allows some food and stomach acid to travel back up again.

Acid in the stomach is normal and a necessary part of the digestion process – it helps break down food.

In most babies, reflux is nothing to worry about as long as they are healthy and gaining weight as expected.

Baby reflux symptoms

Symptoms of baby reflux include:

• constant or sudden crying when feeding
• regularly bringing up milk during or after feeds
• frequent ear infections
• lots of hiccups or coughing
• refusing, gagging or choking during feeds
• poor weight gain
• waking up at night a lot

Did you know?

Reflux is very common in the first 3 months, and usually stops by the time your baby is 12 months.

Silent reflux and GORD

Silent reflux

Silent reflux can be confusing as there are no obvious signs or clues (such as spitting up).

It’s when the food travels back up the food pipe but is swallowed rather than spat out.

This makes it harder to identify, but your baby may display similar symptoms to those of regular reflux.

GORD (gastro-oesophageal reflux disease)

When reflux becomes painful and happens frequently, this is known as gastro-oesophageal reflux disease (GORD).

GORD is more serious than mild, everyday reflux – the strong stomach acid can irritate and make the food pipe sore and inflamed, which is painful for your baby and may result in them needing medication.

The main signs and symptoms of GORD in your baby are:

• spitting up frequently
• abdominal pain
• feeding difficulties
• seeming unsettled and grizzly after a feed

These symptoms can lead to your baby not gaining weight, or even losing weight.

Breastfeeding tips for babies with reflux

These tips may help reduce reflux for your baby when breastfeeding:

• feeding little and often – smaller feeds stop their tummy getting too full
• burping them requently during feeds – have a look at our guide to burping your baby for techniques
• try a different feeding position – check out our our guide to breastfeeding position
• keep your baby upright, for at least 1 hour after feeding – this should help keep the milk down

If you are mixed feeding (combining breastmilk and formula feeds), have a look at our advice on bottle feeding and reflux.

When to see the GP

If your baby has difficulty feeding or refuses to feed, regularly brings milk back up and seems uncomfortable after a feed, talk to your pharmacist, GP or health visitor.

They’ll be able to give you practical advice on how to ease the symptoms and manage it. They may also need to rule out other causes (such as cow’s milk allergy).

It might be helpful to keep a record of when your baby feeds, with details of how often and how much your baby brings the food back up, and how often your baby cries or seems distressed.

This will help your health visitor or GP decide if your baby needs treatment.

Help and support

For confidential breastfeeding information and support, call the National Breastfeeding Helpline on 0300 100 0212.

Lines are open 9:30am to 9:30pm every day.

Why Do Babies Spit Up?

As a new or soon-to-be parent, you might be wondering: “What can be so hard about feeding a baby?” They only consume formula or breast milk, right? But feeding a newborn can be stressful as you learn your baby’s hunger cues and get into a rhythm with breastfeeding or bottle feeding. And sometimes, it can even be a little anxiety-provoking, especially when babies spit up what looks like their entire feeding.

Rest assured, spitting up is completely normal for young babies, and it can happen for a few different reasons. Most babies who spit up generally still eat well and gain weight appropriately, but there are also some red flags to look out for and reach out to your pediatrician about. Ahead, we explain why babies spit up, how to help prevent it, and how much is too much.

Why Do Babies Spit Up?

Overfeeding

The most common reason babies spit up is that they’re being overfed. “Babies will feed until they spit up, so we have to be careful that we don’t offer them too much and offer them the right amount for their age and tummy size,” says Danelle Fisher, MD, FAAP, pediatrician and chief of pediatrics at Providence Saint John’s Health Center in Santa Monica.

Most newborns eat every two to three hours and only take in one to two ounces at each feeding, gradually increasing to two to three ounces by the time they’re two weeks old, according to HealthyChildren. org, created by the American Academy of Pediatrics. Every baby is different, but if they’re spitting up, it’s most likely a sign that they’re full.

To prevent overfeeding, follow your baby’s cues or try providing smaller feedings more regularly. Even if your baby spits up a large amount, they actually got more than what you think they need, Dr. Fisher says. If you’re feeding with a bottle, Dr. Fisher recommends starting with a preemie nipple flow because it’s slower than other nipple flows and allows your baby to pace themselves.

“If your baby starts fighting the bottle, you can always think about using the next-size-up nipple, just to make sure that you’re giving the right amount and flow. And it’s OK to switch back and forth between nipples. Sometimes you have to play around a little bit because babies don’t talk to you. We’re trying to guess what they need,” she says.

Breastfed babies are less likely to be overfed because they’re able to pace themselves when they nurse, says Elena Shea, MD, IBCLC, a pediatrician and certified lactation consultant. However, moms who have an oversupply or a fast letdown can overfeed their babies because the baby ends up consuming a large amount of milk in the first few minutes of nursing.

In this case, “mothers with a fast letdown can hand express milk prior to latching their baby, so that the baby avoids the letdown issue. Mothers with oversupply can work to moderate their supply. Despite the prevalent idea that oversupply is a good thing, it can have lots of consequences, including mastitis and clogged ducts,” Dr. Shea says.

You can also try nursing in a reclined position, which is ideal for preventing spit up: “Mother lies back to about a 45-degree [angle] position and can then hold the baby in the traditional cradle hold or football hold. This position limits the effects of gravity in moving milk and makes the baby work a little harder to feed. It helps slow milk flow,” Dr. Shea says.

Reflux or Gas

The muscle tone in the esophagus, which is the tube that carries food and liquid from your throat to your stomach, is very loose in babies, Dr. Fisher says. So if they overeat, they spit it up.

“What happens is it’s very easy to then have stuff in your stomach come back up. If you think of adult heartburn, it’s the same physiologic thing in babies. Some babies have more tone than others and just have a worse time with reflux than other babies, so there are different patterns of spit up,” she explains.

The connection between the esophagus and the stomach also tends to be immature in babies. “Instead of providing a sharp, band-like stricture, food contents can easily pass from the esophagus to the stomach as well as vice versa from the stomach back up through the esophagus. As infants begin to grow and meet their developmental milestones, such as sitting independently, standing, and walking, it’s common for reflux to resolve on its own with the help of gravity,” says Ronald Potocki, DO, a pediatrician at Orlando Health Arnold Palmer Hospital for Children. Sometimes babies may also spit up when they have increased abdominal pressure, such as while pooping or burping.

Babies can also spit up if they gulp down some air with milk, according to HealthyChildren.org. Because baby stomachs are small and can’t hold a lot, air can fill it up quickly and cause gas or spit up.

One way you can help prevent spit up from reflux or gas is to keep them in an upright position 15 to 20 minutes after a feeding, Dr. Potocki says. This allows gravity to keep breastmilk or formula to stay in your baby’s stomach. As mentioned above, you want to burp after every feeding to remove excess gas and prevent bloating, he adds.

Additionally, you can help remove gas by burping your baby before switching breasts or taking breaks during bottle feedings. If needed, you can also ask your pediatrician about some safe over-the-counter medications, like simethicone, to help break up gas, Dr. Shea says.

“Also, it is important to avoid any activities that could potentially increase abdominal pressure, which can worsen reflux, such as placing [the baby] in swings and car seats immediately after feeding,” Dr. Potocki says.

How Much Spit Up Is Normal?

Some spit up at most feedings is normal; it’s more to note how the spit up is coming out as well as what it looks like. Generally, spit up should be the same color as breast milk or formula, and some curdling is also fine.

But spit up that is projectile — for example, hitting a wall on the opposite side of the room or splattering on the floor — should be addressed with your pediatrician. In addition, spit up that has some color to it, like a yellowish or greenish tinge, could be bile, Dr. Fisher says.

“If that happens, the parents should alert their pediatrician that the baby has unusual-colored spit up,” she says. “You should also talk to your pediatrician if you see blood in spit up, although blood can be tricky. Some moms have very sore, cracked nipples that actually have a little bit of blood. So if the baby spits up, sometimes there could be some swallowed maternal blood. But if that’s the case, you probably are just going to see a small amount. If you see a large amount, that’s also a reason to alert your pediatrician.”

Many parents may worry that their baby is spitting up too much and not taking in enough formula or breastmilk, but if your baby is peeing and pooping regularly, then they’re getting enough food and are gaining weight. That said, if a baby spits up a lot and isn’t peeing or pooping, that’s a red flag that you should bring up with your pediatrician.

Should You Be Concerned About an Allergy?

Many parents may suspect that their baby has an allergy if their baby spits up a lot and often, but spitting up alone isn’t a sign of a food allergy or sensitivity. Babies who have a true allergy (most commonly, to cow’s milk protein) will experience other symptoms such as poor weight gain, a rash or hives, dehydration, a sunken spot on the baby’s head, and blood-tinged or mucousy stools, Dr. Potocki says. If that’s the case, reach out to your pediatrician to get a full evaluation.

However, some babies who nurse may have a sensitivity to certain foods, most commonly milk and soy. If your baby seems very uncomfortable, speak to your pediatrician about possibly doing an elimination diet. If you’re breastfeeding, it’s important to consult your pediatrician before making any changes to your diet to prevent a nutritional deficiency, Dr. Shea says. For example, removing dairy from your diet can lead to calcium and vitamin D deficiency. Similarly, parents should avoid changing their baby’s formula without first consulting their doctor to ensure they’re getting enough of the right nutrients.

When Do Babies Stop Spitting Up?

There’s quite a range for when babies outgrow spitting up — anywhere from four weeks to six months. According to the Mayo Clinic, most babies stop spitting up by their first birthday.

Some babies might outgrow it faster than others, but as your baby gets older with each passing month, the amount and frequency of spit up should gradually decrease over time, Dr. Fisher says.

Image Source: Burst / Sarah Pflug

7 reasons why babies spit up curdled milk and when to worry

Image: Shutterstock

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IN THIS ARTICLE

• Possible causes of spitting up curdled milk
• What does normal baby spitting up look like?
• When to call a doctor?
• Tips to reduce spitting up curdled milk

As a new parent, you may be worried if your baby is spitting up curdled milk. However, milk curdles when mixed with gastric juices, which is normal during digestion. Sometimes babies may spit up curdled or undigested milk because their digestive systems are immature.

Excessive regurgitation of curdled milk or any stomach contents causes anxiety. You may wish to consult a pediatrician in such cases as this may be due to underlying causes that may require medical or surgical care.

Continue reading this post for possible causes and tips for coping with spitting up curdled milk in babies.

Possible causes of regurgitation of curdled milk

Babies may spit up curdled milk from time to time for no apparent reason. However, spitting up curdled milk can be caused by any of the following reasons. (one) .

1. Acid reflux

Acid reflux can be a common cause of spitting up of curdled milk in newborns and young children. Immature gastroesophageal sphincters can cause stomach contents to be expelled through the esophagus into the mouth.

Feeding upright, frequent and frequent feedings, and keeping the baby upright for 20 minutes after feeding may help reduce acid reflux in some babies.

Some babies with severe acid reflux may need food thickeners for breast milk or infant formula. You can seek the advice of a pediatrician to determine the best treatment for acid reflux in your child. Some may need medication to prevent acid reflux.

2. Food intolerance or allergy

Lactose intolerance or milk allergy may cause some children to spit up curdled milk frequently. A dietitian can help you with allergy testing and determine if you need to avoid certain food groups while breastfeeding.

When formula-fed, switching to certain formulas, such as low-lactose or hypoallergenic formula (hydrolysate formula), may improve the baby’s condition.

Some babies may spit up curdled milk if they drink cow’s milk. Eliminating cow’s milk from the diet can solve this problem. Cow’s milk can only be introduced after the baby is 12 months old.

3. Stenosis of the pylorus

The pylorus is the outlet of the stomach. Pyloric stenosis is a condition in which the pylorus is narrowed and obturated. The condition interferes with the movement of food from the stomach to the intestines. This can cause the baby to vomit curdled milk from the stomach.

Infants may experience vomiting of curdled milk, lack of defecation or constipation, and weight loss due to pyloric stenosis. You can seek medical help for diagnosis and treatment.

4. Overfeeding

Babies who are fed more than they need tend to spit up yogurt or plain milk because their stomachs are full. The gastroesophageal sphincters can open due to pressure and cause backflow of stomach contents in overfed babies.

5. Immature gastrointestinal system

Immature or underdeveloped structures and functions of the gastrointestinal tract can cause frequent regurgitation in many children. Newborns and premature babies are more likely to have an immature GI system.

6. Feeding position

Babies who are fed in the supine position may burp more quickly than babies who are primarily fed in the upright position. Milk tends to move down quickly in an upright position, and this position can also help keep the esophageal sphincters closed.

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Breastfed babies can benefit from breastfeeding in a relaxed position, which can help speed up the flow of milk.

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7. Swallowing air

Swallowing air due to the rapid flow of milk or suboptimal latch on to the breast or bottle nipple during feeding may increase the chance of regurgitation. The gastroesophageal sphincters may open to burp, and children may burp milk or curdled milk along with the burp.

Try to identify and avoid possible causes of spitting up curdled milk. Seek medical attention if the child continues to spit up curdled milk despite interventions.

What does normal baby regurgitation look like?

Regurgitation may be whitish in breastfed and formula-fed infants. Older children who eat solid foods may spit up other colors, depending on what they eat. Sometimes children may spit up saliva or stomach acid, which may look like a clear liquid.

Red and coffee grounds may indicate bleeding in the stomach or upper gastrointestinal (GI) tract, while yellow or green may be due to bile or phlegm. You may want to seek medical attention if spitting up has these colors.

When to call a doctor?

You can call your health care provider if your baby is spitting up too much curdled milk or spitting up frequently. You can seek medical help for both cheesy spitting up and regular spitting up.

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Get medical help if your child has any of the following conditions with profuse spitting up. (4) .

• No weight gain
• Severe regurgitation or vomiting
• Green or yellow liquid Blood in stool
• Breathing problems after spitting up
• dehydration
• Continuous or frequent crying

Stopping or reducing breastfeeding or switching to artificial feeding without consulting a pediatrician is not ideal. Spitting up curdled milk can be caused by a variety of reasons. The doctor will determine the cause and prescribe the necessary treatment.

Tips for reducing spitting up of curdled milk

The following tips can help reduce spitting up of curdled milk in babies. (two) (3) .

• Feeding in an upright position or lying on your back can help minimize regurgitation.

• Do not overfeed as babies tend to spit up more when the stomach is full.

• Do not let your baby lie on his stomach immediately after feeding.

• Manage your milk flow or change your feeding position if you have too much milk.

• Do not dress your baby in tight clothes that may put pressure on the stomach during feeding.

• Feed at regular intervals; long intervals between feedings can increase the accumulation of acid in the stomach.

• Give medicines on time if they are prescribed.

• Change the diet of infants on solid foods as recommended.

• Breastfeeding mothers can change their diet as recommended.

• Discuss with your doctor if spitting up is caused by certain conditions, such as pyloric stenosis.

Many children can avoid spitting up curdled milk. However, if your baby is spitting up more than usual, you may want to seek medical attention.

one. Why do babies spit up; Healthy children; American Academy of Pediatrics
two. Spitting up in babies: what is normal and what is not; St. Clair Hospital
3. Why is my baby spitting up so much breast milk?; Texas Children’s Hospital
Four. Problems with regurgitation; Boys Town National Research Hospital

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Child spitting up curdled milk: causes and remedies

Most children spit up. The main reason is the formation of the digestive system. However, if they become more frequent, become too plentiful, parents begin to worry about the question: why does the baby spit up cottage cheese or curdled milk? We will answer it in the article.

The main causes of spitting up curdled milk or formula

First you need to find out if the baby is really spitting up curdled milk in the stomach or vomiting. This can be determined by the following signs:

1. Ordinary regurgitation does not cause contraction of the abdominal muscles. The discharge does not have an unpleasant odor, is very similar to curdled milk or cottage cheese, and occurs shortly after feeding. The frequency of regurgitation does not exceed 2-3 times a day, the child feels normal.
2. vomit is more abundant, breaks between them are accompanied by active salivation. Due to the admixture of bile, gastric juice, they have a yellowish tint. The frequency of vomiting depends little on meals, the skin becomes pale, the baby is naughty, there are signs of poisoning.

The main reason why a child often spits up cottage cheese is the lack of a diet. May also be affected by:

1. Incorrect feeding technique. Often, a baby swallows air while eating due to improper breast capture. A possible cause may be a wide opening in the nipple.
2. Overeating. Since the nervous system of the baby is not sufficiently developed, he is still poorly able to recognize the feeling of fullness. Too plentiful amount of food is hard perceived by the stomach, the food asks to go out. That is why it is important to follow the diet, controlling the duration of feedings.
3. Violation of the diet of a nursing mother. Some foods cause flatulence, and then belching, along with which the food comes out.
4. Active teething period. At this time, a lot of excess saliva is released, which goes down and then comes back along with breast milk.

This is important! There is a widespread misconception that the mother’s diet has little effect on breast milk, the child will definitely take everything he needs from food. There was no confirmation of this theory, doctors strongly recommend following a diet, excluding all foods that negatively affect lactation, as well as the quality of breast milk.

In addition to harmless causes, the child sometimes spits up curdled milk on the background of pathologies:

1. Fetal hypoxia during pregnancy, complicated or premature birth. All this often implies deviations of the central nervous system. Regurgitation due to diseases of the central nervous system is characterized by high intensity, they are also called gushing. At the same time, other neurological symptoms are observed: severe tilting of the head, chin tremor. There may be a violation of the tone of the digestive tube.
2. Diseases of the gastrointestinal tract. They are also indicated: violation of the stool (rare emptying, strange consistency), weight loss.
3. Infections of various etiologies. The main symptom is lethargy, fever to subfebrile values, pallor of the skin.
4. Increased intracranial pressure.
5. Renal failure.
6. Metabolic disorder, inherited.
7. Lactase deficiency (milk protein intolerance). Then only a complete transition to a lactase-free mixture will help.

If parents suspect the development of pathological regurgitation, you should immediately contact your pediatrician.

How to distinguish the norm from the pathology?

Doctors are calm about the fact that a child sometimes burps up with a curdled mass, because this phenomenon disappears by itself by about 12 months of his life. Pathological regurgitation often does not require special therapy, except for changing the diet, controlling the amount of food eaten. Only occasionally medications are prescribed.

Drug treatment includes the following cases:

1. The baby spit up more than 15 ml of liquid at a time. Measuring the amount is easy – it fits in about two tablespoons.
2. The child often spits up curdled milk, not only after eating. This can happen after tantrums, but if the baby is in a calm state, there should be no belching.
3. Spitting regurgitation.

Usually belching occurs immediately after eating. If at the same time the child behaves as usual, there is no reason to fear for his health.

When should you see a doctor?

It happens that the baby actively spits up curd 5-7 times a day. So that he does not choke while he lies alone in the crib, his mother should help him. To do this, it is important to ensure that the clothes do not squeeze the baby’s stomach. Before each feeding, it is recommended to spread the crumbs on the stomach so that excess air comes out. And if the baby suffers from a runny nose, before giving him a breast, you need to rinse the nose with saline.

If all the above measures do not bring results, regurgitation becomes more frequent, becomes more intense, and the child begins to refuse food altogether, you should definitely consult a doctor.

How to get rid of frequent and profuse regurgitation?

If the baby begins to spit up during feeding, a number of actions should be taken:

• 3-4 minutes hold him in a column after each meal;
• reduce the time of feeding, while breastfeeding more often;
• during feeding position the baby so that the upper part of the body is slightly raised;
• give the bottle to artificial babies so that the baby food completely fills the nipple, leaving no room for air;
• try introducing small amounts of plain water into the diet.

Put the baby to sleep on its side, and put a miniature cushion under the head.

Since the digestive system is largely controlled by the muscles, it is important to monitor the correct physical development of the baby. Strengthen the muscles will help massage (done by a specialist), regular gymnastics. A young mother can gently stroke the baby’s belly around the navel in a clockwise direction.