Why does my breastfed baby spit up curdled milk. Is curdled spit-up normal for breastfed babies. How can I prevent my baby from spitting up curdled milk. What causes excessive spit-up in breastfed infants. When should I be concerned about my baby’s spit-up.

Understanding Curdled Spit-up in Breastfed Babies

New parents often find themselves alarmed when they notice their breastfed baby spitting up what appears to be curdled milk. This phenomenon, while potentially concerning at first glance, is actually a common occurrence in infants. To understand why this happens and what it means for your baby’s health, let’s delve into the science behind curdled spit-up and its implications for breastfed babies.

The Science of Curdled Breast Milk

When breast milk enters a baby’s stomach, it mixes with stomach acid. This interaction causes the milk to curdle, much like how cheese is made. The curdling process is a natural part of digestion and doesn’t indicate any problem with the milk or your baby’s health. In fact, this curdling is beneficial, as it helps break down the milk proteins for easier absorption.

Frequency of Spit-up in Infants

Spitting up is incredibly common in babies, with over half of all newborns experiencing at least one episode daily. This frequency tends to peak around 4 months of age and typically resolves by the time the baby reaches their first birthday. While it may seem alarming, occasional spit-up is generally not a cause for concern.

Common Causes of Excessive Spit-up in Breastfed Babies

While some spit-up is normal, excessive regurgitation can be uncomfortable for your baby and messy for you. Understanding the potential causes can help you address the issue effectively.

Overactive Letdown and Fast Milk Flow

An overactive letdown or forceful milk ejection reflex can cause your baby to gulp milk too quickly, leading to excessive spit-up. This rapid intake can overwhelm your baby’s small stomach, causing some of the milk to come back up.

Swallowing Air During Feeding

Babies who swallow air while feeding are more prone to spitting up. This can occur due to poor latch during breastfeeding or using a bottle with a nipple that flows too quickly. The trapped air in the stomach can push milk back up, resulting in spit-up.

Gastroesophageal Reflux (GER)

Some babies experience a more severe form of reflux, which can cause frequent spit-up and discomfort. Signs of problematic reflux include refusal to feed, fussiness during and after feedings, and persistent irritability throughout the day.

Less Common Causes of Excessive Spit-up

While most cases of spit-up are benign, there are some less common causes that may require medical attention.

Tongue Tie and Its Impact on Feeding

A tongue tie, or ankyloglossia, is a condition where the tongue is tethered too tightly to the floor of the mouth. This can affect a baby’s ability to latch properly, leading to increased air intake during feeding and subsequently more spit-up.

Milk Protein Allergy

Some babies may have an allergy to cow’s milk protein, which can pass through breast milk. This allergy can cause symptoms such as excessive spit-up, vomiting, diarrhea, and in severe cases, hives or anaphylaxis. If you suspect a milk protein allergy, consult with your pediatrician about potentially eliminating dairy from your diet while breastfeeding.

Pyloric Stenosis: A Rare but Serious Condition

Pyloric stenosis is an uncommon condition where the passage between the stomach and small intestine becomes narrowed, preventing proper emptying of stomach contents. This can lead to forceful vomiting and requires surgical intervention. While rare, it’s important to be aware of this possibility if your baby shows signs of persistent, projectile vomiting.

When to Seek Medical Attention for Baby Spit-up

While most instances of spit-up are harmless, there are situations where medical intervention may be necessary. Being aware of these signs can help you determine when to consult your pediatrician.

Signs of Dehydration

If your baby is spitting up excessively, watch for signs of dehydration. These may include fewer wet diapers than usual (less than 6 in 24 hours), dark urine, dry mouth, or sunken fontanelles (soft spots on the head).

Poor Weight Gain or Weight Loss

If your baby is not gaining weight as expected or is losing weight, this could be a sign that they’re not retaining enough nutrients due to excessive spit-up. Regular weight checks with your pediatrician can help monitor this.

Blood in Spit-up

While rare, blood in spit-up can indicate a more serious issue and warrants immediate medical attention. Keep in mind that a small amount of blood-tinged spit-up can occur if the mother has cracked nipples, but this should be evaluated by a healthcare provider.

Strategies to Reduce Curdled Spit-up in Breastfed Babies

While some spit-up is inevitable, there are several strategies you can employ to minimize its frequency and volume.

Proper Feeding Techniques

Ensuring a good latch during breastfeeding can significantly reduce the amount of air your baby swallows. If you’re using a bottle, choose one with a slow-flow nipple to prevent your baby from drinking too quickly. Holding your baby in a more upright position during feeding can also help reduce spit-up.

Frequent Burping

Burping your baby frequently during and after feedings can help release trapped air, reducing the likelihood of spit-up. Try burping your baby after every 2-3 ounces if bottle-feeding, or when switching breasts if breastfeeding.

Avoiding Overfeeding

While it’s important to feed your baby on demand, try to avoid overfeeding. If your baby seems satisfied, don’t force them to finish a bottle or continue nursing. Smaller, more frequent feedings can be easier for your baby to digest.

The Role of a Lactation Consultant in Managing Spit-up

A lactation consultant can be an invaluable resource for breastfeeding mothers, especially when dealing with issues like excessive spit-up.

Assessing Latch and Feeding Position

A lactation consultant can observe your breastfeeding technique and provide guidance on achieving the optimal latch and positioning. This can help reduce the amount of air your baby swallows during feeding, potentially decreasing spit-up.

Managing Oversupply and Forceful Letdown

If you have an oversupply of milk or a forceful letdown, a lactation consultant can provide strategies to manage these issues. This might include techniques like block feeding or using breast compression to slow the flow of milk.

Long-term Outlook: When Does Spit-up Typically Resolve?

Understanding the typical timeline for spit-up can help alleviate concerns and set realistic expectations for parents.

Developmental Milestones and Spit-up

As your baby’s digestive system matures and they begin to sit up independently, you may notice a decrease in spit-up. This typically occurs around 6-7 months of age. The introduction of solid foods can also help reduce spit-up, as the thicker consistency of these foods is less likely to come back up.

When to Expect Complete Resolution

Most babies outgrow frequent spit-up by their first birthday. However, every child develops at their own pace, and some may continue to have occasional spit-up episodes beyond this point. As long as your baby is growing well and not showing signs of discomfort, this is generally not a cause for concern.

Curdled spit-up in breastfed babies, while often alarming for new parents, is a normal part of infant development. Understanding the causes, knowing when to seek medical attention, and implementing strategies to minimize spit-up can help you navigate this phase of your baby’s life with confidence. Remember, every baby is unique, and what works for one may not work for another. Don’t hesitate to reach out to your pediatrician or a lactation consultant if you have concerns about your baby’s spit-up patterns or overall feeding experience.

As your baby grows and their digestive system matures, you’ll likely see a reduction in spit-up episodes. In the meantime, keep plenty of burp cloths on hand, practice patience, and remember that this phase is temporary. Your baby’s curdled spit-up is simply a sign of their developing digestive system hard at work, processing the nutrition they need to grow and thrive.

Help! Why Is My Breastfed Baby Spitting up Curdled Milk?

• It is completely normal for young babies to spit up several times each day.
• Breast milk curldles quickly when mixed with stomach acid.
• Do not be alarmed by your breastfed baby’s curdled spit-up. 
• See your doctor if your baby stops gaining weight or has very few wet diapers.
• Holding your baby upright and burping them frequently can help prevent excessive spit-ups.

Most parents plan for a little spit-up when their baby comes into the world. New moms and dads carry around diaper bags full of burp cloths, wipes, and outfit changes. Although you know that babies spit up, you might be surprised at both the amount and appearance of baby spit-up. 

Baby spit-up can come in many different colors and textures, making it difficult to tell what is normal and what is not. You may wonder why your breastfed baby is spitting up curdled milk and if this is unusual or cause for alarm.

Breastfed Baby Spitting up Curdled Milk: Is It Normal?

Both breastfed babies and formula-fed babies commonly spit up. In fact, the experts at American Family Physician state that over half of all newborns spit up at least once per day. Spit-up in babies tends to peak around 4 months, and most babies grow out of it by the time they reach their first birthday. 

While it looks and smells bad, spitting up curdled breast milk is completely normal. 

Reasons Why Babies Spit Up Curdled Milk

When breast milk enters your baby’s tummy, it curdles. Because your baby has an immature digestive system, their stomach contents frequently come back up out of their mouth (or even their nose). Sometimes, those stomach contents include curdled breast milk. 

Some babies are more likely to spit up curdled milk than others. A few possible reasons for excess spit-up milk include: 

1. Too Much Milk Flow

Forceful letdown or a bottle with a fast-flowing nipple can cause your baby to drink too much, too fast. When a newborn baby’s stomach gets too full after breast or bottle feeding, their stomach fluids are more likely to come back up through their mouth. 

2. Swallowing Air

Similarly to drinking too much too fast, if a baby swallows air while eating, their stomach will fill and the contents will come back up. Swallowing air can be caused by problems with bottle feeding or a poor latch. 

3. Acid Reflux

While frequent spitting up is normal, some babies experience excessive spitting up due to acid reflux. If your baby refuses feedings, acts fussy during and immediately after feedings, or is irritable and fussy throughout most of the day, they may be struggling with severe acid reflux.

4. Tounge Tie

According to the International Journal of Clinical Pediatrics, children with a tongue tie are more likely to have problems with spitting up. This is primarily because they have a hard time getting a good seal on a breast or bottle nipple and end up swallowing a lot of air.  

5. Allergic Reaction to Milk

The Mayo Clinic states that cow’s milk allergy is one of the most common food allergies in children and studies show that milk allergies “can occur in both formula-fed and exclusively breastfed infants.” Breastfed babies with a cow’s milk allergy may experience vomiting, diarrhea, hives, and even anaphylaxis. If your baby has a severe cow milk allergy, you will have to avoid drinking regular milk until you are finished breastfeeding.  

6. Pyloric Stenosis

While uncommon, pyloric stenosis is one of the few possible reasons that your baby spits up excessively. Pyloric stenosis is a condition where the stomach contents cannot empty into the small intestine, forcing them to come back up through the mouth. 

Pyloric stenosis can cause weight loss and dehydration and is treated surgically. 

What to Do if Your Breastfed Baby Spits Up Curdled Milk

If your baby spits up curdled milk, do the same things you would do for normal baby spit-up. Simply hold your baby in an upright position until they have finished spitting up, give them a rest, and try to burp them. 

It is okay to give your baby more milk if they seem hungry after spitting up. Simply stop to let them frequently burp during their feeding. 

As your baby’s digestive system matures and they start eating more solid foods, their spitting up should resolve on its own. 

Tips on How to Prevent Your Baby From Spitting Up Curdled Milk

While spitting up is not usually a health risk, it can be uncomfortable for your baby and cause a big mess for you to clean up. There are a few things you can do to prevent your baby from spitting up so much curdled milk. 

See a Lactation Consultant

A lactation consultant can help make sure that your baby’s mouth is in the correct position for a good latch, which can prevent swallowing air and reduce your baby’s spitting up. 

Get a Slow-Flow Bottle

Similarly to having a good latch, a slow-flow bottle prevents your baby from swallowing too much air or drinking milk too quickly.  

Hold Your Baby Upright

Hold your baby upright for about 30 minutes after each feeding to allow gravity to keep your baby’s acidic stomach fluid moving in the right direction. 

Burp Your Baby Frequently

Your baby’s body may need extra time to digest their food and a little help relieving gas trapped in the belly. Many babies need to be burped two or three times during each feeding session. 

Lay Your Baby on Her Left Side

It may reduce spit-up frequency to let your baby rest on his or her left side. Only lay your baby on their side with direct supervision. If you cannot keep your eyes on your baby, lay them flat on their back to reduce the risk of sudden infant death syndrome.  

When to See a Doctor if Your Baby Is Spitting Up Curdled Milk

While it is normal for young babies to spit up, make sure you can spot the difference between normal spit-up and vomiting. If your baby exhibits any of the following symptoms, make an appointment with your medical doctor right away.  

Projectile vomiting

Forceful vomiting or vomit accompanied by crying is not normal. If your baby seems uncomfortable when they spit up, they may be experiencing a gastrointestinal illness. 

Vomit that looks like coffee grounds

Spit-up or vomit that looks like coffee grounds may actually be dried blood. If your baby spits up fluid with a coffee ground appearance, is pink, or bright red, take them to the pediatrician right away. 

Losing weight

Newborn babies should double their birth weight by 5 months of age and triple it by one year. If your baby is losing weight while spitting up frequently, they may have a problem with their digestion. 

Difficulty breathing

Severe acid reflux may cause wheezing, coughing, or difficulty breathing. If your baby is wheezing or having trouble breathing, they need emergency medical care immediately.

Fewer wet diapers than usual

If you are worried that your baby is spitting up too much, keep an eye out for signs of dehydration. Signs of dehydration include having fewer wet diapers than usual, crying without tears, and dry mouth. 

FAQs

What makes a baby spit up curdled milk?

Just like it does when sitting out in warm temperatures, milk curdles when mixed with stomach acid. Because babies have immature digestive systems, they frequently experience normal spitting up. Spitting up curdled milk is just a normal part of newborn life. 

Is it okay to feed a baby after spitting up curdled milk?

It is okay to feed your baby after they spit up curdled milk. If your baby does spit up, give them a break from feeding and burp them. If they still seem hungry, it is okay to feed them again. 

Can spitting up curdled milk cause my breastfed baby to become dehydrated?

Usually, spitting up does not cause problems with dehydration or weight loss. However, if your baby is spitting up excessively, they may become dehydrated. If your baby has fewer wet diapers than usual, is not gaining weight, or is crying with no tears, it might be time to see your child’s doctor to discuss their condition.  

Is it safe to lay my baby down immediately after feeding if they are spitting up curdled milk?

It is always a good idea to hold your baby in a more upright position for 30 minutes after a feeding, especially if they are spitting up. Babies are more likely to have problems with spit up if they are laid flat immediately after a feeding. 

Can stress or anxiety in the mother affect the quality of breast milk and cause the baby to spit up curdled milk?

Stress and anxiety may affect breast milk quantity, but there is no evidence to show that it affects breast milk quality. Breast milk from stressed or anxious mothers is not more likely to cause baby’s spit up than breast milk from mothers who are less anxious. 

References

1. Burris AD, Burris J, Järvinen KM. Cow’s Milk Protein Allergy in Term and Preterm Infants: Clinical Manifestations, Immunologic Pathophysiology, and Management Strategies. Neoreviews. 2020 Dec;21(12):e795-e808. doi: 10.1542/neo. 21-12-e795. PMID: 33262206.
2. Mayo Clinic. Milk allergy: Symptoms and causes. Mayo Clinic website. Updated May 6, 2021. Available from: https://www.mayoclinic.org/diseases-conditions/milk-allergy/symptoms-causes/syc-20375101
3. Mayo Clinic. Pyloric stenosis: Symptoms and causes. Mayo Clinic website. Updated March 24, 2021. Available from: https://www.mayoclinic.org/diseases-conditions/pyloric-stenosis/symptoms-causes/syc-20351416
4. Mehta S, Goldman RD. Exclusive breastfeeding: overcoming challenges. Am Fam Physician. 2015 Oct 15;92(8):705-6. Available from: https://www.aafp.org/pubs/afp/issues/2015/1015/p705.html
5. Siegel, S. Aerophagia Induced Reflux in Breastfeeding Infants With Ankyloglossia and Shortened Maxillary Labial Frenula (Tongue and Lip Tie). International Journal of Clinical Pediatrics, North America, 5, apr. 2016. Available from: https://theijcp.org/index.php/ijcp/article/view/246

The information WonderBaby provides is not intended to be, and does not constitute, medical or other health advice or diagnosis and should not be used as such. Always consult with a qualified medical professional about your specific circumstances.

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Clinical and anatomical conference on the topic “Chronic alcohol intoxication”


– Alcoholic genocide is a tragedy of colossal proportions, – said, opening the clinical and anatomical conference, the head of the Department of Therapy, Clinical Pharmacology and Emergency Medicine of the Moscow State Medical University. A.I. Evdokimova, Professor, Honored Worker of Science of the Russian Federation A.L. Vertkin. – Up to 30% of all deaths in Russia, one way or another, are related to alcohol. The WHO warns of the risk of serious health problems if more than 8 liters of pure alcohol per year per person are consumed. In Russia, an average of 15 liters per person. Today, as a result of mass and systematic consumption of alcoholic beverages by the population, the pathomorphosis of many well-studied diseases has occurred. Alcohol affects all organs and tissues, changing the morphological picture and clinical manifestations of diseases, and leads to multiorgan damage. And our task is to understand the medical aspects of these injuries, the expert concluded.

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In this regard, I would like to quote the famous American writer, socialist and public figure Jack London: “ Alcoholism – a product of barbarism – holds humanity in a stranglehold from the time of gray and wild antiquity and collects a monstrous tribute from it, devouring youth, undermining strength, suppressing energy destroying the best color of the human race. You can’t argue with the classic.

Clinical and anatomical analysis was carried out on the history of a patient who, with his short life, demonstrated the irreversible multi-organ consequences of alcohol abuse. So, a 45-year-old man was admitted in a serious condition to the intensive care unit of one of the capital’s multidisciplinary hospitals with a referral diagnosis: “Cirrhosis of the liver. Gastrointestinal bleeding.”

From the anamnesis it is known that the patient has been abusing alcohol for many years. By profession, he is a driver. Hasn’t worked lately. Previously, he was repeatedly hospitalized in different hospitals for decompensated liver cirrhosis. The last hospitalization was a month ago. Then, due to the accumulation of a large amount of free fluid in the abdominal cavity, the patient underwent laparocentesis. There were also marked diffuse changes and an increase in the size of the liver.

EGD revealed mixed gastritis, duodenitis and hiatal hernia. Varicose veins of the esophagus were not diagnosed. X-ray showed a high standing dome of the diaphragm due to an enlarged liver. Colonoscopy revealed polyps of the colon, diagnosed with mixed hemorrhoids. Against the background of the therapy, there was a positive trend. The patient was discharged under the supervision of a physician at the place of residence.

According to relatives, for 2 weeks before the present hospitalization, the patient began to notice a deterioration in the form of an increase in edema, an increase in the volume of the abdomen, and the appearance of jaundice. 10 hours before hospitalization, vomiting with an admixture of blood appeared. After the man lost consciousness, the brigade “03” was called by relatives.

In connection with the soporous condition, the patient did not complain. The skin and sclera are icteric, pronounced acrocyanosis. The abdomen is enlarged due to ascites. Agonal breathing and unstable hemodynamics are noted. Heart rate and blood pressure are not determined. In the general analysis of blood – macrocytic anemia and thrombocytopenia. In the biochemical analysis of blood – hypoproteinemia, hyperbilirubinemia due to an increase in both fractions, a sharp increase in liver enzymes, a slight increase in creatinine.

Based on the severity of the condition, unstable hemodynamics, resuscitation measures were started, which turned out to be ineffective, a lethal outcome was stated. Final clinical diagnosis: Chronic alcoholic cirrhosis. Background diseases: chronic alcoholic polyvisceropathy, encephalopathy, cardiopathy, polyneuropathy, pancreatitis. Complications: portal hypertension, bleeding, acute post-hemorrhagic anemia. Concomitant diseases: colon polyps.

The results of the autopsy were reported by the pathologist of the city clinical hospital named after V.I. S.I. Spasokukotsky of the Department of Health of Moscow A.M. Gavrilov: “Macroscopic changes in the internal organs are typical for patients with chronic alcoholism: the liver is of a characteristic icteric color, enlarged in size, with a small nodular pattern. There are signs of varicose veins of the esophagus – the wall of the organ is saturated with altered blood. In the lumen of the small intestine – partially clotted blood. Chronic indurative pancreatitis. Pulmonary edema. Signs of alcoholic cardiomyopathy are an increase in the size and expansion of all cavities of the heart, myocardial hypertrophy, subepicardial fat hypertrophy, and interstitial obesity. The spleen is reduced due to blood loss. Thickening of the meninges is an indirect sign of alcoholic encephalopathy. Edema of the brain. Microscopically – focal demyelination, which can also indirectly indicate a long-term toxic effect of alcohol.

“The polyclinic therapist should be well aware of the clinical markers of the development of cirrhosis, as this changes the tactics of managing the patient,” commented on the described case, Associate Professor of the Department of Clinical Pharmacology, Pharmacotherapy and Emergency Medicine of the Moscow State Medical University. A.I. Evdokimova E.I. Vovk. – This is the appearance of signs of portal hypertension, a process that is accompanied by the expansion of the veins of the anterior abdominal wall, the so-called. “medusa head” Varicose bleeding from the esophageal and hemorrhoidal veins, as well as bleeding from the small veins of the stomach, which often occur subclinically (the so-called portal gastropathy), an increase in ascites, centralization of blood circulation with the formation of persistent hypotension. Restructuring of metabolism with the development of hypogonadism, gynecomastia in men, hyperthyroidism. As a rule, progressive cirrhosis of the liver leads to weight loss, dystrophy, and immune disorders. Laboratory studies show low plasma albumin, low prothrombin, high INR, an increase in total bilirubin with normal alkaline phosphatase. Also, for alcoholic blood damage, the development of macrocytic (folic and B12-deficient) anemia is characteristic. An increase in liver transaminases speaks of acute cytolysis, she added.

Of course, the algorithm for diagnosing these conditions in outpatient practice should be quite clear. It is noteworthy that to date, tests have been developed to identify individuals with chronic alcohol intoxication. After all, alcoholic damage to organs, hepatosis, oncological and vascular diseases are the main causes of death in our country. And the early detection of such patients is a priority for the outpatient therapist.

– At present, a huge layer of medical work, medical examination, examination of disability, anti-epidemic measures, drug provision, sanitary and educational work, sanatorium treatment, etc. falls on the shoulders of one therapist. One therapist sees more than 17,000 patients, has only 15 minutes to see her, and must fill out more than 30 paperwork forms in a timely manner. And, unfortunately, it becomes obvious that the real model for identifying socially significant diseases in the framework of mass medical examination does not work, – noted A.L. Vertkin. – This is evidenced by the terrible numbers of mortality from oncological diseases in the hospital, which were simply “missed” in the early stages in the primary care. The polyclinic therapist should always be aware of risk factors and the so-called “red flags” – small signs of cancer. It is necessary to completely change the strategy of outpatient admission and screen socially significant diseases, in particular oncological diseases, every time a patient visits a doctor. At the same time, the patient should prepare for a visit to the clinic and formulate his complaints and questions in advance in order to minimize the time spent on the appointment,” the professor emphasized.