Why Does My Baby Spit Up After Burping? Understanding Breastfeeding Challenges
Why does my baby spit up after burping. How can I prevent my baby from spitting up. What’s the difference between spitting up and vomiting. How can I stop my baby from gagging during feedings. What should I do if my baby bites while breastfeeding.
Understanding Baby Spit-Up: Causes and Concerns
Spitting up is a common occurrence in infants, especially after feedings or during burping. It happens because babies’ digestive systems are still developing and learning to process food efficiently. While it may seem alarming to new parents, spitting up is usually harmless and doesn’t cause discomfort to the baby.
Is spitting up after burping normal? Yes, it’s perfectly normal for babies to spit up after burping or during feedings. This often happens because:
- Their stomachs are small and can easily become overfilled
- The muscle between the esophagus and stomach (lower esophageal sphincter) is still maturing
- Babies swallow air while feeding, which can lead to spit-up when released
Should you be concerned about your baby spitting up? Generally, there’s no need to worry as long as your baby is:
- Gaining weight appropriately
- Not showing signs of discomfort
- Producing wet diapers regularly
However, it’s essential to differentiate between normal spitting up and more serious issues like vomiting.
Spitting Up vs. Vomiting: Recognizing the Difference
Understanding the difference between spitting up and vomiting is crucial for parents. While both involve the expulsion of stomach contents, they differ in several key aspects:
Spitting Up:
- Gentle flow of fluids from the mouth
- Often occurs without much force
- Baby usually doesn’t seem upset or bothered
- Small amounts of milk or formula are expelled
Vomiting:
- Forceful projection of stomach contents
- Often accompanied by distress or crying
- Larger amounts of fluid are expelled
- May be a sign of illness or other medical issues
When should you contact a doctor about your baby’s spit-up or vomiting? It’s advisable to seek medical attention if:
- Your baby is vomiting forcefully or frequently
- There are signs of dehydration (e.g., fewer wet diapers, sunken fontanelle)
- Your baby isn’t gaining weight or is losing weight
- The vomit contains blood or looks like coffee grounds
- Your baby seems to be in pain or discomfort
Effective Strategies to Reduce Baby Spit-Up
While some spit-up is normal, there are several strategies parents can employ to help minimize its occurrence:
- Burp your baby frequently during and after feedings
- Feed smaller amounts more often, rather than large meals
- Keep your baby upright for at least 30 minutes after feeding
- Avoid vigorous play or movement immediately after meals
- Ensure proper positioning during feeding, with the baby’s head higher than their feet
- Consider elevating the head of your baby’s crib or bassinet slightly (consult with your pediatrician first)
Are there any specific techniques for bottle-fed babies to reduce spit-up? Yes, here are some additional tips for bottle-feeding:
- Use slow-flow nipples to prevent overfeeding
- Burp your baby after every 1-2 ounces consumed
- Avoid feeding your baby while they’re lying down
- Practice paced bottle-feeding to mimic breastfeeding patterns
Dealing with Gagging During Breastfeeding
Gagging during breastfeeding can be distressing for both mother and baby. It often occurs due to a forceful letdown of milk or an oversupply. Here are some strategies to help manage this issue:
Positioning Techniques:
- Try nursing in a more upright position
- Use a side-lying position to slow milk flow
- Experiment with different holds to find what works best
Managing Milk Supply:
- Express a small amount of milk before feeding to reduce initial flow
- Feed more frequently to prevent engorgement
- Consider using breast compression to control milk flow
What should you do if your baby gags or chokes during a feeding? If this happens, quickly sit your baby up in a seated position and gently pat their back. This can help them calm down and clear their airway before continuing the feeding.
Addressing Biting During Breastfeeding
Biting during breastfeeding can be a challenging and painful experience for mothers. It often occurs when babies are teething or experimenting with their new teeth. Here are some strategies to discourage biting:
- Pay attention to your baby’s cues and end the feeding when they seem satisfied
- Immediately remove your baby from the breast if they bite
- Use a firm but calm voice to say “no” or “no biting”
- Offer a teething toy or cold washcloth before feeding to soothe sore gums
- Try different breastfeeding positions that make it harder for the baby to bite
Can biting be a sign that my baby is ready to wean? Not necessarily. Biting is often a phase that babies go through and doesn’t always indicate readiness to wean. However, if biting persists despite your efforts to stop it, you may want to consult with a lactation consultant for additional guidance.
The Role of Proper Latch in Preventing Breastfeeding Issues
A proper latch is crucial for successful breastfeeding and can help prevent many common issues, including spit-up, gagging, and nipple pain. Here’s what you need to know about achieving a good latch:
Signs of a Good Latch:
- Baby’s mouth covers a large portion of the areola, not just the nipple
- Baby’s lips are flanged outward, not tucked in
- You can hear or see your baby swallowing
- Breastfeeding is comfortable for you, without pain or pinching
Tips for Improving Latch:
- Ensure your baby’s tummy is facing your body
- Support your breast with your hand, keeping fingers away from the areola
- Tickle your baby’s upper lip with your nipple to encourage a wide mouth opening
- Bring your baby to your breast, not your breast to the baby
How can you tell if your baby isn’t latched properly? Signs of a poor latch include nipple pain, clicking sounds during feeding, and your baby seeming frustrated or unsatisfied after feedings. If you’re struggling with latch issues, consider seeking help from a lactation consultant.
Understanding and Managing Oversupply
Breast milk oversupply can contribute to issues like forceful letdown, gagging, and excessive spit-up. While having plenty of milk might seem ideal, it can actually lead to various breastfeeding challenges. Here’s what you need to know about managing oversupply:
Signs of Oversupply:
- Engorgement that doesn’t improve after feeding
- Baby choking or gulping during letdown
- Excessive leaking between feedings
- Baby gaining weight rapidly
- Recurrent plugged ducts or mastitis
Strategies to Manage Oversupply:
- Try block feeding: Feed from one breast for a set period (e.g., 3-4 hours) before switching sides
- Express a small amount of milk before feeding to soften the breast and slow initial flow
- Use laid-back breastfeeding positions to let gravity help slow milk flow
- Consider using cabbage leaves or cold compresses between feedings to reduce production
- Avoid pumping unless absolutely necessary, as this can stimulate more milk production
Can oversupply resolve on its own? In many cases, oversupply will regulate naturally over time as your body adjusts to your baby’s needs. However, if oversupply is causing significant issues, it’s best to work with a lactation consultant to develop a personalized management plan.
The Impact of Diet on Breastfeeding and Spit-Up
While most foods are safe to consume while breastfeeding, some mothers find that certain foods in their diet may affect their baby’s digestion or increase spit-up. Here’s what you should know about diet and breastfeeding:
Common Foods That May Affect Babies:
- Dairy products
- Caffeine
- Spicy foods
- Garlic
- Onions
- Cruciferous vegetables (e.g., broccoli, cauliflower)
Dietary Considerations:
- Keep a food diary to track potential correlations between your diet and your baby’s symptoms
- Introduce new foods one at a time to easily identify any that cause issues
- Stay hydrated by drinking plenty of water
- Maintain a balanced diet rich in fruits, vegetables, whole grains, and lean proteins
- Consider consulting with a nutritionist or lactation consultant for personalized advice
Should you eliminate certain foods from your diet while breastfeeding? It’s generally not necessary to restrict your diet unless you notice a clear pattern of your baby reacting to specific foods. If you suspect a food intolerance or allergy, consult with your pediatrician before making significant dietary changes.
When to Seek Professional Help for Breastfeeding Challenges
While many breastfeeding issues can be resolved with patience and proper techniques, there are times when professional help is necessary. Here are some situations where you should consider seeking assistance from a lactation consultant or healthcare provider:
Signs You May Need Professional Help:
- Persistent nipple pain or damage
- Difficulty achieving or maintaining a proper latch
- Concerns about milk supply (too little or too much)
- Baby not gaining weight adequately
- Recurring breast infections or mastitis
- Persistent gagging or choking during feedings
- Emotional distress or anxiety related to breastfeeding
Benefits of Professional Support:
- Personalized assessment of your breastfeeding technique
- Expert advice on positioning and latch
- Strategies for managing supply issues
- Guidance on pumping and milk storage
- Emotional support and reassurance
- Referrals to other specialists if needed
Where can you find breastfeeding support? Many hospitals and birthing centers offer lactation services. You can also seek help from:
- La Leche League International
- Certified Lactation Consultants (IBCLCs)
- Local breastfeeding support groups
- Your pediatrician or obstetrician
Remember, seeking help early can prevent small issues from becoming major obstacles in your breastfeeding journey.
Breastfeeding, while natural, is a learned skill for both mother and baby. It’s normal to encounter challenges along the way, including issues like spit-up, gagging, and biting. By understanding these common problems and implementing appropriate strategies, most mothers can overcome these hurdles and enjoy a successful breastfeeding experience.
Remember that every mother-baby pair is unique, and what works for one may not work for another. Don’t hesitate to seek professional help if you’re struggling with breastfeeding issues. With patience, persistence, and support, you can navigate these challenges and provide your baby with the numerous benefits of breastfeeding.
Breastfeeding FAQs: Spitting Up, Gagging, and Biting (for Parents)
en español: Preguntas más frecuentes sobre la lactancia materna: regurgitación, arcadas y mordidas
Medically reviewed by: Jamila H. Richardson, BSN, RN, IBCLC
Breastfeeding is natural, but it takes practice to get it right. Here’s what you need to know about spitting up, gagging, and other concerns during breastfeeding.
Is it Normal for My Baby to Spit Up After Feedings?
Sometimes, babies spit up when they eat too much, or when they burp or drool. Many infants will spit up a little after some — or even all — feedings or during burping because their digestive systems are immature. That’s perfectly normal.
As long as your baby is growing and gaining weight and doesn’t seem uncomfortable with the spitting up, it’s OK. The amount of spit-up often looks like more than it actually is. But spitting up isn’t the same as forcefully vomiting all or most of a feeding.
What’s the Difference Between Spitting Up and Vomiting?
Vomiting is a forceful projection of stomach fluids. Spitting up is a more gentle “flow” of fluids that come up. Babies don’t usually react to spitting up, but a vomiting baby will usually look upset or cry.
If you’re concerned that your baby is vomiting, call your doctor. In rare cases, there may be an allergy, digestive problem, or other problem that needs medical care. It helps to keep track of how often and how much your baby is vomiting or spitting up.
How Can I Keep My Baby From Spitting Up?
If the doctor says your baby’s spitting up is normal, here are some things you can do to help lessen it:
- Burp your baby after each feed from each breast. Sometimes giving smaller feeds more often can help, rather than giving larger-volume feeds.
- Keep your baby upright after feedings for at least 30 minutes. Holding your baby is best, since the way your baby sits in an infant seat may actually make spitting up more likely.
- Don’t jiggle, bounce, or actively play with your baby right after feedings.
- Keep your baby’s head above the feet while feeding. Don’t hold your baby in a dipped-down position when feeding.
- Raise the head of your baby’s crib or bassinet. Roll up a few small hand towels or receiving blankets (or you can buy special wedges) to place under — not on top of — the mattress. Never use a pillow under your baby’s head. Make sure the mattress doesn’t fold in the middle, and that the incline is gentle enough that your baby doesn’t slide down.
If your baby also gets bottles of breast milk or infant formula supplements:
- Burp after your baby drinks 1–2 ounces from a bottle.
- Don’t give the bottle while your little one is lying down.
- Make sure the hole in the nipple is the right size and/or flow for your baby. For example, fast-flow nipples may cause babies to gag or may give them more milk than they can handle at once. Many breastfed babies do well with the slow-flow nipple until they are 3 months old, or even older.
Many babies outgrow spitting up by the time they’re sitting up.
How Can I Keep My Baby From Gagging?
Sometimes the force of your milk (especially when it “lets down”) is so strong that it can cause your baby to gag and pull off of the breast. If this happens during feeding:
- Try nursing your baby in a more upright position (head above the breast). This may ease the force of the milk.
- Nurse in a side-lying position, which also might help slow the flow of milk.
- Make sure your breasts are not engorged or over-full. Nursing every 2–3 hours can help prevent engorgement. If your breasts are too full and you’re concerned about a forceful letdown, express or pump a little bit of milk a few minutes before feeding time to avoid a strong letdown.
If your baby is pulling off and gagging or coughing during feeding, sit your baby up in a seated burp position. Gently pat the back to help your baby calm down before continuing feeding. If you’ve tried the steps above and this continues to happen, talk to your doctor or lactation consultant.
If your baby sometimes gags or chokes while taking a bottle of breast milk:
- Try a different nipple with a slower flow.
- Practice “paced” bottle feeding. This is where you slow down the milk flow from the bottle by holding it at less of an angle and allowing your baby to pause for breaks.
My Baby Bites During Breastfeeding. What Can I Do?
Babies will often play with their mothers’ nipples with their gums, not meaning to cause any harm. But once they start teething, a baby might bite down, not knowing this is hurting mom.
Sometimes you can tell when your baby’s about ready to bite down — usually when satisfied and starting to pull away from the breast. When you sense that your baby is finished feeding and may be bored or feeling playful, end the feeding. Break the suction by slipping your finger into the corner of your baby’s mouth.
If your baby is already biting down, pull your baby closer to you to make it more difficult to pull off easily. Then, break the suction. React calmly without raising your voice.
Here are more ways to make baby less likely to bite:
- Before a feed, give your baby something to chew on. Make sure it’s big enough that it can’t be swallowed or choked on and that it can’t break into small pieces. A wet washcloth placed in the freezer for 30 minutes makes a handy teething toy. Be sure to take it out of the freezer before it becomes rock hard — you don’t want to bruise those already swollen gums. Wash after each use.
- Say, “Mommy is not for biting. You can bite this.” Then, offer your little one a teething toy or ring.
- Praise your baby — with a hug, kiss, or cuddle — whenever they nurse without biting or trying to bite.
Usually this is enough to stop the biting, but if your baby continues, talk to your doctor or lactation consultant for advice.
Medically reviewed by: Jamila H. Richardson, BSN, RN, IBCLC
Date reviewed: January 2021
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Why Babies Spit Up – HealthyChildren.org
By: Alejandro Velez, MD, FAAP & Christine Waasdorp Hurtado, MD, FAAP
All babies spit up. Some babies spit up more than others, or at certain times.
Typically, babies spit up after they gulp down some air with breastmilk or formula. A baby’s stomach is small and can’t hold a lot, after all. Milk and air can fill it up quickly.
With a full stomach, any change in position such as bouncing or sitting up can force the flap between the esophagus (food pipe) and stomach to open. And when that flap (the esophageal sphincter) opens, that’s when some of what your baby just ate can make a return appearance.
So, what can you do―if anything―to reduce the amount of your baby’s spit up? How do you know if your baby’s symptoms are part of a larger problem? Read on to learn more.
Common concerns parents have about spit up
My baby spits up a little after most feedings.
Possible cause:
Gastroesophageal reflux (normal if mild)
Action to take: None. The spitting up will grow less frequent and stop as your baby’s muscles mature—especially that flap we talked about earlier. It often just takes time.
My baby gulps their feedings and seems to have a lot of gas.
Possible cause: Aerophagia (swallowing more air than usual)
Action to take: Make sure your baby is positioned properly during feeds. Also be sure to burp the baby during and after feeds. Consider trying a different bottle to decrease your baby’s ability to suck in air.
My baby spits up when you bounce them or play with them after meals.
My baby’s spitting up has changed to vomiting with muscle contractions that occur after every feeding. The vomit shoots out with force.
I found blood in my baby’s spit-up or vomit.
Possible cause: Swelling of the esophagus or stomach (esophagitis or gastritis), or another health problem that requires diagnosis and treatment.
Action to take: Call you pediatrician right away so they can examine your baby.
Remedies for spitty babies
Regardless of whether or not your baby’s spit up warrants watchful waiting or medical intervention, there are some simple feeding suggestions that can help you deal with the situation at hand.
5 tips to reduce your baby’s spit up
Avoid overfeeding. Like a gas tank, fill baby’s stomach it too full (or too fast) and it’s going to spurt right back out at you. To help reduce the likelihood of overfeeding, feed your baby smaller amounts more frequently.
Burp your baby more frequently. Extra gas in your baby’s stomach has a way of stirring up trouble. As gas bubbles escape, they have an annoying tendency to bring the rest of the stomach’s contents up with them. To minimize the chances of this happening, burp not only after, but also during meals.
Limit active play after meals and hold your baby upright. Pressing on a baby’s belly right after eating can up the odds that anything in their stomach will be forced into action. While
tummy time is important for babies, postponing it for a while after meals can serve as an easy and effective avoidance technique.
Consider the formula. If your baby is
formula feeding, there’s a possibility that their formula could be contributing to their spitting up. While some babies simply seem to fare better with one formula over another without having a true
allergy or intolerance, an estimated 5% of babies are genuinely unable to handle the proteins found in milk or soy formula―a condition called Cow Milk Protein Intolerance/Allery (CMPI and CMPA). In either case, spitting up may serve as one of several cues your baby may give you that it’s time to discuss alternative formulas with your pediatrician. If your baby does have a true intolerance, a 1- or 2-week trial of hypoallergenic (hydrolyzed) formula designed to be better tolerated might be recommended by your baby’s provider.
If breastfeeding, consider your diet. Cow’s milk and soy in your diet can worsen spit up in infants with Cow Milk Protein Intolerance/Allergy (CMPI and CMPA). Removing these proteins can help to reduce or eliminate spit up.
Try a little oatmeal. Giving babies cereal before 6 months is generally not recommended—with one possible exception. Babies and children with dysphagia or reflux, for example, may need their food to be thicker in order to swallow safely or reduce reflux. In response to concerns over
arsenic in rice, the American Academy of Pediatrics (AAP) now recommends parents of children with these conditions use of oatmeal instead of rice cereal.
See
Oatmeal: The Safer Alternative for Infants & Children Who Need Thicker Food for more information.
Vomit vs. spit up: what’s the difference?
There is a big difference between vomiting and spitting up:
Vomiting is the forceful throwing up of stomach contents through the mouth. This typically involves using the abdominal muscles and is often uncomfortable, leaving you with a crying child.
Spitting up is the easy flow of stomach contents out of the mouth, frequently with a burp. Spitting up doesn’t involve forceful muscle contractions, brings up only small amounts of milk, and doesn’t distress your baby or make them uncomfortable.
What causes vomiting?
Vomiting occurs when the abdominal muscles and diaphragm contract vigorously while the stomach is relaxed. This reflex action is triggered by the “vomiting center” in the brain after it has been stimulated by:
Nerves from the stomach and intestine when the gastrointestinal tract is either irritated or swollen by an infection or blockage (as in the stomach bug)
Chemicals in the blood such as drugs
Psychological stimuli from disturbing sights or smells
Stimuli from the middle ear (as in vomiting caused by motion sickness)
Always contact your pediatrician if your baby vomits forcefully after every feeding or if there is ever blood in your baby’s vomit.
Remember
The best way to reduce spit up is to feed your baby before they get very hungry. Gently burp your baby when they take breaks during feedings. Limit active play after meals and hold your baby in an upright position for at least 20 minutes. Always closely supervise your baby during this time.
More information
-
How to Keep Your Sleeping Baby Safe: AAP Policy Explained -
Gastroesophageal Reflux & Gastroesophageal Reflux Disease: Parent FAQs -
How Much and How Often Should Your Baby Eat
About Dr. Velez
|
About Dr. Waasdorp
|
- Last Updated
- 10/5/2022
- Source
- American Academy of Pediatrics Section on Gastroenterology, Hepatology and Nutrition (Copyright © 2022)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
Reflux and belching | Nestlé Health Science
- Nestlé Health Science
- health care
- Reflux and belching
Regurgitation is the flow of milk from the stomach into the mouth, which is often ‘spit out’ by the baby. Spitting up is not the same as vomiting , which forces milk out of the baby’s stomach. Symptoms of infantile reflux and regurgitation are typical and usually subside by 12 months of age.
Why is my baby refluxing or spitting up?
Occasionally, infantile reflux and regurgitation can be caused by a food allergy , such as cow’s milk protein allergy (CMP) . An immature gastrointestinal tract, lying down most of the time, and eating almost entirely liquid food can also lead to infantile reflux and regurgitation.
Can my child be allergic to cow’s milk protein?
Infantile reflux and regurgitation are typical symptoms in infants with CMPA.
Children with CMPA usually have more than one symptom, and these symptoms can be very different from each other.
If you think your child has symptoms of reflux or regurgitation , it could be CMPA.
You may have noticed other symptoms (besides reflux or regurgitation) that may affect other parts of your baby’s body.
For a simple and easy way to check for typical symptoms associated with CMPA, you can use our Symptom Checker.
Symptom Analysis
This will allow you to select all cow’s milk related symptoms your baby may have. You can then discuss this with your doctor.
In any case, if you have any doubts or concerns about the health of your child, you should consult with a healthcare professional as soon as possible
Other symptoms of cow’s milk protein allergy
ANAPHILACTIC SHOCK
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CRYING AND COLIC
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CONSTIPATION
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COUGH
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DIARRHEA
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ECZEMA
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GROWTH DISTURBANCE
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urticaria
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REFUSAL TO FOOD
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RASH
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Runny nose and sneezing
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EDITEC
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VOMITING
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HRIP
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IMPORTANT NOTE: : It is possible to continue breastfeeding if the infant is allergic to cow’s milk protein. To do this, the mother needs a special diet with the exclusion of all sources of cow’s milk protein. Only if these measures do not bring the desired effect, the doctor recommends the use of a special therapeutic mixture intended for children from 0 to 1 year old.
It is important to follow the correct methods of preparing the mixture: using boiled water, sterilized bottles and following the rules for diluting the mixture. Medicinal mixtures intended for diet therapy of CMPA should be used under the supervision of a physician.
Regurgitation in newborns – when to see a doctor?
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