SPIT UPS
Q: My newborn has a lot of spit ups. When should I worry?
Dr.Moore: “Spit ups” or what is sometimes
referred to as “spitting up” is a common concern of new
moms. Most know that spit ups are a normal part of infancy due to swallowed
air with their feedings—the real worry is knowing the difference
between spit ups and vomiting (which is not normal). Spit ups are non-stressful,
passive and often come up with a burp. They can be so silent as to not
notice it even happened. The baby will not usually mind either. It is
caused by weakness and immaturity of the valve between the stomach and
esophagus and most resolve by 12 months.
Vomiting, on the other hand, is forceful (“retching”) and
involves larger amounts of feeding—sometimes all of it. It can
be quite distressing to the baby. Vomiting is abnormal but not necessarily
an emergency. Common causes are stomach viruses and other infections
(earache or upper respiratory), overfeeding and food allergies. The
baby may run fever. Pyloric stenosis, although more rare, deserves mention.
Its incidence is 1 in 300, most likely seen at 2 to 8 weeks of age and
mostly affects male babies. A blockage of the stomach valve causes them
to vomit the entire amount of every feeding within 30 minutes. It is
associated with “projectile vomiting”, and yes, that is
easy to identify.
Spit ups are common and pose no danger to the healthy infant; however,
there are a few things that can be done to reduce their occurrence.
First, give smaller amounts during more frequent feedings. Burp the
baby frequently, between breasts when breastfeeding, and at least every
5 minutes when bottle-feeding. Elevate the head of their crib or place
infant in car seat or stroller after feeds to keep their head higher
than their stomach. Do like mama told us: “rest some after eating”
to let stomachs settle, that is, limit their playtime and activity after
feeds.
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Readers may send questions to this
email address. This column is for informational purposes
only and is not a substitute for professional or medical advice.
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