breastfeeding, chestfeeding, reflux, supplementing

Reflux…regurgitation…spit up

Whatever you call it, it’s pretty common for newborns. When our babies spit up often or forcefully it can be worrisome. We wonder if we ate something which is upsetting baby. Are we burping the right way and long enough? Should we change something about how we are feeding baby?

Let’s set the record straight with some facts about infant reflux:

Reflux is common and not a problem for most newborns.

  • About half of babies aged 2 weeks to 4 months have reflux (which just means they spit up once or more times per day). 
  • Most babies outgrow reflux by 6 months. 
  • Reflux is more common if your baby was born prematurely, has Down syndrome, or other conditions which affect neuromuscular function.
  • Symptoms peak at 4 months and gradually get better.
  • Very few infants have GERD (uncomfortable or painful reflux with additional symptoms like weight gain difficulty, crying, etc)
Newborn looking into the camera, blowing bubbles with their tongue sticking out.

Okay, so what causes it?

Overfeeding is one of the most common causes. Many parents are told to feed their babies every 3 hours which is less often than what most babies would like. Spacing out feeds means that baby may be taking larger volumes than their stomach can comfortably hold.

Laying baby down after a feed puts pressure on the stomach. Because the sphincter (a ring of muscle at the top of the stomach) is immature laying baby down after feeding or putting pressure on their belly can cause spit up.

Diet While most babies are not sensitive to anything in the parent’s milk, they can have spit up more frequently with formula feeding. Using the right formula which baby can digest more easily helps reduce the frequency of reflux.

Crying We all know that babies cry and sometimes it’s unavoidable like when you are driving and can’t comfort baby. And sometimes you can comfort baby but it seems like nothing is working…it happens to us all. Excessive crying can make reflux worse so talk with your provider to get to cause of baby’s discomfort.

Sometimes parents think baby is crying because of the spit up but it’s usually the other way around. Unlike adults, baby has a very acid in their stomach so it doesn’t burn or hurt when they spit up most of the time.

It’s developmentally normal. Spitting up that doesn’t bother baby or cause any problems with growth and development isn’t something to worry about medically.

What can we do to reduce it?

•Get a great latch! Have your baby’s latch and suck assessed by an experienced Lactation Consultant.

•Keep baby upright without abdominal pressure for 30 minutes after feeds. Babywearing works great!

•If you need to lay baby down and you can keep an eye on them try laying them on their left side. If you are doing tummy time, use a prop like a nursing pillow under their chest to keep pressure off the belly

Frequent burping, after each breast

•Frequent, unscheduled feeds.  Responsive feeding

•If using formula, use a hydrolyzed whey formula

•If using a bottle, use paced feeding techniques

As always, check in with your Lactation Consultant for tips and tricks! We are here to help!

❤ Megan Dunn, IBCLC