Gone are the days of clean shirts and sofas. Holding your baby comes with an obligatory warning, “You might end up wearing his milk.” Your bag now contains an assortment of extra burp cloths, blankets and outfits for baby and you. You’re not quite sure how to get that smell out of your couch…or your hair. Keep reading to find out How to Find the Cause of Baby Spit up.. 

When is Spit-up Normal?

All babies have gone through a rapid period of growth and development that prepares them for life outside of the womb. After they make their grand debut they continue to rapidly grow and develop. Most infants double their birth weight at six months! When your baby turns 3, his brain will be 80% of it’s adult size! The truth is, all of your baby’s bodily systems are still developing and fine-tuning. It’s incredible to watch it happen before your eyes. 

This comes into play when talking about spit-up. It drives parents crazy! But is it a problem? Your baby will be born with a GI system, however, it is immature. Milk is the optimal food source for babies for many reasons, and one of them is because of how easy it is to digest for their brand new tummies. It is easy to digest, but because they’re on liquid only diet, that makes spitting up happen easier.

 In some cases, reflux can be caused by an allergy to what mommy is eating or an ingredient in formula. If you think this may be the case, it would be a good idea to reach out to a health professional or dietician for guidance on this issue. However, in most cases, spit-up is simply due to an immature little muscle called the lower esophageal sphincter. This is a circular muscle that sits between the esophagus and the stomach. Normally, when it contracts it blocks food (or in this case milk and gastric contents) from coming back up into the throat. About half of all infants have poor muscle tone, or strength, in this muscle causing their meal to come back up for an encore. Curdled milk anyone? 

Call your pediatrician if you notice blood in the stool. If you little one has, indeed, developed an allergy this along with the spit-up could be a warning sign. 

The Bottom Line 

If your baby is happily spit-prone and it’s more of an annoyance for you than for him it’s simply your job do what you can to prevent it and wait it out. He’ll grow out of this phase only to drive you mad in some new terrible way in the next. Joking. A little. 

Ways to Help With Normal Infant Spit-Up

• Burp, baby, burp! When bottle-feeding, stop to burp every 5 minutes or so and at the end of the feeding. When breastfeeding, burp between switching sides and when finished.   
• When babies have an air bubble in their tummy after a big feeding sometimes milk can be forced out along with the air bubble if you don’t burp them after. When the air bubble becomes trapped, this can cause baby to become fussy and uncomfortable after a feeding as well. 
• If bottle feeding, use a bottle with an air vent to prevent baby from swallowing as much air.
• Feed baby in an upright position and if bottle feeding use the paced bottle feeding technique.
• Avoid over-feeding your baby. Just because your baby is crying doesn’t always mean it’s because they’re hungry! Do not feed your baby again if they spit up right after a feed. If it hasn’t been long since the last feed, look for other causes of discomfort like a dirty diaper.
• Keep baby propped up or held upright for 30 minutes after a feeding and avoid jostling them.

When Isn’t Baby Spit-Up Normal?

If you’re obsessively looking for answers on Dr. Google for your inconsolable, hysterical child I’ve been there Mama. Dealing with GERD in your new baby can truly rock your world. Please reach out to me for support. Even if you just need someone to listen to how you’re feeling. Anxiety is very common in parents with a child exhibiting the symptoms of GERD. And because I have personally been through this, I would absolutely love to support you through this time. And, thank heavens, it IS temporary.  

Poor growth or weight gain combined with extreme irritability during or after feedings with or without feeding refusal can be signs of gastroesophageal reflux disease or GERD. Other symptoms that are associated with GERD are noisy breathing sounds and nasal congestion. They may arch their back during feedings. Some babies will forcefully vomit a large portion of their feeding, but some, have what is called “silent reflux” where the spit-up doesn’t come out. It just sits there in their throat and causes pain from the acidic stomach contents. 

Causes of GERD

Often times, The cause of GERD is the same as that of spit-up in infants – an immature lower esophageal sphincter (LES). It is something infants simply outgrow and the tips mentioned above for spit-up can help. Sometimes, it can be aggravated by a cow’s milk allergy or an intolerance to the high amounts of iron in US made formula. 

Risk Factors for GERD

• Prematurity- your baby’s LES is even more immature than a term infant.
• Neurological diseases affecting muscle tone
• Hiatal hernia
• Previous esophageal surgery

Should We Try a Reflux Medication?

Some pediatricians may consider starting baby on a reflux medication, however, the efficacy of these medications has been called into question in scientific studies of infants with GERD. Many studies have shown that the treatment of reflux with medications show no difference between the medicated group and the placebo group. This combined with the risks associated with giving them has lead many providers to stop prescribing these drugs. 

Babies are frequently misdiagnosed with GERD when really the cause of a fussy baby is something else like a sleep or feeding issue. If you’ve seen your doctor and they prescribed an acid blocker for your baby and it hasn’t helped in the slightest it’s time to consider other causes of fussiness. Reach out to a for help if you need to!