On a bad day, Lori Kittelberg’s six-month-old Malcolm spits up milk after every feed. “On those days, he’s just full of puke and misery,” says the Vancouver mom. “And I feel like I’m not capable of feeding my child properly.”
Malcolm has gastroesophageal reflux (GER). GER is a common cause of spitting up; in fact, 40 per cent of babies suffer reflux. Reflux occurs when the sphincter between the esophagus and stomach, which stops us having constant heartburn, is not fully developed. The result is breast milk or formula that will dribble from your baby’s mouth onto his onesie (or, more often, your shirt) after a feeding.
Unfortunately, babies with reflux often have associated colic or constipation, which can mean that reflux may be difficult to diagnose. Excessive crying can put more pressure on their tummy and encourage vomiting, says Dr. Keyvan Hadad, a Vancouver-based pediatrician and clinical assistant professor in pediatrics at the University of British Columbia. “It’s hard to know whether the baby’s crying because it has colic or this constant acidic feeling, especially in the esophagus or in the back of the throat,” he says.
While the occasional upchuck isn’t usually cause for alarm, if your child appears to be in discomfort (arching her back, wheezing) or isn’t gaining weight, you should check in with your physician, says Dr. Hadad. The same goes for a baby that is projectile vomiting. While it does happen to babies with reflux from time to time, if your little one re-enacts the puking scene from The Exorcist after every feed and appears very hungry all the time, it can be a sign of pyloric stenosis, an obstruction in the stomach that usually presents itself in the first few months and requires surgery.
If your baby does have reflux, take heart that it improves with age as Junior learns to sit up and his digestive system matures (though some will have symptoms up to their first birthday.) Until then, there are a few things you can try to help prevent spit up.
gravity is your friend
“A baby is less likely to spit up if he is kept upright for 30 minutes after a feed,” says Dr. Hadad. Hold your baby in a vertical position in your arms or a baby carrier.
thicken up baby’s milk or formula with rice cereal
“Many parents who have tried this have found that it works for them. It helps the food stick to the stomach,” Dr. Hadad says. “But consult with your doctor before introducing solids before the recommended six months.”
a last resort
If your baby’s symptoms are significant, your pediatrician can prescribe medications that will either decrease stomach acid production or help empty your baby’s tummy. While not a cure, they can help until your child outgrows her reflux.
In fact, medication ended up being the only solution for Malcolm. “He still spits up,” says Kittelberg, “but he is gaining weight now and never spits up through his nose anymore, so he’s in less pain. Which makes both of us a lot happier.”
Writer Lola Augustine Brown says it seems like spit happens with her six-month-old daughter when she is all dressed up to go out.
Keep reading for tips and tricks on how to remove those tough spit up stains
Illustration by Andrea Bowers
