Having your baby cover you in warm, white, pre-loved milk is a pretty common occurrence.
It’s also a fairly normal one.
Most babies in the first 3-4 months of their feeding lives will experience some ‘spitting up’, ‘posseting’, ‘bringing up’ or ‘reflux’ and generally it doesn’t cause anything more than a little mess. Find out more about the ups, downs, ins and outs of Baby Puke..
1. Simple Reflux
(Gastroesophageal Reflux or GER)
Reflux happens when some stomach contents (breast milk or formula) passes from the stomach back up into a baby’s oesophagus (the muscular tube that leads from the mouth to the stomach) and sometimes spills out her mouth. This is common in babies, especially after a feed. Reflux occurs in adults too, but we’re mostly not aware of it. Babies spend a lot of time lying down, have a liquid diet and a short oesophagus. These factors make reflux more noticeable.
Reflux is equally common in formula-fed and breastfed babies, but formula-fed infants have episodes of reflux more often than breastfed babies and they last longer, which is probably due to formula staying in the stomach longer as it takes longer to digest.
Babies have a small oesophagus, which is vulnerable to increased abdominal pressure from crying, straining to poop, or coughing. In most instances, they outgrow the condition between 6 and 12 months of age, after they learn to sit up, begin eating solid foods, and spend more time in an upright position.
If a baby with reflux is otherwise happy and putting on weight well, this is called ‘simple reflux’. It doesn’t hurt the baby and it usually stops by itself as the baby grows. It shouldn’t cause you any troubles other than having a lot more bibs and spew cloths to wash than the other mums in your group!
A Friendly Note Mamas: Baby spew will find its way around bibs and cute neckerchief thingies”¦it gets into all the little chubby rolls and smells quite gross after a while. My summertime chucky baby spent many a comfy shirt free day! Also, you might be the source of the strange odour you are searching for in your home. Check your shoulder and hair. Prime baby up-chuck positions!
2. Reflux Disease
(Gastroesophageal Reflux Disease, GERD)
GERD is a medical problem and requires medical advice as soon as is possible.
The following symptoms may indicate reflux disease:
- Your baby is bringing up a large amount of milk after most feeds.
- She seems to be in pain after feeds (you know the scary pain cry)
- She is fussy and unhappy between feeds.
- She arches her back during and after most feeds (Sandifer’s Syndrome).
- She has problems gaining weight due to difficulty feeding and loss of nutrients from frequent regurgitation
- Ongoing breathing problems which may be the result of acid irritation of the airways and inflammation in the lungs. Constant reflux increases the risk that stomach contents can enter the windpipe through inhalation, and can ultimately cause pneumonia
There is no single test to confirm that a baby has GERD. The diagnosis is often made after an infant has been referred to a paediatric gastroenterologist for severe reflux.
Your baby’s paediatrician may prescribe medications either to reduce reflux episodes by speeding stomach emptying or to protect the lining of the oesophagus from acid damage by suppressing the production of stomach acids.
Antacids, though, are generally not recommended for infants. Some older treatments of this kind are still available straight off the shelf in pharmacies and supermarkets. Don’t kid yourself, you’re not saving time and money this way and you won’t be helping your little one either, do the sensible thing and get your baby to a Doctor!
The Heads Up For Keeping The Milk Down
It often helps to feed a baby with reflux in a more upright position than is usual. Experiment with some different positions! Some mothers sit their baby facing the breast, astride mum’s leg or cuddle them against the side of the sofa, facing the breast. Others have found that instead of cradling their baby around their body, they can cradle the baby down the body. To do this, some mothers feed twin-style (footy hold), while others feed standing up; or you can recline so that your baby lies on top of your body (my fave, Biological Nurturing).
- After a feed, keep baby upright and still for about half an hour, give the burping a miss for now. You might find putting baby on your shoulder keeps him happier and is comfortable for both of you for a longer period of time.
- A wrap or carrier is a great asset when coping with a reflux baby, you’ll have your hands free and bub will be content longer and less likely to chuck.
- Avoid cigarette smoke. For oh so many reasons but in this case though it can boost acid secretion and loosen the spincher muscle function.
- Keep your baby’s nappy loose, don’t change it straight after feeds (prop his top half up a bit if you absolutely have to change a blowout) and avoid tight pants. Go the onesie!
Fine Tune Your Frequency
Some babies do better with smaller, more frequent feeds. This causes less pressure on the sphincter muscle between the oesophagus and the stomach. They may not want both breasts at each feed, or may do better if offered only one side, but more often as they’ll receive more hindmilk and be more satisfied even with the smaller quantity.
However, as reflux episodes are worse in the first hour or so after feeds, some babies may prefer a larger feed less often. These babies may feed from both breasts at each feed, and go longer between feeds.
You really need to experiment to see what your baby prefers, and carefully watch how it affects their reflux afterwards, to find what suits you best.
Typically, these lifestyle and feeding changes used to treat Simple Reflux can help alleviate Reflux Disease also, helping your baby to be more comfortable and settled.
Cow’s milk may cause allergic reactions, such as vomiting or inconsolable crankiness in infants, which can mimic the symptoms of GERD. Although milk allergies are rare, infants with eczema, chronic congestion, or a family history of allergies are more at risk.
To determine the true cause behind baby’s ill health, paediatricians may first ask that formula-fed infants with severe reflux be switched to a protein hydrosolate formula (Neocate) which doesn’t contain cow’s milk, for a week or two to see if symptoms improve. Similarly, the mother of a breastfed infant may be asked to eliminate cow’s milk from her diet for a trial period.
Unlike spitting up or reflux, vomiting can be a symptom of a wide variety of medical problems, ranging from a bacterial or viral infection to a cow’s milk allergy, an intestinal blockage, or a head injury.
Repeated projectile vomiting that begins around 3 to 5 weeks may be due to a thickening of the muscle where the stomach empties into the small intestine, know as pyloric stenosis. This condition requires immediate medical attention.
Also, notify the doctor if your infant:
- vomits after two or three consecutive feedings
- has blood- or yellow-stained vomit
- has a swollen or tender abdomen
- refuses to drink
- is vomiting along with having other symptoms.
Does your baby suffer from reflux?
Reflux Infants Support Association (RISA) Inc. PO Box 1598, Fortitude Valley Qld 4006. Phone: 07 3229 1090. Website: www.reflux.org.au
If you become concerned about any symptoms please seek immediate medical attention we have some hotlines and suggested websites for further information and advice https://www.stayathomemum.com.au/my-kids/babies/important-hotlines-websites/
SAHM takes no responsibility for any illness, injury or death caused by misuse of this information. All information provided is correct at time of publication.