When babies are born, they have not fully developed the digestive system, therefore, episodes of regurgitation appear. Find out more about how it happens and when you should be concerned.
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It is normal for babies to spit up their milk during the first months of life; however, most parents may find this issue a bit worrisome. This happens because, sometimes, regurgitation can bring some complications.
In relation to this, a study by the Hospital Universitario de Canarias states that this normally occurs sporadically in any healthy individual, but it happens in a significant percentage in babies. Thus, in infants up to 4 months it appears in 75% of them, and up to 7 months in 15%.
When is it normal for babies to spit up their milk?
Regurgitation is a normal process in newborns and young babies.
It is normal for babies to spit up after eating or even while eating . In this sense, it is something that can happen both with breast milk and with formulas.
In general, it can be considered normal when they regurgitate, but they feel comfortable and this does not cause respiratory problems, does not hinder weight gain and allows optimal growth. It should be noted this problem resolves spontaneously between 12 and 18 months of age .
Why do babies spit up?
As expressed in the study Physiology of nutritional sucking in newborns and infants , the swallowing process, understood as the passage of food (in this case, milk) through the esophagus until it reaches the stomach, is altered because in the Newborns the digestive system is still developing.
The esophagus is connected to the stomach through a series of muscles that relax and contract; their scientific name is «lower esophageal sphincter». This is opened so that the food descends and then it is closed again to prevent the food from returning to the mouth.
In newborns and even young babies, this mechanism is not mature. Consequently, milk reflux or regurgitation may appear.
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What is the difference between spitting up and vomiting?
While regurgitation does not cause discomfort, vomiting does; in this case, medical consultation is recommended.
It is important to learn to tell the difference between spitting up and vomiting, as it can sometimes be difficult to determine which situation is occurring. Fortunately, there are several distinguishing factors that can help tell the difference between the two.
Let’s see what they are below:
- Spitting up usually comes on quickly and is silent. Babies who spit up are happy before, during, and after this event.
- Spit-up in breastfed and formula-fed babies generally looks similar to what they just consumed.
- It occurs less frequently as the child approaches the yearand, from then on, it happens only on specific occasions.
- On the other hand, the vomiting is usually a symptom of a larger diseaseand not a disease in itself. Therefore, it can be accompanied by episodes of fever or diarrhea.
- Vomiting usually comes on and ends quickly, but often involves retching and appears greenishdue to the presence of bile.
When should I be concerned?
While it’s normal for babies to spit up their milk, there is a condition called gastroesophageal reflux disease (GERD) that can lead to certain complications. Fortunately, there are signs that may indicate that you are in the presence of it, so knowing them is necessary to prevent problems
In relation to this, the study Management of the most frequent functional digestive disorders in healthy infants suggests that you should be concerned when the following symptoms appear:
- There is weight loss.
- The baby shows restlessness and irritation during the day due to the discomfort caused by the reflux.
- The liquids that come out do not resemble “curdled milk”and vary in color (green, yellow or brown) and textures.
- The baby spits up an excessive amount of milk.
- Regurgitation takes effort.
- The child is tired and slow.
- The feeding is rejected.
- Appear respiratory complicationssuch as sleep apnea.
Keep in mind that if you have any doubts, it is advisable to consult a professional specialized in the subject.
Other causes of babies spitting up milk
The baby can regurgitate from different situations such as air intake or overstimulation.
In addition to the lack of development of the digestive system of babies, there are other reasons that cause regurgitation. These include the following:
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Eat excessively
This is a common cause. Since babies have small stomachs, if they drink a quantity of milk that exceeds this capacity, in addition to being full, they will spit up.
Sensitivity or allergies to certain foods that the mother eats
The allergens contained in some foods, such as peanuts, almonds, wheat, or others, can transfer into breast milk and cause the baby to spit up.
Overstimulation
Overstimulation can be caused by excessive rebounding, by placing the baby on his stomach after eating or by placing him with an excessive forward lean, among other possible causes.
Aerophagia or air intake during feeding
When the baby feeds quickly, he may also swallow air along with the milk. In fact, this is more likely to happen when the mother produces a high milk supply or has a strong output or “milk ejection” .
Pyloric stenosis
A less common cause than the previous ones may be pyloric stenosis . This condition blocks the passage of food to the small intestine because the muscular valve (pylorus) that connects the stomach and the small intestine has become narrowed. Consequently, the stomach contents return to the esophagus and cause regurgitation.
This can also trigger forceful vomiting, dehydration, and weight loss. For this reason, once diagnosed, this problem must be corrected urgently with surgery.
Tips to avoid reflux
There are a number of tips to consider when ruling out gastroesophageal reflux disease and concluding that the baby only has spit-up. In this way, it will be avoided that they are excessive or at inappropriate times.
Let’s see then, what are the aspects to consider:
- First of all, don’t force your baby to eat if he doesn’t show hunger. This applies to children who are breast or bottle fed , even more so if they have frequent spit-up.
- In case of giving a bottle, avoid that the formula is concentrated or has an excess of water.
- Ideally, you should feed your baby when he is not too hungry, as if this happens, he is likely to suck strongly and swallow air with that.
- Try to feed the child in an environment that is calm and relaxed, without rushing. In this way, you will avoid discomfort or crying that will cause him to swallow air.
- When he finishes eating, that is, while the process of digestion begins, let the child rest. Don’t start to move it or jump and bounce; on the contrary, let it be calm so that it regurgitates calmly.
- Adopt a simple postural measure for the baby, this means that you should not lay him down completely, but let him be semi-bent forward on your lap or in a chair. This will help the stomach contents stay in place.
It is normal for babies to spit up their milk
Avoid worrying about a natural and normal process in the vast majority of babies. Of course, you should go to the doctor if you notice that the baby does not spit up “happy” , has weight loss, feels tired, if vomiting appears, or any of the above mentioned situations.
Remember that you can always consult a professional to indicate what would be a normal situation and which would not. No one better than your child’s pediatrician to provide timely diagnosis and advice.
