Baby reflux

- Julie Matheney

My baby is spitting up a lot. Is that normal?

Reflux occurs when milk flows back up (refluxes) from the stomach, causing baby to spit up. In babies, the ring of muscle between the esophagus and the stomach, the lower esophageal sphincter (LES), is not fully mature, so stomach contents can flow backward. With time, the LES opens only when baby swallows, keeping stomach contents in the stomach. It is rarely serious and becomes less common as baby‘s system matures.

Baby spit up for lots of reasons:

  • Baby is not be able to swallow quickly enough when milk ejects forcefully during let down, resulting in swallowing extra air.
  • Mom has an oversupply of milk and baby takes too much too fast for the stomach to handle.
  • Tongue or lip tie causing baby to swallow more air
    Less common reasons:
  • Immature muscle control
  • Allergy to foods and/or dietary supplements mother may consume
  • Disease

Spitting up occurs in healthy babes multiple times a day. As long as baby is healthy, happy and growing well, spit up is not a concern.
See your baby’s doctor if your baby:

  • Isn’t gaining weight
  • Refuses to feed from breast or bottle
  • Consistent, forceful spitting up (projectile vomiting)
  • Green or yellow fluid spit up
  • Spitting up blood or material that looks like coffee grounds
  • Blood in baby’s poop
  • Difficulty breathing or a chronic cough

Help reduce reflux:
🍽Feeding positions: baby’s head higher than their tummy, such as a laid-back position or koala hold. Avoid positions that have baby bending at the waist, putting more pressure on their belly. The mama in this picture is practicing an upright, side lying to help reduce reflux.

  • Keep baby upright 15-20 minutes after feedings to aid digestion.
  • Shorter, more frequent feedings, to reduce the volume in their tummy at any given time and to keep your breasts filling with a higher water content milk
  • Try nursing with only one breast each feeding to avoid two strong milk ejections, reducing overfeeding and excess swallowing of air.
  • Burp frequently, after each breast and at the end of feeding.
  • If reflux is severe or painful see your pediatrician for medication, which should be the last resort.