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Newborn Issues
: Infant Regurgitation ("Spitting Up")
"Spitting up", or regurgitation, is very common during
a baby's first few months of life. About 40% of normal, healthy
babies spit up, usually right after feeding. The liquid your baby
regurgitates may look very similar to the milk she or he was just
fed; or, if it has been partially digested, it may appear curdled
and smell like sour milk. Though it may seem like your baby is
spitting up a lot of milk, that's not likely to be the case. The
liquid spit up during regurgitation is usually made up mostly
of saliva and gastric juices, and only a small amount of milk.
What causes regurgitation?
In older children and adults, an elastic-like muscle at the entry
to the stomach closes like a valve to prevent liquids from being
pushed back up. In babies, however, this valve or sphincter isn't
fully effective until between 6 and 12 months of age. Since it
isn't fully developed yet, the valve is easily pushed back by
the contents of the stomach - resulting in regurgitation or spitting
up. Regurgitation often occurs after overfeeding, or in combination
with burping. Consequently, breastfed babies tend to spit up less
than bottle-fed babies, because they usually take in only as much
milk as they need, and because they tend to swallow less air.
Regurgitation is not caused by allergy or food intolerance, and
shouldn't be confused with vomiting.
How can I tell the difference between regurgitation and vomiting?
Unlike spitting up, vomiting is characterized by the forceful
expulsion of the contents of the stomach. It's important to know
the difference between vomiting and spitting up because repeated
vomiting can be a signal of a more serious illness, and because
it can easily lead to dehydration. Dehydration is a dangerous
condition in which excessive loss of body fluids results in a
potentially life-threatening imbalance of water and essential
body salts. If vomiting is persistent, accompanied by very high
temperatures and/or increasing lethargy, or if vomit contains
blood, medical attention should be sought immediately. Occasional
vomiting, if unaccompanied by other symptoms, may not be a cause
for concern but should be discussed with a doctor.
What can I do to minimize my baby's regurgitation?
Your baby's stomach and undeveloped sphincter are like a bottle
with a cap that isn't fully closed. If the bottle is filled to
the brim with any type of liquid, be it water, milk or juice,
it will overflow through the partially closed cap. If it is moved
or tilted, it will also overflow or spill. Understanding this
comparison will help you better understand regurgitation and what
you can do to minimize it. It's important not to overload your
baby's stomach, or it will "spill" its contents, causing
your baby to spit up. Instead, give your baby less to drink during
a feeding, but feed him or her more frequently. And don't move
your baby about too vigorously after a feeding.
In addition, how you position your baby during the twenty minutes
after a feeding is important. Any upright position, such as holding
your baby to your shoulder (as you would to burp him or her),
will help reduce regurgitation.
However, placing the baby in an infant seat can make matters worse
and should be avoided, especially immediately after a feeding.
The baby's slouching position in this kind of seat puts pressure
on the stomach that can result in regurgitation. Be sure to consult
your doctor before making any changes in your baby's position
or diet.
Can regurgitation affect my baby's health?
Usually, the vast majority of babies outgrow this problem by 12
months or earlier and their growth and development are not affected
at all. However, a small proportion of babies regurgitate so much
that they don't grow properly. For this reason, babies who spit
up frequently should be weighed regularly. If very large amounts
of milk are being spit up, or if regurgitation is forceful, a
pediatrician should be consulted. Fortunately, even if your baby
spits up frequently but is growing normally, there is probably
no cause for alarm.
Other Newborn Issues
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The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
© Autograph Communications Inc.,
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