When I was little, I remember thinking that it was natural for babies to spit up about half of their feeding every time they were burped. Now I know that was not true, and it is very likely that my younger brothers and sisters all had severe reflux. Gastroesophageal reflux (infant acid reflux) is basically the inability of a baby's throat to close all the way to keep food down.
For general questions about your baby's spit-up, check here.
It is theorized that many babies have this issue early on, but most grow out of it within the first couple of weeks. The symptoms don't all have to be as extreme as the example I've given, the medical rule of thumb is much broader: If a baby has thrown up 1/3 of a feeding 3 times a day for 3 weeks out of a month for the first 3 months they are considered to have reflux. Of course using that system of measure, you won't even receive the diagnosis until your baby is 3 months old. Since there are several simple easy things you can do to help your baby avoid the discomfort associated with reflux, I recommend that for those first 3 months, if you are in doubt, go ahead and treat it as if it is reflux, it can't hurt, and could very well help.
1. Feed your baby on a 45 degree angle and keep them like that for about 20 minutes after they finish.
Keep your baby's head up, that way the milk won't simply run back up your baby's throat, and has a better chance of being digested right away. A baby will begin to digest breast milk within seconds of the start of nursing, and formula is not far behind, that means that if this milk comes back up the esophagus the stomach acids in it will burn and cause discomfort. Keeping your baby's head elevated during a feed, and for 15-20 minutes afterward will help give them time to completely digest the remainder of the milk.
2. Do not rough-house with your baby for at least an hour after eating.This tip is hard for some proud daddies to remember. There is nothing so fun as twirling around with your baby in your arms, or lifting them up in the air and swinging them up and down to get giggles and grins. However this will almost certainly result in a thorough splattering with a warm white chunky substance. Though the spit-up itself is not really dangerous, your baby's milk is put to much better use in their tummy than on your face, or the furniture.
3. Add a couple of drops of fennel, chamomile and peppermint herbal tea to your baby's feeding.If you are breast feeding, you can drip a couple of drops in your baby's mouth just before you begin to nurse (a trick for doing this is to use a bottle nipple that is unattached to a bottle, and when it is in your baby's mouth, use a plunger to squirt a very small amount into it. Though your baby may not like the taste and will probably spit out the nipple right away, they only need to have ingested a very small bit to get the positive effects). If you are not breast feeding you can add a couple small drops directly to the formula. You can make the tea with a couple fresh sprigs of fennel, a few leaves of peppermint and a teabag of chamomile (unless you have some wild growing nearby, then fresh is best). Just soak them in some hot water until they are wilted, or the water changes color, there is no need to make it particularly strong. You can drink the rest of the tea, it boosts digestion and is calming to the nervous system (though you might want to save a little to give to your baby later). These drops should be given no more than 3 times a day, and as little as once can be beneficial.
4. Burp your baby at least three times during each feed, as well as afterward.The less gas in your baby's tummy, the better digestion will be and there will be less internal pressure as well. Do not feel that you need to make a bubble come up each time you pause for a burping, it is just a short break (4-5 minutes) to give gas an extra chance to come up if it is there, if you spend too long waiting for a bubble each time, the feeding could end up lasting hours.
5. Tuck a rolled up burp cloth or wash cloth under one of your baby's shoulders when you lay them down to sleep for the night.Raising one shoulder just a little will encourage your baby to sleep with their head turned to the side. Though all of the food in their tummy should be digested before you lay them down to sleep for the night sometimes they will have saved a little surprise for later. Though the chances that they might choke on their own spit-up are small, the process of coughing, gurgling and gulping that can happen when spiting up while laying completely flat can cause your baby quite a bit of discomfort and stress. Since discomfort and stress are not conducive to anyone having a good nights rest, it is better if your baby has to spit-up, that they do it to the side, and don't have to clear their airway after.
A bumper-sticker I saw the other day had some wise words to share on this topic: "spit happens". Nothing could be more true in the world of babies, except maybe the more crude saying that this one is making a play off of. However, despite all of the unpleasant things we have to deal with as parents, knowing we have done everything we could to help our baby be safe and happy makes it all better. I hope these tips are helpful to you and your baby. Please feel free to leave comments and questions and share this blog with any new mothers you might know.