1. Is spit-up dangerous during sleep?
Laying your baby on his back to sleep is considered the safest position. But this obviously leads to the concern that your infant may choke on his own spit-up. This is not a common problem for most babies. Most babies will turn their head slightly to the side during sleep, and even if they don't they have reflexes that help them avoid choking on their spit-up. If you have ever dripped water on your little splasher's face during his bath, you might have seen him arch his head and body backward while waving his arms. This reflex is to help your baby roll onto his side if any thing obstructs his breathing. He will do the same thing, even while asleep, if his airway is not clear. Even swaddling will not keep your baby from arching his back and turning his head. The only time when night-time spit-up might be dangerous is if your baby has a cold that is producing a lot of mucus. If your baby is having trouble breathing anyway, there is a chance some spit-up could be sucked into the lungs on accident. There are some dangers that this could cause, so if you suspect that this has happened I would contact your pediatrician right away. Signs that your baby might have inhaled some spit-up are, excessive coughing, coughing while crying, and a rattling sound to their breathing between coughing.
2. Why does my baby spit up when laying down?
Many babies have trouble keeping their food down when laying flat, because there is a valve that is often under developed or not yet very strong at the top of the stomach that is meant to keep food down once swallowed. When this valve is so underdeveloped that it hardly functions it causes the condition known to most of us parents as "infant reflux". Even if your baby doesn't have reflux, when there is still liquid in her belly and you lay her down, the food will sometimes leak back into her throat (which can be painful because there will probably be some stomach acid mixed in) and stimulate the gag reflex, which causes spit-up. It helps clear food out of the airway before it is accidentally inhaled into the lungs, but also causes a bit of a mess. Most of the time digestion of breast milk and formula is pretty fast, and almost all of your baby's food will be gone within 10-15 minutes after a feeding. However, every baby is different, and as your little one grows she will change as well. Sometimes this means that digestion will take longer, or that there is something about the feeding that disagrees with your finicky nibbler's tummy, and there may be a bit more left to toss back up the pipes than normal. As a good rule of thumb, try to keep your baby's head elevated a few inches above her stomach for at least 20 minutes after feeding to try and ensure that most of the food has been digested before you lay her down flat.
3. Is white chunky spit-up normal?
There are several different types of spit up. The most common is fairly watery with a few chunks of white cheesy-creamy stuff in it. This kind is usually seen pretty quickly after a feeding, and most often in infants that are having a bit of excess drool. The reason the spit-up is watery with little white chunks is usually because the spit-up was triggered by a burp which brought up both bits of partially curdled milk (curdling is a natural reaction to your baby's stomach acids, and is part of the digestion process), and mixed it with the excess saliva that was both in your baby's throat, and in his mouth. Another common kind is a large amount of milky-white chunky stuff. This usually comes right up from the tummy, and is often the result of a strong gag reflex getting triggered accidentally by a burp (...or a finger, or a toy, or a pacifier). It can also be caused by a bit too much horsing around too soon after eating. And, more rarely, it can be caused by nausea from a sickness. In general, white chunky spit up is absolutely normal. Other common types of normal spit-up are mostly milky (few chunks) and mostly watery (no milk or curdled milk chunks).
4. Is my baby spitting-up too much?
Almost always the answer to this question is "no". If your baby is eating regularly, having a normal number of wet and dirty diapers, and is continuing to gain weight, then she is getting enough to eat. It can seem like your baby is spitting up an awful lot, but it is extremely rare for a baby to spit up an entire feeding. The reason for this is, that digestion begins as soon as your baby swallows her first mouthful. And for a baby who is 3-4 months old digestion proceeds at an average rate of 1 ounce (30 ml) every 10-15 minutes. So if your baby eats approximately 5-6 ounces (150-180 ml) and a feeding lasts around 15-25 minutes, a great deal has been digested by the time your adorable little lactarian has finished. Even if your baby occasionally empties everything left in her stomach within 5-10 minutes after eating, the most that would come up would be around 2 ounces (60 ml). Now, don't get me wrong, 2 ounces (60 ml) can seem like an awful lot when poured down your neck, but as far as it being a sign that your little tulip isn't getting enough nutrition, it is unlikely. However, trust your instincts, and if you feel like something is really wrong with your baby, always check with your pediatrician.
5. How can I tell if my baby's spit-up is not normal?
In some cases there are conditions that cause strange spit-up. Some signs that you should immediately bring to your pediatrician's attention are:
- If your baby's spit-up is discolored (Yellow, green, red, blue, etc).
- If your baby spits up something that looks like coffee grounds.
- If your baby is not gaining weight appropriately.
- If your baby is forcefully expelling spit-up type fluid (projectile vomiting) frequently.
- If your baby resists feedings and is still spitting up large amounts.
- If your baby spits up constantly throughout every feeding.
- If spitting up seems to be causing your baby sharp pain (screaming and crying immediately after spitting up on a regular basis).
Although there are many things to worry about with your new baby, generally spit-up shouldn't be one of them. The worst thing about spit-up for most parents is the inevitable spoiling of a favorite shirt, or getting some splattered on your face. If you have found these tips helpful, please forward them to any new, or expecting parents you know. As always questions and comments are always welcome! Happy Parenting!