Reflux (Spitting Up)

When to Call for Reflux (Spitting Up)

Care Advice for Spitting Up (Reflux)

1. What You Should Know About Spitting Up:
   • Spitting up occurs in most infants (50%).
   • Almost always doesn't cause any pain or crying.
   • Spitting up does not interfere with normal weight gain.
   • Infants with normal reflux do not need any tests or medicines.
   • Reflux improves with age.
   • Here is some care advice that should help.
2. Feed Smaller Amounts:
   • Skip this advice if age less than 1 month or not gaining weight well.
   • Bottlefed Babies. Give smaller amounts per feeding (1 ounce or 30 mL less than you have been). Keep the total feeding time to less than 20 minutes. Reason: Overfeeding or completely filling the stomach always makes spitting up worse.
   • Breastfed Babies. If you have a good milk supply, try nursing on 1 side per feeding. Pump the other side. Switch sides you start on at each feeding.
3. Longer Time Between Feedings:
   • Formula. Wait at least 2½ hours between feedings.
   • Breastmilk. Wait at least 2 hours between feedings.
   • Reason: It takes that long for the stomach to empty itself. Don't add more milk to a full stomach.
4. Loose Diapers:
   • Do not put the diaper on too tight. It puts added pressure on the stomach.
   • Don't put pressure on the stomach right after meals.
   • Also, do not play too hard with your baby during this time.
5. Upright Position:
   • After meals, try to hold your baby in the upright (vertical) position.
   • Use a front-pack, backpack, or swing for 30 to 60 minutes after feedings.
   • Decrease the time in a sitting position (such as infant seats).
   • After 6 months of age, a jumpy seat is helpful. The newer ones are stable.
   • During breast or bottle feeds, hold your baby at a slant. Try to keep your baby's head higher than the stomach.
6. Less Pacifier Time:
   • Frequent sucking on a pacifier can pump the stomach up with swallowed air.
   • So can sucking on a bottle with too small a nipple hole.
   • The formula should drip 1 drop per second when held upside down. If it doesn't, the nipple hole may be clogged. Clean the nipple better. You can also make the nipple hole slightly bigger.
7. Burping:
   • Burping is less important than giving smaller feedings. You can burp your baby 2 or 3 times during each feeding.
   • Do it when he pauses and looks around. Don't interrupt his feeding rhythm in order to burp him.
   • Burp each time for less than a minute. Stop even if no burp occurs. Some babies don't need to burp.
8. Add Rice Cereal to Formula:
   • If your baby still spits up large amounts, try thickening the formula. Mix it with rice cereal.
   • Start with 1 level teaspoon of rice cereal to each ounce of formula.
9. Acid Blocking Medicines:
   • Prescription medicines that block acid production are not helpful for normal reflux.
   • These medicines also can have side effects.
   • They do not reduce excessive crying from colic.
   • They are only useful for symptoms of heartburn.
10. What to Expect:
    • Reflux gets better with age.
    • After learning to sit well, many babies are better by 7 months of age.
11. Call Your Doctor If:
    • Spitting up changes to vomiting (forceful or projectile)
    • Poor weight gain
    • Your baby does not get better with this advice
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.