Spitting up

A baby sometimes regurgitates small amounts after a feeding. This is called spitting up.

What is going on in the body?

Spitting up occurs in many young infants. In some children, it may continue through the first year. The problem occurs because some of the muscles in the baby's digestive system are not yet mature.

When food is swallowed, it travels to the stomach through a long muscular tube known as the esophagus. Waves of muscle contractions propel food down the esophagus. The valve connecting the esophagus to the stomach is called the gastroesophageal sphincter. Normally, this valve closes after eating to keep food from rising back into the esophagus.

In newborns, this valve has not fully developed. That makes it easier for food to move backward, up the esophagus. Spitting up usually occurs during or shortly after feeding. Most of the time, the food rolls out of the mouth without much force. The amount that comes out is rarely more than an ounce.

It is important to distinguish spitting up from vomiting. With vomiting, larger amounts of stomach contents are forcefully expelled. Material may come out of the nose as well. Vomiting is usually a sign of an illness.

What are the signs and symptoms of the condition?

Spitting up usually occurs during or after a feeding. It does not appear to cause any discomfort to the baby. It is not associated with fever or any other symptoms. The spit up material that the baby expels looks like the breast milk or formula the baby has just taken in.

What are the causes and risks of the condition?

Premature infants may be more likely to spit up. This is because their digestive systems are not as mature at birth as those of full term infants.

What can be done to prevent the condition?

Some infants spit up despite prevention efforts. For most babies, however, the following steps may help minimize the problem: · Burp the infant every 4 to 5 minutes during feeding to prevent the stomach from filling with air. · Avoid over feeding. · Refrain from vigorous play immediately after feeding. · Feed the baby in an upright or semi-upright position, and use appropriate techniques for infant feeding. · Keep the baby upright for 20 minutes after feeding, in a position that does not compress the abdomen. · Add a small amount of rice cereal to each bottle of formula. · Feed the infant before he or she becomes too hungry, to avoid over-vigorous sucking.

How is the condition diagnosed?

Diagnosis of spitting up is made on the basis of a medical history and physical examination. The following criteria are used to differentiate spitting up from more serious conditions. · Undigested food is expelled only in small amounts. · Food is not expelled forcefully. · The infant is gaining weight well. · The infant shows no signs of illness or discomfort.

If the healthcare provider is concerned about the baby, he or she may order further testing.

What are the long-term effects of the condition?

As the baby grows, the sphincter in the esophagus usually gets stronger and the baby spits up less and less. Spitting up usually goes away by itself sometime during the baby's first year.

What are the risks to others?

Spitting up is not contagious and poses no risk to others.

What are the treatments for the condition?

Most babies outgrow the spitting up without treatment. Changing the formula usually does not help with spitting up. Sometimes a healthcare provider will recommend thickening the formula with a small amount of rice cereal.

What are the side effects of the treatments?

Thickening the formula has no significant side effects.

What happens after treatment for the condition?

Most babies outgrow the spitting up as their digestive system matures, and they have no further problems.

How is the condition monitored?

Spitting up is of little concern for a healthy infant who is growing normally. The healthcare provider should be contacted if the spitting up infant also shows these signs: · blood in the spit up material · frequent coughs · frequent irritability · poor growth rate · repeated vomiting

Any other new or worsening symptoms should also be reported to the healthcare provider.