- Spitting up small amounts of breastmilk or formula. Also called reflux.
- Spitting up 1 or 2 mouthfuls of milk at a time
- No effort or crying
- Normal symptom in half of young babies
Symptoms of Normal Spitting Up
- Smaller amounts often occur with burping ("wet burps")
- Larger amounts can occur after overfeeding
- Most often seen during or shortly after feedings
- Occurs mainly in children under 1 year of age
- Begins in the first weeks of life
- Caution: normal reflux does not cause any crying
Complications of Spitting Up (GERD)
- Most infants are "happy spitters." Normal spitting up (normal reflux) occurs in half of babies. It does not cause crying or colic.
- Normal crying occurs in all babies. Frequent crying (called colic) occurs in 15% of babies. Crying and colic are not helped by heartburn meds. These meds also have side effects.
- If they develop complications, it's called GERD (gastro-esophageal reflux disease). This occurs in less than 1% of babies.
Symptoms of GERD
GERD problems occur in less than 1% of infants:
- Choking on spit up milk
- Heartburn from acid on lower esophagus. Infants with this problem cry numerous times per day. They also act very unhappy when they are not crying. They are in almost constant discomfort.
- Poor Weight Gain
- Poor closure of the valve at the upper end of the stomach (weak valve)
- Main trigger: overfeeding of formula or breastmilk
- More than half of all infants have occasional spitting up ("happy spitters")
Reflux Versus Vomiting: How to Tell
- During the first month of life, newborns with true vomiting need to be seen quickly. The causes of vomiting in this age group can be serious. Therefore, it's important to tell the difference between reflux and true vomiting.
Reflux. The following suggests reflux (normal spitting up):
- You've been told by a doctor your baby has reflux
- Onset early in life (85% by 7 days of life)
- Present for several days or weeks
- No pain or crying during reflux
- No effort with spitting up
- No diarrhea
- Your baby acts hungry, looks well and acts happy.
Vomiting. The following suggests vomiting:
- Uncomfortable during vomiting
- New symptom starting today or yesterday
- Forceful vomiting
- Contains bile (green color)
- Diarrhea is also present or
- Your baby looks or acts sick.
Pyloric Stenosis (Serious Cause)
- This is the most common cause of true vomiting in young babies.
- Onset of vomiting age 2 weeks to 2 months
- Vomiting is forceful. It shoots out of the baby's mouth. This is called projectile vomiting.
- Right after vomiting, the baby is hungry and wants to feed. ("hungry vomiter")
- Cause: the pylorus is the channel between the stomach and the gut. In these babies, it becomes narrow and tight.
- Risk: weight loss or dehydration
- Treatment: cured by surgery.