| Your Baby: Spitting Up and Vomiting |
Spitting up and vomiting in babies have become a huge area of parental concern. Part of the concern is positive because it reflects a better understanding of reflux disease, but another part may be negative and reflects a push to blame vomiting for all problems (such as colic). As a result, there is a trend to place younger and younger infants on medications they may not really need and for whom possible side effects have not been determined.
What Causes Reflux in Babies?After your baby swallows milk, it glides past the back of the throat into a muscular tube (the esophagus) and, from there, into the stomach. At the junction of the esophagus and the stomach is a ring of muscles (lower esophageal sphincter) that opens to let the milk drop into the stomach and then tightens to prevent the milk (and the stomach contents) from moving back up into the esophagus. If the stomach contents should happen to re-enter the esophagus, this is called "reflux." Infants are especially prone to reflux because:
Is Your Baby a "Happy Spitter?"Every baby spits up or vomits occasionally, and some do quite often or even with every feeding. If, despite the spitting, your baby is
she is what pediatricians call "a happy spitter" and no treatment is needed. Typically, the lower esophagus valve tightens up sometime in the first year, usually around 4-5 months of age, at which time the spitting up may go away. Could Your Baby Have Gastroesophageal Reflux Disease (GERD)?Unlike happy spitters, babies are diagnosed with GERD if the vomiting seems to be causing significant problems, such as:
If your baby has any of the above GERD symptoms, talk to your pediatrician, who can perform different tests to diagnosis and treat it correctly. One misconception is that GERD is often due to an intolerance to the milk. But if you think about it, the milk has just entered the stomach and hasn't had time to be digested, much less be recognized as one type or another. So changing your baby's formula usually does not help. Tips for Concerned ParentsFor any spitter, there are a few things that might help:
Sometimes these simple maneuvers help enough to keep your baby as a happy spitter. But when they don't work, your pediatrician may suggest antacid medications and/or medications that tighten the valve. Each has potential benefits and side effects, and only your pediatrician can decide which, if any, is right for your baby When to Worry About Baby's Spitting Up and VomitingIf your baby is a spitter and experiencing discomfort, poor growth, choking, gagging, coughing, or frequent respiratory symptoms, then GERD should be considered. However, most babies who have reflux are happy spitters. Medications in such cases should be avoided! |
