Weekend Doctor


It is very common for a baby to have reflux after feeding, also known as spitting up. At least 90 percent of babies have some reflux symptoms by 4 months of age and more than 50 percent of babies spit up regularly in the first months of life.

Good news: Spitting up gets much better after 6 months and usually stops by 12 to 18 months. A majority of these babies grow well without medication.

What causes reflux for babies?

In an infant, the ring muscle between the esophagus and stomach, called the esophageal sphincter, is not well developed or tight enough, especially for premature babies. This muscle is supposed to be closed after babies swallow to prevent stomach content from flowing backwards. Meanwhile, babies spend most of their time lying flat after feeding. At the same time, babies eat completely liquid diets for the first 4 months of life, either breast milk or formula.

If the baby is growing properly, reflux is not a problem and the baby usually doesn’t need any medication.

Here’s how to decrease spitting up at home:

  1. Breast-feeding if possible. Most babies tolerate breast milk much better than formula.
  2. Decrease the size of each feeding, feed more frequently and avoid overfeeding the baby. For babies under 4 months old, each feeding should be less than 4 ounces.
  3. Don’t immediately feed the baby again if the baby spits up. Wait at least one to two hours.
  4. Burp your baby more frequently throughout feeding.
  5. Keep your baby in an upright position for about 15 to 20 minutes after feeding.
  6. Avoid exposure to tobacco smoking.
  7. Avoid changing the diaper or changing clothes right after a full feeding.

However, please call and see your baby’s doctor if your baby shows the following signs:

  • Baby is not gaining weight
  • Baby constantly spits up forcefully, especially projectile vomiting
  • Baby spits up yellow fluid/blood or has blood in the stool
  • Baby has a bad cough, wheezes or stops breathing
  • Baby is unusually irritable after feeding

Some of these signs can indicate other severe diseases, which require further evaluation and treatment.

Chen is with the Caughman Health Center, Findlay. Questions for Blanchard Valley Health System experts may be sent to Weekend Doctor, The Courier, P.O. Box 609, Findlay 45839.


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