Baby regurgitation after feeding


Infant Regurgitation - About Kids GI

What is infant regurgitation?

Regurgitation means the backward movement of stomach contents up the esophagus (the “swallowing tube’) into the mouth. Regurgitation often includes the release of the material from the mouth, as in infants who “spit up.”

It occurs when the muscle between the esophagus and stomach relaxes (as it does during burping). This allows the stomach material up because the normal pressure within the stomach is greater than the pressure in the chest and throat.

When regurgitated stomach material comes out of the mouth, it is often mistaken for vomiting, and may look exactly like vomiting. But technically, and medically speaking, vomiting is more forceful and uncomfortable. It usually includes nausea, retching, and gagging.

Is infant regurgitation normal?

Regurgitation is a symptom that is normal and common in infants. That is because of the very small volume that the infant esophagus can hold and because of other factors, including their large liquid meals and the amount of time they spend lying down.

Infants who have a lot of regurgitation, but no actual disease, have a condition that is called functional infant regurgitation. Functional means that the symptom is real, but there is no disease. (For example, a runner’s cramp is painful but the muscle is healthy.)

Functional infant regurgitation has been defined by an international group of experts, the Pediatric Rome Working Team, as consisting of:

  • at least 3 weeks of regurgitation of stomach contents,
  • at least twice daily during infancy,
  • the first year of life.

There must be no retching, bleeding, refusal to eat, or breathing problems, because these additional symptoms suggest a disease, rather than a functional condition. Half of all healthy infants meet these symptom-based criteria for functional regurgitation.

Should I worry if my infant regurgitates?

In the USA there are over 1 million doctor visits yearly for infant regurgitation. Medical professionals want to help. So do formula companies and drug companies. However, the evidence that formula changes or medicines alter the course of functional infant regurgitation is generally weak.

The evidence is that no matter what you do, functional infant regurgitation gets better by itself by the end of the first year in nearly all of those who have it.

It makes no difference whether the stomach contents come out the mouth, the nose, or both. Also, the apparent forcefulness of the material coming out cannot set apart functional regurgitation from non-functional diseases.

Projectile (or forceful) vomiting occurs in some serious conditions. But projectile regurgitation that looks like vomiting is also commonly seen in functional infant regurgitation.

Signs that something more serious may be going on would include your baby having problems gaining weight, crying excessively, problems feeding, problems breathing, or throwing up blood or bile. If your child is having any of these problems you should consult your physician.

What is the difference between GER, GERD, and infant regurgitation?

It is important to know the differences between similar terms such as gastroesophageal reflux (GER), gastroesophageal reflux disease (GERD), and functional infant regurgitation.

Gastroesophageal reflux episodes occur when stomach contents move backwards up into the esophagus. Regurgitation episodes are when reflux actually reaches the mouth.

Everyone has episodes of reflux every day, but few people are aware of them. In healthy adults and infants, there is acid in the esophagus many times every day, for a total time of about one hour a day. However, reflux does not cause harm in most people, because our bodies have defenses against acid in the esophagus.

GER became a popular diagnosis only in the 1980’s, when esophageal pH testing became available. As with every new technology, there was great enthusiasm for using esophageal pH testing to measure a day-long recording of acid episodes in the esophagus. Just as a certain quantity of regurgitation episodes defines the condition of functional regurgitation, reflux episodes of certain frequencies have been used to define GER. In both of these situations, although there may be an amount of regurgitation or reflux that is greater than the average person experiences, there is no “disease.”

Gastroesophageal reflux disease (GERD) refers to tissue damage or harmful symptoms that happen because of reflux. GERD is not common in otherwise healthy infants. GERD is common following preterm birth and in infants with chronic lung disease or cerebral palsy. Common problems due to GERD include:

  1. Recurrent aspiration (inhaling) of refluxed material into the lungs
  2. Inflammation in the esophagus, causing pain, food refusal, or bleeding and anemia (low red blood cell counts)
  3. Failure to gain weight appropriately

Some clinicians believe that too much reflux can also cause sinusitis and ear infections. Many dentists believe that too much acid reflux into the mouth can wear away dental enamel, causing what they call dental erosions.

As noted above, functional infant regurgitation refers to regurgitation (spitting up or even what appears to be forceful “vomiting”) in a healthy infant younger than 1 year of age that occurs 2 or more times daily and lasts at least 3 weeks. By definition, there is no tissue damage or other harmful symptoms.

Functional infant regurgitation shows up as repetitive symptoms, but which have no harmful consequences. Clinicians cannot find damage to the esophagus or anywhere else in the body in healthy infants with infant regurgitation.

What tests are necessary to diagnose infant regurgitation?

No testing is necessary or desirable if your child meets symptom-based criteria for infant regurgitation.

Should I change formulas?

There is usually no reason to change formulas. The idea of changing formulas is usually because your clinician suspects protein allergy. Formula protein allergy affects 3 to 5 of 100 infants. A healthy child with spit-ups is not likely to have protein allergy. If you are formula feeding, a two-week trial of a hydrolyzed protein (hypoallergenic) formula may help any portion of the symptoms due to allergy.

What about lactose intolerance?
Lactose is the sugar in human breast milk, so babies are born with the ability to digest lactose. Lactose intolerance is rare below age 8 years, except after a severe infection of the small intestine. Lactose intolerance does not cause infant regurgitation.

What causes infant regurgitation?

Probably many factors contribute to infant regurgitation. The most important might be the size of the infant’s feeding.

The human infant must triple its birth weight in the first year. Think of how much you would have to eat next year to triple your current weight. What a wonder it is that half the healthy babies manage to keep it all down.

Adults do not notice when they have an episode of gastroesophageal reflux. They may reflux over an ounce of gastric contents, but that ounce never makes it up to the throat. That’s because the adult esophagus holds about an ounce and a half of fluid. In contrast, the infant esophagus holds only less than one-tenth of that amount. As little as a teaspoon of reflux may cause a bit of spit up in the infant’s mouth.

A reflux episode may occur every time the pressure inside the abdomen exceeds the pressure of the lower esophageal sphincter (LES). The LES is the muscle barrier that acts to prevent reflux of stomach contents into the esophagus. Increases in pressure within the abdomen are caused by routine body activities. Examples of these activities include sneezing, coughing, and bearing down to push out a bowel movement.

Treatment

Change the feeding environment

Some infants are more sensitive to their surroundings than other infants. For infants with sensitive temperaments, feedings are more likely to go well in a calm, relaxing, uninterrupted setting.

In families with lots of children (or other disruptive factors), it is best that caretaker and infant excuse themselves for 20 minutes, and go to a quiet room with dim lighting and soft, pleasant sounds.

The goal is to soothe the infant, and provide comfort. When the infant is fussy and refusing the nipple, the caretaker must remain calm, because the infant can sense the caretaker’s anxiety, and “catch” worries from the caretaker.

Thickened feeding

Several studies proved that formula thickened with cereal helps infants to nap longer, cry less, and have fewer spit ups. One tablespoon of dry rice cereal per ounce of formula is the thickener generally studied, and this thickening gives the formula 50% more calories per ounce, so the fed volume should be reduced to offset that.

Thickened feedings are especially useful if the infant’s weight is below ideal, but may be a bad idea if the infant is too heavy. Thickening formula with rice cereal may cause constipation.

Do not overfeed

With overfeeding, the infant may become uncomfortable, and learn that regurgitation will make the abdominal discomfort disappear promptly.

Drugs

Despite millions of research dollars invested by multiple drug companies to determine whether their drugs might help, no drug has been proven to reduce spitting up in infant regurgitation.

Surgery

The most common operation in the United States is the fundoplication, an operation for treating GERD.

However, fundoplication is unnecessary for functional infant regurgitation, which will resolve spontaneously by the end of the first year of life.

Effective reassurance

Infant regurgitation is a common, passing, harmless functional symptom. A clinician provides reassurance of this when listening with empathy.

Outcomes in Infant Regurgitation

As far as we know, infant regurgitation has no permanent consequences. It does not cause any problems later on in life.

Adapted from IFFGD Publication: Frequently asked questions about infant regurgitation (845) by Paul E. Hyman, MD, Louisiana State University and Children’s Hospital New Orleans, LA and Susan R. Orenstein, MD, University of Pittsburgh, PA.

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Topics of this article

Reflux (Spitting Up)

Is this your child's symptom?

  • 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

Cause

  • 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.

When to Call for Reflux (Spitting Up)

Call Doctor or Seek Care Now

  • Blood in the spit up
  • Choked on milk and turned blue or went limp
  • Age less than 12 weeks and spitting up changes to vomiting (forceful or projectile)
  • Age less than 1 month old and looks or acts abnormal in any way
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Chokes a lot on milk
  • Poor weight gain
  • Frequent crying
  • Spitting up is getting worse
  • Age more than 12 months old
  • Spitting up does not get better with this advice
  • You have other questions or concerns

Self Care at Home

  • Normal reflux (spitting up) with no problems

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

  • Bellevue
  • Everett
  • Federal Way
  • Seattle

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.

Last Reviewed: 10/25/2022

Last Revised: 01/13/2022

Copyright 2000-2022. Schmitt Pediatric Guidelines LLC.

Why does the baby spit up after feeding?

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Regurgitation is a common condition in newborns and infants and is most often a normal variant. However, it is not uncommon for parents to worry if their baby is spitting up frequently, believing that it is due to nutritional or health problems in general. Sometimes these fears are not unfounded, and regurgitation really has a pathological origin. What is its cause and when should you really consult a doctor about this?

Regurgitation - Return of a small amount of food (uncurdled or partially curdled milk) from the stomach up the digestive tract: into the esophagus and further into the oral cavity. According to statistics, at least 1 time during the day, at least 50% of babies from 0 to 3 months old can spit up, more than 60% of children 3-4 months old, and in 5% of children spit up continues up to the year 1 .

Regurgitation in newborns is considered a physiological process. It is caused by a number of factors, including:

  • Features of the structure of the upper digestive tract in babies
  • In newborns and infants up to a year of life, the stomach has a spherical shape. It holds a small amount of food, besides, the release from it into the duodenum is slower in comparison with children after the year 2 .
  • Weakness of the lower esophageal sphincter that separates the esophagus from the stomach
  • Normally, the lower esophageal sphincter should tightly "close" the esophagus, allowing food to pass into the stomach and not allowing it to enter back into the upper digestive tract. However, in young children (up to a year), the muscles of the esophageal sphincter are poorly developed, and it does not do its job very well 2 .
  • Slow movement of food through the gastrointestinal tract
  • The neuromuscular system of newborns is immature. It does not ensure the proper movement of food through the esophagus, causing regurgitation.

One of the important risk factors contributing to regurgitation in newborns is aerophagia. This is the swallowing of large amounts of air during feedings. This happens when the baby is not properly attached to the breast, the mother has a lack of breast milk, or the bottle is in the wrong position in the child who receives the mixture. The size of the opening in the nipple also matters - if it is too large, the newborn swallows a lot of air 3 .

With aerophagia, the baby becomes capricious, restless immediately after feeding. Noticeable bloating. If the baby spits up immediately after a feed, the milk (or formula) remains practically fresh, uncurdled 3 .

Promotes regurgitation after feeding and a predominantly horizontal position of the baby during the day, combined with relatively high intra-abdominal pressure 4 . Therefore, the correct position of the baby after feeding is so important. To avoid regurgitation of an excessive amount of stomach contents, after feeding, it is necessary to hold the baby in an upright “column” position for some time (10-20 minutes), lightly patting on the back and allowing excess air to “exit”.

Regurgitation in many newborns can be provoked by other situations in which pressure in the abdominal cavity increases and stomach contents are thrown into the esophagus, in particular 3 :

  • tight swaddling;
  • stool disorders, in particular constipation;
  • long, forced cry and some others.

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How can you tell the difference between normal spitting up and vomiting?


Sometimes regurgitation is considered a manifestation of disorders in the digestive tract of children. Due to the constant reflux of acidic stomach contents into the upper sections, inflammation and other complications may develop, including growth retardation, a decrease in hemoglobin levels, and others. Therefore, it is important for parents to understand where the line is between physiological and pathological regurgitation 1 .

If the mother is worried that her baby is spitting up, keep track of when this happens and count the total number of spit ups per day. Normally, regurgitation usually occurs after eating (the child burps after each feeding), lasts no more than 20 seconds and repeats no more than 20-30 times a day. With pathology, the problem manifests itself at any time of the day, regardless of when the baby was fed. Their number can reach 50 per day, and sometimes more 1 .

The amount of discharge during regurgitation also matters. With normal, physiological regurgitation, it is approximately 5 - 30 ml. If this volume fluctuates between 50 and 100 ml, it is already defined as profuse vomiting. When the range of the jet of vomit is up to 50 cm, doctors talk about "vomiting a fountain." A variant of atonic vomiting is possible, when the contents of the stomach flow "sluggishly". It occurs with atony of the stomach (decrease in muscle tone of the stomach wall) and disruption of the esophagus 1 .

Vomiting in babies is a warning sign. Doctors are especially alarmed by repeated vomiting, a fountain, with an admixture of bile, in combination with constipation. Vomiting can lead to the development of dehydration, acid-base imbalance and other consequences, therefore, if it occurs, you should urgently contact a pediatrician to find out the cause and begin treatment. A doctor's consultation is necessary if the child is spitting up a lot (more than 15-30 ml at a time), with a frequency of more than 50 episodes per day 1.3 .

Physiological regurgitation: symptoms


Regurgitation in newborns, which is considered a normal variant and does not cause concern to pediatricians 3 :

  • usually continues for a certain period of time;
  • is characterized by slow, "passive" leakage; if the baby spits up a fountain, it is better to consult a doctor;
  • has a sour smell of curdled milk;
  • occurs without the participation of muscles - the baby does not strain during regurgitation;
  • does not affect the general well-being of the baby.

How to help a newborn who spit up often?


If the baby is healthy, no medication is prescribed for spitting up. To help the child allow simple measures based on lifestyle changes and feeding.

  • Frequent feeding of the baby
    It is known that the baby is more prone to spit up if his stomach is full. To improve the situation, it is recommended to feed the baby more often, avoiding oversaturation, best of all - on demand 5 .

  • Correct feeding technique
    Every feeding, the mother must ensure that the baby does not swallow too much air during suckling. When sucking, there should be no loud, smacking, clicking sounds. You also need to control that the baby captures the nipple along with the areola.

  • Choosing the right bottle and nipple
    If the newborn is bottle-fed and receiving formula, it is important to choose the right bottle and nipple. The hole in it should be such that the milk flows out in drops, and not in a stream. The nipple must not be filled with air

    New Anti-colic bottle with AirFree valve

    The AirFree valve prevents air from entering the baby's stomach.

    • Baby standing upright after eating

    To allow air that has entered the digestive tract during meals to escape, it is important to keep the newborn upright for 10-20 minutes after feeding 4 .

    • Ensure the correct position of the baby during sleep

    To reduce the negative impact of the acidic contents of the stomach on the esophagus, it is necessary to put the baby to sleep in the supine position. The side or prone position, which many pediatricians used to recommend, is no longer recommended. It was found to be associated with an increased risk of sudden infant death syndrome 5 .

    If parents notice alarming symptoms, such as spitting up too often or large volume, etc., it is important to consult a pediatrician without delay. This will allow you to identify the real problem in time and help the baby grow up healthy and happy.

    References

    1 Zakharova I. N., Andryukhina E. N. Regurgitation and vomiting syndrome in young children // Pediatric pharmacology, 2010. V. 7. No. 4.

    Nagornaya 2900 V., Limarenko M. P., Logvinenko N. G. Experience in the use of domperidone in suspension in young children with regurgitation syndrome // Child Health, 2013.

    No. 5 (48).

    3 Zakharova IN Regurgitation and vomiting in children: what to do? //Pediatrics. Supplement to Consilium Medicum, 2009. No. 3. S. 58-67.

    4 Zakharova I. N., Sugyan N. G., Pykov M. I. Regurgitation syndrome in young children: diagnosis and correction // Effective pharmacotherapy, 2014. No. 3. P. 18-28.

    5 Vandenplas Y. et al. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) //Journal of pediatric gastroenterology and nutrition. 2009; 49(4): 498-547.

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    Breastfeeding is a very special time for a mother and her newborn baby. Together with the feeling of closeness and affection that feeding brings, understanding its nuances cannot but raise many questions, including the question of how to help an infant spit up. Regurgitation in a newborn is by no means always the result of a simple pat on his back.

    In this article, we'll talk about the basics of helping a newborn spit up, as well as other questions you may have about spitting up.

    Why do babies spit up?

    Let's get this straight: Why do newborns need to burp in the first place? During feeding, children usually swallow extra air - this is called aerophagia. Spitting up helps prevent this air from entering the intestines, as well as vomiting, gas, and crankiness in the baby. To avoid the return of milk after feeding, you should give the baby the opportunity to burp more often.

    How to help a newborn spit up?


    During the first six months, the baby should be kept upright in a column for 10-15 minutes after each feed. This will help keep the milk in his stomach, but if the baby occasionally burps anyway, parents need not worry. While carrying your baby in an upright position, you can put a baby diaper or wipes on your shoulder to keep your clothes clean.

    We've already seen why spitting up is important, now let's find out how to help your baby spit up. Parents should gently pat the baby on the back with a hand folded in a handful until he burps. Folding your hand into a handful is important because clapping with a flat palm may be too strong for an infant.

    Every baby is different and there is no one right position for spitting up. To get started, you can try the following options:

    1. Sitting position with the baby on the chest. In this position, the parent puts the baby's head with his chin on his shoulder and with one hand supports the baby under the back. With the other hand, you can gently pat the baby on the back. This method is most effective in a rocking chair or when the baby is gently rocking.
    2. Holding a child upright on one's legs. With one hand, parents can hold the baby by the back and head, supporting his chin and placing his palm on the baby’s chest, with the other hand, you can gently pat him on the back. At the same time, it is important to be careful: do not press the child on the throat, but only gently support his chin.
    3. Holding a baby lying on his tummy in his lap. Make sure his head is above his chest and gently pat your baby on the back until he burps.

    Here are some tips on how best to help your newborn spit up:

    • Let your baby spit up while feeding. If the baby is restless or has swallowed air, it is worth giving him the opportunity to burp during feeding, and not just after.
    • When bottle feeding, let the newborn burp after every 50-60 ml.
    • When breastfeeding, let the baby burp at every breast change.

    It is important to let your baby spit up after eating, even if he spit up during feeding!

    If your baby is gassy, ​​spit up more often. Also, if he vomits frequently or suffers from gastroesophageal reflux disease (GERD), have him spit up after every 30 ml bottle-feeding or every five minutes while breastfeeding.

    How long should a baby be held for it to burp? It's different for everyone, but generally keeping a newborn upright for 15 to 20 minutes after a feed helps the milk stay in the baby's stomach.

    Minimize the amount of air you swallow. Gas production and regurgitation result from aerophagia during feeding. The baby will inevitably swallow air, but there are ways to prevent it from swallowing too much. Whether you bottle feed your baby or combine breastfeeding with bottle feeding, the Philips Avent anti-colic bottle with AirFree valve is designed so that the nipple is always filled with milk without excess air, even in a horizontal position, thus preventing the baby from swallowing excess air during feeding.

    Reducing the amount of air your baby swallows can help reduce your baby's risk of colic, gas, and spitting up.

    Breastfeeding is a wonderful time to strengthen the bond between parent and baby. Every mom and every baby is different, so learning to help your newborn burp properly can take time and practice.

    Articles and tips from Philips Avent

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