Baby throwing up milk after feed
Why is my baby spitting up so much breast milk?
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My baby is frequently spitting up – it seems like it’s all of my breast milk! I never thought breastfed babies spit up this much. This can’t be normal, can it? Is there something wrong with my baby?
Don’t worry – we get these questions often. Caring for a baby who spits up can be stressful for parents, creating worries about the baby’s health and proper growth. Spitting up is a very common occurrence in healthy babies, and usually won’t cause any issues in regards to the baby’s growth or development. This often happens because the baby’s digestive system is so immature, making it easier for their stomach contents to flow back up into the esophagus.
Several different factors can contribute to babies spitting up, including:
- Babies regularly spit up when they drink too much milk, too quickly. This can happen when the baby feeds very fast, or when mom’s breasts are overfull. The amount of spit up can appear to be much more than it really is.
- Food sensitivities can cause excessive spitting up in babies. Products with cow milk in the mom or baby’s diet can be a common food sensitivity.
- Some babies can become distracted when feeding at the breast, pulling off to look around. This can cause babies to swallow air and spit up more often.
- Breastmilk oversupply or forceful let-down (milk ejection reflex) can cause reflux-like symptoms in babies.
If your baby seems comfortable, is eating well, gaining weight and developing normally, there’s typically little cause for concern. “Happy spitters” will grow and thrive, despite spitting up frequently. As babies grow and get older, they usually spit up less. Most will stop spitting up by 12 months of age.
Consider these tips:
- Keep your baby upright. Try feeding your baby this way and keep them upright for about 30 minutes after feedings.
- Avoid engaging in immediate active play for at least 30 minutes after feedings. Active play includes use of a bouncy seat, vibrating seat, infant swing or bouncing the baby while walking/holding.
- Frequent burps during and after each feeding can keep air from building up in your baby’s stomach.
- Avoid overfeeding. Feeding your baby smaller amounts more frequently might help decrease spitting up.
- Put your baby to sleep on his or her back. Placing a baby to sleep on its tummy to prevent spitting up is not recommended.
- Monitor your diet closely if you’re breastfeeding. If you feel there are certain foods that might be upsetting your baby’s stomach, try avoiding them for a while.
- If you notice weight loss, forceful spit up, fussiness or other symptoms, talk to your child’s pediatrician about your concerns.
Lactation Support Services at Texas Children’s Hospital offers a variety of services to mothers with questions and concerns regarding breastfeeding, pumping, medications and more. Click here to learn more.
Shelly Nalbone, APRN, CPNP, IBCLC
Baby Vomiting After Feeding Formula: Causes and Treatment
Your little one is happily gulping their formula while cooing at you. They finish off the bottle in no time flat. But shortly after feeding, it seems to all come out as they vomit.
There are several reasons why your baby might be vomiting after a formula feeding, but it’s important to remember that it can be — and often is — very normal.
It’s common for babies to throw up sometimes after feeding on formula or breast milk. Their shiny new digestive systems are still learning what to do with all the yummy milk coming down into their tummy.
However, if your baby often has a hard time keeping their formula down on a regular and frequent basis, let your pediatrician know.
Having a baby around means getting used to soft mushy stuff coming out fairly often. This includes spit-up and vomit.
Spit-up and vomit might seem pretty much the same — and require similar amounts of cleaning to get them off of your sweater and the sofa — but they’re very different. Spitting up is an easy, gentle dribble of milk. Baby may even smile at you as the curd-like spit-up flows from their mouth.
Spit-up is normal in healthy babies, especially if they’re under the age of 1.
On the other hand, vomit takes more effort, as it comes from deeper in your little one’s stomach. It’s a sign that your baby’s stomach is saying nope, not now, please. You might see your baby strain and recoil just before they projectile vomit. This force happens because vomit is squeezed out by the stomach muscles.
Your baby might also look more uncomfortable during and after vomiting. And vomit looks and smells different. This is because it’s usually formula, breast milk, or food (if your baby is eating solids) mixed with stomach juices.
If you’re not sure whether your baby is vomiting or spitting up, look for other vomiting symptoms, like:
- turning red
- arching their back
That said, there doesn’t seem to be agreed-upon definitions of these two terms among healthcare providers, caregivers, and others. Plus, their symptoms may overlap. For example, spitting up may sometimes be forceful, and vomiting may sometimes seem painless.
It’s easier for your baby to overfeed when they’re drinking from a bottle than when they’re breastfeeding. They can also gulp down milk faster from a bottle and rubber nipple. What’s more, because formula is always available, it’s easier for you to give them more milk than they need by accident.
Babies have tiny stomachs. A 4- to 5-week-old infant can only hold about 3 to 4 ounces in their tummy at a time. This is why they need lots of smaller feedings. Drinking too much formula (or breast milk) in one feeding can overfill your baby’s stomach, and it can only come out one way — vomit.
Not burping properly
Some babies need to be burped after every feeding because they swallow lots of air as they gulp down milk. Bottle feeding your baby breast milk or formula may lead to more air-swallowing, as they can gulp even faster.
Too much air in the stomach can make your baby uncomfortable or bloated and trigger vomiting. Burping your baby right after feeding them formula may help prevent this.
To help prevent your baby from swallowing too much air and vomiting after formula feeding, check your baby’s bottle. Make sure you’re using a smaller bottle that’s just big enough to hold a few ounces of milk. Also, check to make sure the nipple hole is not too big, and don’t let your baby continue gulping when the bottle is empty.
Baby or infant reflux
Baby can have acid reflux, indigestion, or occasionally gastroesophageal reflux disease (GERD just like grown-ups! This happens because their stomach and food tubes are still getting used to holding down milk.
Baby reflux happens when milk travels back up toward your baby’s throat and mouth. This usually just causes some painless spitting up, but it can irritate your baby’s throat and trigger gagging and vomiting.
Sometimes, smaller feedings can help prevent baby reflux. If not, don’t worry! Most little ones outgrow baby reflux by the time they’re 1 year old.
While simple constipation would be an uncommon cause of vomiting in an otherwise healthy infant, sometimes baby vomiting happens because of what isn’t happening at the other end.
Most babies who are formula-fed need to poop at least once a day. Anything less than your baby’s typical pattern, though, might indicate they’re constipated.
If your baby is vomiting after a formula feeding, they might be constipated if they have other symptoms, including:
- not pooping for longer than 3–4 days
- a swollen or bloated stomach
- a firm or hard stomach
- crying bouts or irritableness
- straining very hard but not pooping or pooping only a little
- small, hard pellet-like poop
- dry, dark poop
If your baby doesn’t usually vomit after having formula, they might have a stomach bug. Also known as gastroenteritis or the “stomach flu,” a stomach bug is a very common cause of vomiting in babies. Your little one may vomit several times for up to 24 hours.
Other symptoms of a stomach bug include:
- stomach cramps
- stomach rumbling
- diarrhea or watery poop
- mild fever (or none at all in babies)
In rare cases, the cause of your baby’s vomiting might be in the formula. Although it’s uncommon for babies to be allergic to cow’s milk, it may happen to up to 7 percent of babies under the age of 1.
Most children outgrow a milk allergy by the time they’re 5 years old, but it can cause vomiting and other symptoms in babies. A cow’s milk allergy might cause vomiting right after your baby eats. It can also cause vomiting and other symptoms hours or rarely days later.
If your baby has an allergy to milk or something else, they might have other symptoms of an allergic reaction, like:
- skin rash (eczema)
- difficulty breathing
An allergy to milk is different than being lactose intolerant. Lactose intolerance usually causes digestive symptoms like diarrhea. It can also make your baby vomit after drinking formula containing cow’s milk.
Your baby might get temporary lactose intolerance after getting a tummy bug or gastroenteritis, although this is uncommon.
Other symptoms include:
- diarrhea or watery poops
- stomach pain
- stomach rumbling
Note that lactose intolerance is rare in babies under the age of 1.
Some common health conditions can cause vomiting at any time, including after breastfeeding or formula feeding. Some rare genetic conditions can also cause vomiting in babies.
Other causes of vomiting in babies include:
- colds and the flu
- ear infections
- some medications
- motion sickness
- pyloric stenosis
In most cases, minor tweaks can help stop your baby’s vomiting. Remedies to stop your baby’s vomiting after formula depend on what’s causing it. Try some of these tried and tested methods to see what helps your baby:
- feed your baby smaller amounts of formula more often
- feed your baby slowly
- burp your baby after the feeding
- hold your baby’s head and chest up while feeding
- hold your baby upright after a feeding
- make sure your baby doesn’t move around or play too much right after a feeding
- try a smaller bottle and smaller-hole nipple to feed
- check the ingredient list on your baby’s formula
- ask your baby’s doctor if you should try a different kind of formula
- talk to your baby’s doctor about a possible allergic reaction
- dress your baby in looser clothing
- make sure their diaper isn’t on too tightly
If your baby has the stomach flu, you’ll both usually just have to ride it out for a day or two. Most babies and children with a stomach bug don’t need treatment.
If your baby is vomiting, see your doctor or pediatrician right away if they:
- are vomiting often
- are vomiting forcefully
- aren’t gaining weight
- are losing weight
- have a skin rash
- are unusually sleepy or weak
- have blood in their vomit
- have green bile in their vomit
Also, see your doctor urgently if your baby has any sign of dehydration from all the vomiting:
- dry mouth
- crying without shedding tears
- a weak or quiet cry
- floppiness when picked up
- no wet diapers for 8 to 12 hours
It’s pretty common for babies to vomit, especially after feeding. This happens for many reasons, including that these little people are still just getting used to keeping down their milk.
Check with your doctor about what you can do. See your doctor urgently if your baby vomits often for any reason.
Why does the baby spit up after breastfeeding?
Every mother has experienced this phenomenon to some extent - this is completely normal, because in the first months the baby's eating habits are just beginning to form. What are the causes of regurgitation? Can this be prevented? What is considered normal, and when should you see a doctor? Let's find out!
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Often the cause of regurgitation depends on the chosen method of feeding: whether the mother is putting the baby to the breast or feeding from a bottle.When breastfeeding:
- Overfeeding the baby. If the baby eats too much, then the excess milk comes out naturally.
- Incorrect breastfeeding technique, as a result of which a large amount of air enters the baby's stomach along with milk. Try to hold the baby so that he completely grasps the nipple and at the same time can breathe freely through his nose.
- Features of the digestive system of children at an early age. In infants up to a year old, the muscles of the esophagus are not yet fully formed, so regurgitation is often a natural process.
- An abrupt change in the position of the child. After feeding, do not turn the baby over, squeeze, swaddle or swing in the stroller.
- Intestinal disorders such as bloating, colic and other causes that prevent normal digestion.
- In rare cases, serious diseases of the digestive system.
Note that regurgitation is more often observed not in newborns, but in children aged about 4 months.Formula-fed:
- Abrupt transition from breast milk to formula.
- Unsuitable size and opening of the nipple, due to which the baby takes in a lot of air.
- Tendency to overeat. You should follow the rules of nutrition for babies.
- Inappropriate milk formula. Perhaps the child simply does not tolerate it well, consult a doctor about changing baby food.
Valio Baby's adapted milk formulas are as close as possible in composition to breast milk and contain prebiotics, as well as vitamins and microelements necessary for intestinal health. All components of Valio Baby are natural. A balanced composition allows you to maintain the level of cholesterol in the child's body at an optimal level. The mixtures are designed for three age categories, taking into account the peculiarities of the development of babies in a given period:
- from the first days of life to six months;
- for babies from six months to 1 year;
- and for children over 1 year old.
If the baby is lying on his back and starts spitting up, immediately turn him over on his stomach, or pick him up - this will prevent food from entering the respiratory tract.
If your baby seems to be uncomfortable while feeding, or if he comes off the breast and starts crying, let him burp. This can be done in two ways:
- Place a washcloth over your shoulder to keep it clean. Hold the baby on your chest so that his chin rests on your shoulder. Gently stroke or pat your hand on his back.
- Place the cloth on your lap. Turn the baby over on the tummy and position it perpendicular to your body. Support your chin with one hand and pat or rub your back with the other. Please note that the child's head should be higher than other parts of the body so that blood does not rush to it and food does not reflux into the respiratory tract.
As a rule, spitting up 6-8 times a day (in small portions) does not pose a health risk. Over time, when the baby's muscles get stronger, he will better absorb food. Most children stop spitting up after 6-7 months, but in some situations this problem persists up to one year.
If the spitting up is persistent and strong, prevents weight gain, the child cries after this process, then you should consult a doctor. Such symptoms may indicate that the baby has irritated walls of the esophagus.
Call a doctor immediately if your child is vomiting violently and profusely. This may indicate either the presence of food poisoning, or a disease associated with deformation of the internal organs.
If an infant vomits with greenish bile, this may be a sign of intestinal blockage, which requires urgent hospitalization and possibly even emergency surgery.
If your newborn is spitting up a lot after feeding, follow these guidelines:
- Do not breastfeed while baby is squatting or in a car seat as milk or formula may not reach the stomach.
- Create a calm atmosphere. Keep noise and other distractions to a minimum. If the baby is distracted and disturbed by something, there is an increased risk that he will swallow large amounts of air with formula or breast milk. For the same reason, do not let the baby be very hungry.
- Make sure that nothing is pressing on the baby's tummy. Make sure his clothes and diaper are not too tight.
- Avoid driving immediately after feeding.
- Hold the baby for about 30 minutes. upright after eating.
- When breastfeeding, make sure that the baby is properly latching onto the breast (his lips should cover not only the nipple, but also the areola, as far as possible).
- If you are feeding formula or bottled milk, make sure the opening of the nipple is not too small as this can prevent the baby from drinking and cause air to be swallowed. The hole should not be too large, so that the child does not choke.
- Do not overfeed your baby. Try feeding him less milk or formula. Watch the reaction. The baby may agree to drink a smaller volume at a time, however, will want to eat more often.
If regurgitation occurs frequently, after each feed, consult your physician.
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Preventive measures against regurgitation in children
Regurgitation is the spontaneous reflux of gastric contents into the esophagus and mouth. This condition is not uncommon in infants and is often a cause for concern for parents. The frequency of regurgitation syndrome in children of the first year of life is 18-50%: up to 4 months - 67%, up to 6 months 24%, up to 1 year 5%. In most cases, regurgitation is "benign" and disappears on its own after 12-18 months. At the same time, “benign” or physiological regurgitation characterizes:
the age of the child is up to 12 months;
spitting up 2 or more times a day for 3 or more weeks;
sufficient weight gain;
The child has no signs of metabolic disorders, diseases of the gastrointestinal tract or the central nervous system. The child does not experience difficulty in swallowing or feeding, there is no forced position of the body.
Do not confuse regurgitation with vomiting. When a child burps, the abdominal muscles do not tense up. With vomiting, on the contrary, muscle tension occurs and food is ejected by pressure not only through the mouth, but also through the nose. In some cases, there may be general anxiety, pallor, cold extremities. Often with vomiting, the temperature rises, loose stools appear, which is a sign of an infectious disease. Vomit may contain unchanged milk, mucus, blood or bile.
What causes physiological regurgitation
What is the tendency of babies to spit up? This phenomenon is explained by the peculiarity of the structure of the gastrointestinal tract of young children. At the age of one year, the esophagus is shorter and wider, physiological narrowing is weakly expressed. The stomach is located horizontally, its capacity is small, and the muscles that close the entrance to the stomach and prevent the contents from being thrown back into the esophagus are poorly developed. As the child begins to walk, the axis of the stomach becomes more vertical. The capacity of the stomach increases by the year from 30-35 ml to 250-300 ml. The secretory apparatus matures, the work of the closing muscles (sphincters) improves, which leads to a gradual decrease in the frequency and disappearance of regurgitation. These features explain the predisposition of young children to regurgitation and even the inevitability of this condition. However, there are measures to help reduce the frequency of regurgitation.
Factors contributing to physiological regurgitation include:
Overfeeding. As a rule, actively sucking babies begin to suffer from overfeeding, with abundant milk secretion, as well as when switching to artificial or mixed feeding with an incorrect calculation of the required amount of milk formula. Regurgitation appears immediately or some time after feeding in the amount of 5-10 ml. Milk can flow out unchanged or curdled.
Swallowing air during feeding (aerophagia). A similar situation arises if the child suckles greedily at the breast, and the mother's milk is not very plentiful; due to the retracted, flat nipple of the mother's breast, since the child fails to fully capture the nipple and areola; with artificial feeding, if the hole at the nipple of the bottle is large enough or the nipple is not completely filled with milk. Babies with aerophagia often experience anxiety after feeding, bulging of the abdominal wall (belly inflates). After 10-15 minutes, the swallowed milk flows out unchanged, which is accompanied by a loud sound of air eructation.
Intestinal colic or constipation. These conditions lead to an increase in pressure in the abdominal cavity and a violation of the movement of food through the gastrointestinal tract, causing regurgitation.
Until the child is four months old, spitting up up to two teaspoons of milk after feeding, or one spitting up of more than three spoons during the day, is considered the norm. You can check the amount of spitting up in the following way: take a diaper, pour one teaspoon of water on its surface, and then compare this spot with the spot formed after the next spitting up.
Abnormal regurgitation may be due to:
surgical diseases and malformations of the digestive system;
pathology of the central nervous system, trauma of the cervical spine during childbirth;
food intolerance, lactase deficiency;
increased intracranial pressure.
Such regurgitation is characterized by intensity, systematicity, the child spits up a large amount of milk. At the same time, there is a violation of the general condition of the baby - the child is whiny, loses or does not gain weight, cannot eat the amount of food necessary for his age. In such a situation, a pediatrician, gastroenterologist, surgeon, allergist, neurologist should be examined. It also requires examination and exclusion of anomalies in the structure of the upper gastrointestinal tract, the preservation of regurgitation for more than 1 year.
Scale for assessing the intensity of regurgitation:
Less than 5 regurgitations per day with a volume of not more than 3 ml - 1 point.
More than 5 regurgitations per day with a volume of more than 3 ml - 2 points.
More than 5 regurgitations per day up to half the amount of formula or breast milk, not more often than in half of the feedings - 3 points.
Spitting up a small amount of milk for 30 minutes or more after each feeding - 4 points.
Regurgitation from half to full volume of formula or breast milk in at least half of the feedings - 5 points.
Regurgitation with an intensity of 3 or more points requires a visit to a doctor.
Preventive measures against regurgitation in children
If regurgitation is physiological in nature, then it is not worth treating or correcting in this case. It is necessary to deal with the elimination of the cause, if possible, and carry out prevention.
Prevention of regurgitation in children includes the following measures:
Postural therapy: when feeding, it is necessary to hold the baby at an angle of 45 °, make sure that he completely grasps the nipple with the areola; after feeding, hold the baby in an upright position ("column") for 20 minutes - to drain the swallowed air. Due to this, the air that has entered the stomach will be able to go out. If nothing happened, then put the baby down and after a minute or two, lift him upright again.
Make sure that the opening in the bottle is not too large and that the nipple is filled with milk. Experiment with nipples - perhaps the other will be better. Milk should come out in drops, not a trickle.
Before you start feeding your baby, lay him belly down on a solid base.
After feeding, try to minimize the baby's physical activity, do not disturb him unnecessarily, and change clothes only if there is an emergency.