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why does baby spit up after breastfeeding

Spit-up is a common problem for many newborn babies. The lower esophageal sphincter is responsible for keeping stomach contents in the stomach and not back-flowing, also known as refluxing, into the esophagus. This sphincter is immature at birth and takes time to begin working properly. Breast-feeding babies may spit up for many reasons, and spitting up with every feeding doesn t necessarily signify a problem. Speak with your pediatrician or health-care provider if you are concerned about your baby spitting up for diagnosis and treatment recommendations. According to Kelly Bonyata, who oversees the breast-feeding and parenting website Kellymom. com, approximately one-half of all babies from birth to 3 months old spit up daily. Spitting up after feedings typically peaks around 4 months of age and usually resolves itself by the baby s first birthday. Breast-fed babies may spit up with varying severity, from minimal spit-up after feedings to much larger amounts that seem to be equal to an entire feeding. Minimal spit-up isn t a health risk if the baby is gaining weight and has six to eight wet diapers and three dirty diapers per day. One of the most common reasons that breast-fed babies spit up after feedings is due to an oversupply or forceful let-down. Let-down is a reflex that occurs so that the milk can be easily withdrawn from the breast. In some women, this occurs too hard and too fast, releasing milk much faster than a baby can nurse and keep up. Other causes of frequent spitting up are food sensitivities, gastroesophageal reflux disease, or GERD. Treating a baby who spits up frequently isn t necessary unless the baby experiences weight loss or other health problems.

However, if spit-up results from over-supply or forceful let-down, pumping for a few minutes prior to breast-feeding can help decrease the amount of milk or force of the milk during the nursing session. Handle your baby gently to minimize jostling and keep your baby upright for 30 minutes after each feeding. If a food sensitivity is causing your baby to spit up, work with your doctor or midwife to help identify the culprit. Cow s milk frequently causes problems for newborns that have difficulty digesting the casein protein in the milk. If your baby spits up large amounts of milk after every feeding, appears to be losing weight, or doesn t seem satisfied because so much milk is spit up, contact your child s pediatrician. Some babies do have GERD and require medication to help reduce reflux in order for the baby to thrive. If you have any questions related to your baby s care and overall health, do not hesitate to contact your doctor immediately.
Young babies naturally fuss and get cranky when they swallow air during feedings. Although this occurs in both breastfed and bottle-fed infants, itБs seen more often with the bottle. When it happens, it may be helpful to stop the feeding rather than letting your infant fuss and nurse at the same time. This continued fussing will cause her to swallow even more air, which will only increase her discomfort and may make her spit up. A much better strategy is to burp her frequently, even if she shows no discomfort. The pause and the change of position alone will slow her gulping and reduce the amount of air she takes in. If sheБs bottle-feeding, burp her after every 2 to 3 ounces (60Б90 ml).

If sheБs nursing, burp her when she switches breasts. Some breastfed babies donБt swallow very much air, and therefore they may not need to burp frequently. Most babies hiccup from time to time. Usually this bothers parents more than the infant, but if hiccups occur during a feeding, change his position, try to get him to burp, or help him relax. Wait until the hiccups are gone to resume feeding. If they donБt disappear on their own in five to ten minutes, try to resume feeding for a few minutes. Doing this usually stops them. If your baby gets hiccups often, try to feed him when heБs calm and before heБs extremely hungry. This will usually reduce the likelihood of hiccups occurring during the feeding. Spitting up is another common occurrence during infancy. Sometimes spitting up means the baby has eaten more than her stomach can hold; sometimes she spits up while burping or drooling. Although it may be a bit messy, itБs usually no cause for concern. It almost never involves choking, coughing, discomfort, or danger to your child, even if it occurs while sheБs sleeping. Some babies spit up more than others, but most are out of this phase by the time they are sitting. A few Бheavy spittersБ will continue until they start to walk or are weaned to a cup. Some may continue throughout their first year. It is important to know the difference between normal spitting up and true vomiting. Unlike spitting up, which most babies donБt even seem to notice, vomiting is forceful and usually causes great distress and discomfort for your child. It generally occurs soon after a meal and produces a much greater volume than spitting up.

If your baby vomits on a regular basis (one or more times a day) or if you notice blood or a bright green color in your babyБs vomit, consult your pediatrician. While it is practically impossible to prevent all spitting up, the following steps will help you decrease the frequency of these episodes and the amount spit up. Make each feeding calm, quiet, and leisurely. Avoid interruptions, sudden noises, bright lights, and other distractions during feedings. Burp your bottle-fed baby at least every three to five minutes during feedings. Avoid feeding while your infant is lying down. Hold the baby in an upright position for 20 to 30 minutes after each feeding. Do not jostle or play vigorously with the baby immediately after feeding. Try to feed her before she gets frantically hungry. If bottle-feeding, make sure the hole in the nipple is neither too big (which lets the formula flow too fast) nor too small (which frustrates your baby and causes her to gulp air). If the hole is the proper size, a few drops should come out when you invert the bottle, and then stop. Elevate the head of the entire crib with blocks (donБt use a pillow) and put her to sleep on her back. This keeps her head higher than her stomach and prevents her from choking in case she spits up while sleeping. Feeding your baby is one of the most important and, at times, confusing challenges youБll face as a parent. The recommendations apply to infants in general. Please remember that your child is unique and may have special needs. If you have questions, ask your pediatrician to help you find the answers that apply specifically to you and your infant.

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