Baby spitting up milk: Should I worry?
Jul 18, 2011
It is common for babies to spit up milk after feeding or burping. About 40% of infants spit up a small fraction of what they have consumed.
By Anthony Olwoch
It is common for babies to spit up milk after feeding or burping. About 40% of infants spit up a small fraction of what they have consumed.
Cause
According to Dr. Flavia Katamba, a paediatrician at Case Clinic in Kampala, over-feeding (especially in boys) and inhalation of air while feeding are the major causes of spitting up.
“The valve between the oesophagus (the tube between the mouth and the stomach) and the stomach that prevents food from coming up is not well-developed in infants to hold food down, so when a child overfeeds or inhales air during feeding, the valve cannot withstand the pressure, consequently returning the food to the mouth.
“At around six months to a year, infants normally outgrow the tendency to spit up as they begin to eat solid food. As the valve between the stomach and oesophagus develops, it becomes less likely for the food to travel up the oesophagus,†Katamba explains.
Abnormal causes
Vomiting: Dr. Jamiir Mugalu, a neonatologist (specialist in newborns) at Mulago Hospital, says congenital (existing since before birth) obstruction of the upper part of the gut causes vomiting in infants.
Babies with this condition usually take long to pass the first stool, and the mother would have a bigger abdomen than normal during pregnancy because of extra fluid in womb.
“The condition can also occur as a result of stool forming in the lower part of the gut when a baby is still in the womb. The stool blocks the gut and prevents food from going beyond this point, thus causing vomiting.
“A doctor would, therefore, have to dislodge the stool plug to unblock the gut,†Mugalu says.
If the lower part of the oesophagus is wide, this can also cause an infant to vomit. Babies with this condition usually aspirate and turn blue.
Abdominal colic which begins at about two weeks to three weeks can also spark off the condition. This happens because the gut is not well synchronised, so while breastfeeding, a lot of air is inhaled in the gut. During digestion, the organisms in the gut also produce a lot of gas.
In premature babies, because the gut is very brittle and cannot digest well, there is distention of the abdomen and vomiting, which can result in perforation of the gut.
Vomiting can also occur due to infections in the bladder. When all other problems have been ruled out, a urine culture or urinalysis test is done.
In children older than six months to a year, vomiting can be a result of the intestines entangling. The child presents with vomiting and bloody stool which takes on a tomato sauce-like appearance.
In the first one to three days, babies with a blockage in the oesophagus present with increased frothing of saliva, which sometimes goes to the lungs and interferes with breathing. These babies need urgent surgery.
Vomiting can also result from constipation when a baby is fed with formula milk. This is because unlike breast milk, formula milk is more difficult to digest.
“Before a baby vomits, the mother can be able to feel or see a sausage-like mass moving in the upper part of the abdomen before the vomiting occurs†Mugalu says.
Danger signs
when a baby is irritable, weak, refuses to eat, shows signs of dehydration, loses weight, has a fever, chronic cough, or diarrhoea and experiences difficulty in breathing, Katamba says a mother should seek immediate medical attention.
Ensure that a baby sleeps in the right position and the vomit is cleaned to prevent it from going into the airway, which can cause pneumonia, suffocation and death†Katamba warns.
How to keep food down
-Do not over feed a baby. Feed in intervals to allow the stomach contents to empty into the intestines.
- Avoid noise and distraction while feeding. This helps prevent a baby from swallowing air as a result of distraction.
- Always burp your baby after each feeding. Rubbing or patting the baby’s back helps expel air from the stomach.
- Feed your baby while holding him in an upright position.
- Keep your baby in an upright position for half an hour or so after feeding. This allows gravity pull the food down.
- Make sure the hole in the nipple of your baby’s feeding bottle is of the correct size. When it is too large, the fluid will come out too fast and cause him to gulp. When it is too small, the baby will swallow a lot of air.
- Elevate the head of your baby while he sleeps.
- Make sure your baby’s clothing and diaper are not so tight so as to keep pressure off the tummy.
It is common for babies to spit up milk after feeding or burping. About 40% of infants spit up a small fraction of what they have consumed.
Cause
According to Dr. Flavia Katamba, a paediatrician at Case Clinic in Kampala, over-feeding (especially in boys) and inhalation of air while feeding are the major causes of spitting up.
“The valve between the oesophagus (the tube between the mouth and the stomach) and the stomach that prevents food from coming up is not well-developed in infants to hold food down, so when a child overfeeds or inhales air during feeding, the valve cannot withstand the pressure, consequently returning the food to the mouth.
“At around six months to a year, infants normally outgrow the tendency to spit up as they begin to eat solid food. As the valve between the stomach and oesophagus develops, it becomes less likely for the food to travel up the oesophagus,†Katamba explains.
Abnormal causes
Vomiting: Dr. Jamiir Mugalu, a neonatologist (specialist in newborns) at Mulago Hospital, says congenital (existing since before birth) obstruction of the upper part of the gut causes vomiting in infants.
Babies with this condition usually take long to pass the first stool, and the mother would have a bigger abdomen than normal during pregnancy because of extra fluid in womb.
“The condition can also occur as a result of stool forming in the lower part of the gut when a baby is still in the womb. The stool blocks the gut and prevents food from going beyond this point, thus causing vomiting.
“A doctor would, therefore, have to dislodge the stool plug to unblock the gut,†Mugalu says.
If the lower part of the oesophagus is wide, this can also cause an infant to vomit. Babies with this condition usually aspirate and turn blue.
Abdominal colic which begins at about two weeks to three weeks can also spark off the condition. This happens because the gut is not well synchronised, so while breastfeeding, a lot of air is inhaled in the gut. During digestion, the organisms in the gut also produce a lot of gas.
In premature babies, because the gut is very brittle and cannot digest well, there is distention of the abdomen and vomiting, which can result in perforation of the gut.
Vomiting can also occur due to infections in the bladder. When all other problems have been ruled out, a urine culture or urinalysis test is done.
In children older than six months to a year, vomiting can be a result of the intestines entangling. The child presents with vomiting and bloody stool which takes on a tomato sauce-like appearance.
In the first one to three days, babies with a blockage in the oesophagus present with increased frothing of saliva, which sometimes goes to the lungs and interferes with breathing. These babies need urgent surgery.
Vomiting can also result from constipation when a baby is fed with formula milk. This is because unlike breast milk, formula milk is more difficult to digest.
“Before a baby vomits, the mother can be able to feel or see a sausage-like mass moving in the upper part of the abdomen before the vomiting occurs†Mugalu says.
Danger signs
when a baby is irritable, weak, refuses to eat, shows signs of dehydration, loses weight, has a fever, chronic cough, or diarrhoea and experiences difficulty in breathing, Katamba says a mother should seek immediate medical attention.
Ensure that a baby sleeps in the right position and the vomit is cleaned to prevent it from going into the airway, which can cause pneumonia, suffocation and death†Katamba warns.
How to keep food down
-Do not over feed a baby. Feed in intervals to allow the stomach contents to empty into the intestines.
- Avoid noise and distraction while feeding. This helps prevent a baby from swallowing air as a result of distraction.
- Always burp your baby after each feeding. Rubbing or patting the baby’s back helps expel air from the stomach.
- Feed your baby while holding him in an upright position.
- Keep your baby in an upright position for half an hour or so after feeding. This allows gravity pull the food down.
- Make sure the hole in the nipple of your baby’s feeding bottle is of the correct size. When it is too large, the fluid will come out too fast and cause him to gulp. When it is too small, the baby will swallow a lot of air.
- Elevate the head of your baby while he sleeps.
- Make sure your baby’s clothing and diaper are not so tight so as to keep pressure off the tummy.