Tips to reduce spitting up
Is a pediatric gastroenterologist at the Children’s Center for Digestive Health Care / GI Care for Kids, whose books on nutrition for parents led him to start Nutrition4Kids with his co-founders.
Almost all babies spit up. It doesn't matter if it is formula or breast milk. Keep reading for tips that can help reduce how often your baby spits up.
Smaller, More Frequent Feeding
At birth, a baby's stomach is the size of a marble. At one week, it grows to the size of an apricot. Small stomachs can only hold 1 to 2 ounces of breast milk or formula.
At 1 month of age, a baby can hold about 2.5 to 5 ounces. The problem is that sometimes, babies are overfed. This is common when they cry or fuss at the end of a feeding. As a result, the over filled tummy causes the baby to spit up.
To prevent spitting up from overfeeding, try smaller and more frequent feedings. Most babies need about 2 to 2.5 ounces of formula or breast milk per pound of body weight each day.
If the baby cries when the feedings stop, soothe him with your thoroughly washed finger placed upside in mouth. Sucking on your finger should help calm him down. Burping the baby can also help by removing any gas.
Thicken the Feeding
Thickening formula or breast milk with infant cereal can help reduce vomiting. We recommend about 1 teaspoon of cereal per ounce of liquid. If the baby does not improve, you can slowly add an extra 1/2 teaspoon of cereal per ounce of liquid. The maximum amount of infant cereal is 3 teaspoons to an ounce of liquid.
Thickened formula will be more difficult for a baby to suck from a regular nipple. Use a larger, cross-cut or "Y" nipple hole to allow the thickened formula to flow easily. Another tip is to use a coffee grinder or mini food processor to make the cereal into a powder.
Keep in mind that adding cereal also adds calories.
You can try one of the formulas designed for babies with reflux. Similac Sensitive for Spit Up and Enfamil AR add rice starch to help keep babies from spitting up. Feeding slowly and limiting amount is also important with these formulas.
Don't use these formulas if your baby is taking an acid blocker like Prevacid.
Let Gravity Help
Keep your baby upright, at about a 45-60 degree angle (almost half way up) after feedings. Being somewhat upright will help keep the formula or breast milk in their tummies. Try an infant seat or "bouncer" after feedings. You may need to place some rolled up towels on each side of the baby and on the bottom so the legs aren't pressing on the abdomen. You can also elevate the baby's head when he or she is sleeping.
Note that the American Academy of Pediatrics recommends that babies be put on their backs to sleep.
"AAP Expands Guidelines for Infant Sleep Safety and SIDS Risk Reduction," HealtyChildren.org, October 18, 2011, http://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Expands-Guidelines-for-Infant-Sleep-Safety-and-SIDS-Risk-Reduction.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token (accessed July 28, 2012).
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