Pediatrics: Lillian Beard, M.D.

My baby is 8 weeks old and is breast fed. He has a tendency to spit up quite frequently. What causes this, and what can I do to remedy it?

By Lillian Beard, M.D.

You might first try to determine if these episodes are merely "wet burps." Some infants are difficult to burp and spit up a bit of milk with each attempt or hiccup. Believe it or not, many babies are what we call "happy spitters". These babies are not in distress as they spit up; they are alert, well hydrated, and are growing and developing well.

As a breast feeding mom, keep in mind that your baby eats what you do; that is, everything you eat is reflected in your breast milk. You might try to examine your diet by keeping a food diary for one week. Are your meal selections filled with highly seasoned, gassy, or spicy foods? If so, they may precipitate episodes of spitting up. After food is swallowed, it must pass a series of muscular valves as it progresses through the gastrointestinal system. This is nature's design to allow for a steady one way flow of swallowed food and liquid to facilitate the digestive process. Some infants have less fully matured muscle development of these valves; therefore, food and liquid freely flow back and forth with any positional changes or body movement. When that valve between the end of the food pipe (the esophagus) and the stomach is faulty, it is known as "gastroesophageal reflux," allowing return of some part of whatever meal is swallowed.

Many experts recommend minimal or no stimulation while keeping your baby in an upright position for at least 45 minutes following each feeding, so that gravity will assist the desired one way directional flow. In most instances, with time, as these muscles mature, the frequency of the spitting up episodes subside.

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