It is not unusual for babies to spit up after nursing. Usually, babies can spit up and show no other signs of illness, and the spitting up disappears as the baby's digestive system matures. As long as the baby has six to eight wet diapers and at least two bowel movements in a 24 hour period (under six weeks of age), and your baby is gaining weight (at least 4 ounces a week) you can be assured your baby is getting enough milk.
However, some babies have a condition called gastroesophageal reflux (GER), which occurs when the muscle at the opening of the stomach opens at the wrong times, allowing milk and food to come back up into the esophagus (the tube in the throat). Symptoms of GER can include:
- severe spitting up, or spitting up after every feeding, or hours after eating
- projectile vomiting, where the milk shoots out of the mouth
- inconsolable crying as if in discomfort
- arching of the back as if in severe pain
- refusal to eat or pulling away from the breast during feeding
- waking up frequently at night
- slow weight gain
- problems swallowing
- gagging or choking
- frequent red or sore throat
- frequent hiccupping or burping
- signs of asthma, bronchitis, wheezing, problems breathing, pneumonia, or apnea
Many healthy babies might have some of these symptoms and do not have GER. But there are babies who might only have a few of these symptoms and have a severe case of GER. Not all babies with GER spit up or vomit.
Some babies with GER do not have a serious medical problem, but caring for them can be hard since they tend to be very fussy and wake up frequently at night. More severe cases of GER may need to be treated with medication if the baby, in addition to spitting up, also refuses to nurse, gains weight poorly or is losing weight, or has periods of gagging or choking.
If your baby spits up after every feeding and has any of the other symptoms mentioned above, it is best to see his or her doctor for a correct diagnosis. Other than GER, your baby could have another condition that needs treatment. If there are no other signs of illness, he/she could just be sensitive to a food in your diet or a medication he/she's receiving. If your baby has GER, it is important to try to continue to breastfeed since breast milk still is more easily digested than formula. Try smaller, more frequent feedings, thorough burping, and putting the baby in an upright position during and after feedings.