Spitting Up

When what goes in always seems to come out

If you are fortunate, you will be blessed with a baby who, from birth, has the ability to politely keep whatever he drinks to himself and realizes that spitting up does not count as sharing. The information that follows will not be as relevant to you as it will be to those new parents who quickly become conditioned to expect that some part of every feeding will inevitably come back up and out. If you happen to already be sitting with a spit rag over your shoulder(s) and protective coverings over most of your furniture, then you'll undoubtedly be able to relate to the frustration of "what you've worked so hard to put in always seems to come out, even when you don't want it to and despite all your best efforts to keep it in".

For most babies, spitting up is simply the result of a not yet fully developed muscle that is supposed to serve as a gatekeeper at the top of the stomach — in general allowing food (drink, in this case) into the stomach and then keeping it there. For those of you who are dying to know the name of the muscle most likely to blame for your spit-up woes, it is called the lower esophageal sphincter. For a clearer picture, take a minute to visualize your baby's stomach as an upright water balloon with a narrow opening at the top — in the case of a spitty baby, a water balloon left a little too loosely secured. It's not hard to imagine how any amount of applied pressure — a poke or squeeze on the side — or a change in position could cause its contents to overflow — especially at times when the balloon is relatively full. For some newborns, a simple gas bubble or a press on the belly is often quite enough to overpower a novice sphincter muscle and allow a baby to spit up. Most of the time, spitting up doesn't bother babies. For the parents of these so-called happy spitters, a loose sphincter simply means being more diligent about burping, stockpiling a larger supply of burp cloths or spit rags, and investing in a bottle (or 3) of stain remover..

Remedies for Spitty Babies

Burping and spitting up often go hand in hand for newborns. The air in a baby's stomach decides to come up, and the stomach contents often opt to tag along for the ride — a tendency that serves to explain why you'll find a fair bit of overlap between burp prevention and spit-up avoidance techniques. If you find that your newborn tends to spit up quite a bit, there are several things you can try to remedy the situation.

• Position your baby's head higher than the rest of her body when she's eating.
• Step up your burping efforts. You can either just put a little more effort into eliciting a good burp after each feeding, or even try burping more frequently during the feeding — after every 5 minutes of breastfeeding or every ounce or so from a bottle. Only you and your baby can decide whether the interruption in feeding is worth the results.
• Hold or position your baby relatively upright for a good 20 to 30 minutes after meals.
• While some parents find that simply switching brands of formula or eliminating certain foods in a breastfeeding mother's diet can help decrease the amount of spitting up, it's always worth checking with your doctor before considering such changes. While on occasion a change might help, for many newborns and their parents it's an unnecessary inconvenience.

 

The Shape of Things to Come (Up)

No matter how curdled or "spoiled" your baby's spit-up appears, you can reassure yourself that it doesn't really matter. The curdled appearance just reveals that your baby's stomach had already started processing it before it managed to escape and nothing more.

The Path of Least Resistance

Many parents get alarmed when liquid comes spewing out of their baby's nose, when in reality this is an anatomically normal (albeit potentially surprising and/or unpleasant) occurrence. In case you haven't already discovered it for yourself, we all have a direct connection between the backs of our throats and our noses. Stomach contents expelled by spitting up or vomiting usually follow the path of least resistance, so depending on the circumstances — your baby's positioning and the force of the eruption to name a couple — the exit route may be his mouth and/or his nose.