|Spitting Up - Reflux|
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|Does this describe your child's symptoms?|
These complications occur in less than 1% of infants:
Reflux Versus Vomiting: How to Tell
|When to Call Your Doctor|
|Call Your Doctor Now (night or day) If|
|Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If|
|Call Your Doctor During Weekday Office Hours If|
|Parent Care at Home If|
|HOME CARE ADVICE FOR SPITTING UP (REFLUX)|
- Mild reflux occurs in most infants (50%).
- Usually it doesn't cause any discomfort or complications.
- Infants with normal reflux do not need any tests or medicines.
- Reflux improves with age.
- Feed Smaller Amounts:
- Skip this advice if age less than 1 month or not gaining weight well.
- Bottlefed: Give smaller amounts per feeding (1 ounce or 30 ml less than you have been). Keep the total feeding time to less than 20 minutes (reason: overfeeding or filling the stomach to capacity always makes spitting up worse).
- Breastfed: If you have a plentiful milk supply, try nursing on 1 side per feeding and pumping the other side. Alternate sides you start on.
- Longer Feeding Intervals:
- Formula: Wait at least 2½ hours between feedings.
- Breastmilk: Wait at least 2 hours between feedings.
- Reason: It takes that long for the stomach to empty itself. Don't add food to a full stomach.
- Loose Diapers: Avoid tight diapers. It puts added pressure on the stomach. Don't put pressure on the abdomen or play vigorously with your child right after meals.
- Vertical Position: After meals, try to hold your baby in the upright (vertical) position. Use a front-pack, backpack, or swing for 30 to 60 minutes. Reduce time in sitting position (e.g., infant seats). After 6 months of age, a jumpy seat is helpful (the newer ones are stable).
- Less Pacifier Time:
- Constant sucking on a pacifier can pump the stomach up with swallowed air.
- So can sucking on a bottle with too small a nipple hole. If the formula doesn't drip out at a rate of 1 drop per second when held upside down, clean the nipple better or enlarge the hole.
- Burping is less important than giving smaller feedings. You can burp your baby 2 or 3 times during each feeding.
- Do it when he pauses and looks around. Don't interrupt his feeding rhythm in order to burp him.
- Burp each time for less than a minute. Stop even if no burp occurs. Some babies don't need to burp.
- Expected Course: Reflux improves with age. Many babies are better by 7 months of age, after learning to sit well.
- Call Your Doctor If:
- Your baby doesn't improve with this approach
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 9/15/2011
Last Revised: 4/6/2012
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.