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Parent’s Guide

Parent’s Guide: Reflux (Spitting Up)

Spitting up is a messy but usually harmless part of infancy. It happens because the valve at the top of the stomach isn't strong enough to keep milk down yet.

1

🔎Identifying Reflux vs. Vomiting

The “Happy Spitter” (Normal):

The baby spits up 1–2 mouthfuls but smiles, looks healthy, and is gaining weight. There is no effort or pain.

True Vomiting (Abnormal):

The milk comes out forcefully. The baby looks sick, acts cranky, or is in pain.

GERD (Complication):

Occurs in <10% of babies. Signs include choking, poor weight gain, and constant crying from heartburn.

2

🏠Immediate Home Care (How to reduce spit ups)

  • Smaller Feeds: Overfeeding is the #1 trigger. Give slightly less milk (1 oz less) but feed a bit more often if needed.
  • Gravity Helps: Keep the baby upright (vertical) for 30-40 minutes after eating. Use a front pack or swing.
  • Diaper Check: Ensure the diaper is loose around the waist to prevent squeezing the stomach.
  • Thickening: If advised by a doctor, adding rice cereal to formula (1 tsp per oz) can help keep milk down.
3

🚨 When to Get Help

Call 911 Now

  • Baby chokes on milk and turns blue or goes limp.
  • There is blood in the spit-up.

Call Doctor Now or Go to ER

  • Projectile Vomiting: Forceful vomiting that shoots out (especially in babies 2 weeks to 2 months old). This could be Pyloric Stenosis.
  • Vomit contains green bile.
  • Newborn acts sick or abnormal.
  • Baby is losing weight or not gaining.
4

Prevention & Triggers

  • Pacing: Wait at least 2 hours between feedings to let the stomach empty.
  • Air Intake: Check bottle nipples. If the hole is too small, the baby sucks in air. Limit pacifier use if it causes air swallowing.
  • Positioning: Avoid “tummy time” or rough play immediately after a meal.

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