Newborn Spit-up / Newborn
By Michael Schoenwetter, MD
newborns spit-up. I answer questions about newborn spit-up daily.
Recurrent spit-up is called reflux and is very common in the newborn
period. Some newborns spit up a little and some spit up a lot. I get a
lot of concerned parents asking me if the spit up that comes out of
their newborn's nose is okay. The answer is yes. In the DVD I will speak
more about newborn spit up.
Newborn vomiting is different. Some parents
are nervous that they won't be able to recognize the difference between
vomiting and reflux. Even the inexperienced first time parents will be
able to recognize the differences. Vomiting is the forceful evacuation
of stomach contents. Any recurrent vomiting needs to be evaluated by
your doctor as it could be a sign of serious illness in the newborn.
Reflux, in most cases, does not need
intervention. There are a few scenarios where reflux is not considered
normal. For these situations, multiple interventions are available. The
newborn DVD will discuss when newborn spit-up and newborn Reflux are
normal and the specific situations that might concern a pediatrician.
The newborn DVD will also review the interventions for this very common
Why do newborns
Almost all newborns and babies spit-up. If the spit-up is recurrent, it
is called reflux. Anatomically, there is an area between the esophagus
and the stomach that acts like a door, called the Lower Esophageal
Sphincter (LES). When your newborn has food in its esophagus, the "door"
is open to let the food into the stomach. When the food has passed into
the stomach, the door is supposed to close. Newborns and babies commonly
have a "door" that doesn't close tight, allowing the food to pass from
the stomach up into the esophagus and sometimes out the mouth or nose.
If the "door" is slightly open, there is a little reflux. If the door is
not closing much at all, a lot of reflux can occur.
There are three scenarios where intervention
is needed for newborn reflux. First, your child has to gain weight
appropriately. If 60% of your newborn's milk is on your shoulder instead
of in his belly, he will not grow correctly and intervention needs to be
done. Second, if your newborn is sickly. If the baby has a history of
lung problems, such as wheezing or pneumonia, the doctor might be
concerned that the refluxed food is getting into the newborn's lungs and
this would necessitate intervention as well. The third scenario, which
is the most common that I intervene for, is if the newborn is an unhappy
baby. If parents voice their concern regarding how unhappy their baby
is- crying more than they think they should- in combination with their
baby having reflux, it is possible that the reflux might be contributing
to their newborn's temperament. This can happen as acid might be
refluxed from the stomach along with the food causing pain. The
interventions most commonly done for these scenarios are medications and
dietary changes. Sometimes, for severe reflux, a referral to a
specialist is warranted for other management options.
A lot of the newborns and babies I see do
not need intervention for their reflux. If the baby is healthy, happy
and gaining weight, I call the reflux a laundry problem as the only
thing that needs to be done is cleaning more spit-up! A point to
remember is that reflux can peak between 3-5 months so symptoms that do
not require intervention early might at a later time.
Check out the
care DVD for even more great information!
Newborn Care Site Map
Newborn Care DVD
Newborn Care Home