The Preemie Parents' Companion: the Essential Guide to Caring for Your Premature Baby in the Hospital, at Home, and Through the First Years by Susan Madden

Author:Susan Madden [Madden, M.S., Susan L.]
Language: eng
Format: epub
Publisher: Harvard Common Press

Spitting Up or Gastroesophageal Reflux

Spitting up, also known as reflux, is another very common trait among premature babies. Although rarely serious, it can make life difficult, as this mother describes:

"My son spit up so much, I basically spent the first year of his life sitting in a chair in the kitchen, twenty-four hours a day. I never knew when he would spit up and I didn't want it in the living room or bedroom.... I felt like I was constantly covered in throw up."

Spitting up is most often caused by an immature or weak muscle at the bottom of the esophagus where it enters the stomach. This allows the contents of the stomach to get pushed back up into the throat and out the mouth. Sometimes the milk will only come part way up the throat so that the baby does not actually spit up. Because stomach acids can irritate the esophagus, your baby may act uncomfortable after feedings, or cry and squirm if this is happening.

In most cases, reflux is not a serious problem. As long as your baby continues to eat well, gain weight, and not seem too uncomfortable, medical treatment is usually unnecessary. If you are concerned that your baby is losing too much of her feeding, try pouring a tablespoon or two of milk on a counter to see what it looks like. Most reflux amounts are not signif icant and amount to a teaspoon or two of milk mixed with stomach juices and mucous. In most cases, spitting up decreases gradually as your baby grows, and is usually gone by about 6 to 12 months of age.

There are a number of things you can try that may help to decrease the amount of spitting up your baby is doing. First, try not to jostle her during or after a feeding, hold her in more of an upright position, burp her often, and make sure she isn't sucking in air with the milk in the bottle. Angled bottles or those with collapsing disposable bags may help decrease the amount of air she takes in. Holding your baby upright against your shoulder for about 30 minutes after a feeding may help the milk settle and reduce spitting. You can also place your baby on her stomach with the head of her bed raised so that she is lying at a 45° to 80° degree angle for 30 to 60 minutes after a feeding. If you worry about placing your baby on her stomach, position her on her right side instead; this helps the food pass more quickly through her stomach. Sitting her in an infant seat may actually put more pressure on your baby's tummy and cause more spits.

Some pediatricians suggest that you thicken your baby's feeding with one or two tablespoons of infant rice cereal per ounce of formula. You will have to cut a cross-hatch in the nipple in order to get the thickened formula to flow and it can be quite frustrating to get this to work right.

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