Baby Spit-Up: What's Normal, What's Not

Avoid overfeeding. Smaller and frequent feedings will empty the stomach faster.

• Avoid overfeeding. Smaller and frequent feedings will empty the stomach faster.
  
• Minimize intake of air during feeding. If the bottle is too low, the baby can swallow air, causing gas and crying.
  
  
• Don't jiggle the baby during and after feeding. Too much movement may cause reflux.
  


• Sit her in an upright position after feeding. Sitting and lying on the back makes reflux worse. Hold the baby in your arms as much as you can.
  


• Elevate the crib at a 30-degree angle. I suggest using a book under the legs at the head of the crib. Do not use pillows since this can cause suffocation.
  


• With your pediatrician's approval, put a baby with severe GERD to sleep on her tummy. The American Academy of Pediatrics recommends that babies sleep on their back in order to avoid SIDS. There is an exemption for babies with severe GERD since it can improve gastric emptying. Only follow this under doctor's orders.
  
  
• Avoid exposure to tobacco smoke. This relaxes the esophageal sphincter.
  
  
• Thicken formula with rice cereal. Add one tablespoon of rice cereal for every two ounces of formula and cross-cut the nipple to facilitate the flow of this mixture. Although this may improve reflux, it can cause excessive gas and constipation. Consult your doctor before trying.

When these lifestyle measures do not improve the symptom of vomiting, the following medical therapies are available, but should only be tried under doctor's advice:

• Antacids. Maalox and Mylanta are over-the-counter drugs, and Zantac liquid is available by prescription.
  
  
• Drugs to improve gastric emptying. The most popular drug, Propulsid, is no longer available due to dangerous side effects. Another drug, Reglan, is available, but also has side effects to be considered.
  
  
• Hypoallergenic formula. Babies who are allergic to cow's or soy milk may require a different formula. Breast-feeding mothers should go on a milk-free diet with calcium supplement.

Read more about baby's first year.

The content on these pages is provided as general information only and should not be substituted for the advice of your physician.