Today I got pulled out of my yoga class because my baby was "throwing up." I told the care taker that he spits up a lot and she proceeded to tell me that he did it 6 times. Um, ok... no big deal. They didn't seem to agree.
Now, for my baby, this really is nothing. He spits up. A lot. I'm not exaggerating and most of the other moms I know and know him would agree that he spits up more than pretty much every other baby they know. He used to spit up after every feeding. I even started nursing him on a single side at each feeding instead of offering him both because of how much he spit up. It helped, but only marginally. As he has gotten older, the spit up tends not to come immediately after nursing, but it still shows up. He'll spit up multiple times over the course of an hour or so after nursing. Sometimes it's projectile, sometimes it dribbles. Either way, it is a lot. I keep stacks of burp rags in various places around the house and can gather 2-3 burp rags from each area at the end of the day (that amounts to anywhere from 4-9 in a day). For my baby, this is normal - and yes, I did discuss it with the pediatrician.
Spitting up is normal for babies. There are several different reasons they do so. Some swallow air while drinking or nursing and when they burp that air up, up comes the spit up with it. Other babies eat too much and spit up what does not fit in the stomach.
Babies in general have an underdeveloped sphincter muscle at the top of their stomach. In adults and older kids, this muscle keeps food in the stomach, for babies, it hasn't matured, so food comes up much easier. As they get older, this muscle tightens and does a better job. Babies that are fed formula typically spit up less (unless they get a bubble under it which is common from bottle feeding) since formula is denser than breast milk and has the help of gravity to keep it in the stomach. The same goes for older babies once they start eating solids.
At seeing or hearing about how much my baby spits up, most people would be worried or concerned about reflux. Some have even suggested I have it checked out. Reflux in babies is like extreme heartburn in adults. I'm not sure of the mechanism that causes it and why some babies get it while others don't, but it is associated with excessive spitting up. In recent years, more information and more cases of reflux being diagnosed have lead many people to think it is more common than it is. In order to diagnose the condition, babies must go through a series of GI testing including an endoscopy, lab work, etc.
So, how do I know that my baby isn't suffering from reflux? Well, there are several key indicators. First, my baby is rather unphased by the episodes. He spits up and moves on. Ok, well, sometimes he tries to play with the spit up, but that's neither here nor there. Reflux is painful for babies. It can be painful when they are spitting up or when they are nursing/eating. Some experience it in both situations, for others it is one or the other. Some babies with reflux are soothed by nursing/eating. Many of them experience cholic like crying habits where it is hard to identify the reason they are crying. Another indicator that my baby does not have reflux is that he isn't suffering from malnutrition because of the amount he spits up. Now, it may look like he doesn't get anything, and believe me, it does appear that he must spit up his entire stomach's worth. He continues to grow however (staying significantly larger than the other babies in my mom group and well above the 80th percentile for his age) and he produces plenty of diapers - which I could use less, but I'm not really complaining.
While I'm not suggesting you ignore symptoms, I really think that many people exaggerate the commonality of reflux. Babies spit up. It's just one of the things they do. Even older babies like mine (10 mo). In his case it's a lot. As in, copious amounts. But that's ok. He's growing and happy. So for now, I'm not concerned. I may need to have a discussion with the care takers where I take yoga, though... it is not throwing up, it is spitting up and it's normal.
