Regurgitation in babies is a fairly common experience, but it also easily worries many parents, especially first-time parents. In the following post you will learn what exactly regurgitation is, why it occurs in babies and how it can be treated effectively. You will understand that, although regurgitation can be disconcerting, in most cases it is completely normal and does not represent a risk to the baby's health. Finally, we will give you tips and advice to avoid it and so that both you and your baby are calmer.

What is regurgitation in babies?

Regurgitation is the process in which the contents of the baby's stomach return to the mouth or are expelled. This regurgitation is usually accompanied by a belch, in most cases.

Why does a baby spit up? Causes

Regurgitation is a common phenomenon in healthy babies, especially during the first months of life. About half of babies experience regurgitation due to a condition known as gastroesophageal reflux or infant reflux. This condition occurs when the contents of the stomach return to the esophagus, causing the baby to expel milk involuntarily and its main causes are:

Immaturity of the lower esophageal sphincter

The lower esophageal sphincter is a muscle located between the esophagus and the stomach, whose function is to keep stomach contents in place. In babies, this muscle is not yet fully developed, so it can easily open and allow milk to flow back into the esophagus.

Overfeeding

Babies can spit up if they consume more milk than their small stomach can handle, and when the stomach is too full, the pressure can force the contents upward, causing regurgitation.

Air swallowing during feeding

When feeding, babies usually swallow air along with milk. This air takes up space in the stomach and increases internal pressure, making it easier to regurgitate when the baby burps to release air.

Liquid nature of infant nutrition

Liquid foods, such as breast milk or formula, are more likely to be regurgitated compared to solid foods; the characteristic lightness of liquids makes it easier for them to go back up the esophagus.

Symptoms of regurgitation in babies

The symptoms associated with regurgitation in babies are:

• Spitting up milk: The baby spits up milk frequently, especially after feeding or when lying on his back.
• Frequent burping: Burping is abundant after each meal, regardless of how much the baby has eaten.
• Back arching: The baby arches his back or tilts his head back during or after feeding. This position may be the baby's attempt to relieve discomfort caused by regurgitation.
• Irritability: The baby seems to be upset or uncomfortable after eating, sometimes crying, frowning, or making a face of pain.
• Difficulty sleeping: If there are difficulties getting the baby to fall asleep or stay asleep.

Difference between reflux and regurgitation in babies

While the terms “reflux” and “regurgitation” are often used interchangeably, there is a subtle difference between the two. Gastroesophageal reflux is the passage of stomach contents into the esophagus and is a normal process that occurs in all babies. In fact, most babies experience some degree of GER during the first months of life.

On the other hand, regurgitation is when the contents of the baby's stomach return to the esophagus and come out through the mouth. It is a common symptom of GER, but it can also be caused by other things, such as overstimulation in babies,  overeating or excessive belching.

Is it normal for a baby to spit up a lot?

Regurgitation is very common in babies and is usually harmless, as we have already said, it affects almost half of babies during the first three months of life. What does this mean? In most cases, regurgitation is not a cause for concern, however, there are some signs that may indicate that there is some other health problem, these symptoms are:

• Vomiting: If your baby vomits forcefully or frequently, he could be suffering from gastroesophageal reflux disease (GERD).
• Poor weight gain: If your baby is not gaining weight adequately, there could be excessive milk loss through regurgitation.
• Blood in vomit: The presence of blood in your baby's vomit is a serious symptom that requires immediate assistance.
• Irritability: If your baby seems upset or irritable almost continuously and you find it very difficult to comfort him or get him to calm down.

How to treat regurgitation in babies?

Regurgitation is very common in babies and is usually not a cause for concern. In fact, most babies stop spitting up as they grow and their digestive system matures. If you have questions you can always ask a pediatrician about your specific case. Although you shouldn't do anything like "treat" it as such, there are things you can do to avoid it, which we discuss in the next section.

How to avoid regurgitation in babies?

The first thing you should understand about regurgitation is that avoiding it completely is impossible, since it is something that happens naturally. This does not mean that they cannot be avoided to some degree, although difficult, it is possible. Some measures you can take to reduce its frequency and severity are:

• Adopt fractional feeding: Instead of offering large feedings of milk at long intervals, opt for smaller, more frequent feedings. This helps reduce the amount of milk in the baby's stomach at one time, minimizing pressure and the chance of regurgitation.
• If you are breastfeeding: Hold the baby in a semi-inclined position, with the head higher than the stomach to promote the natural flow of milk and reduce the risk of reflux.
• If you use a bottle: Tilt the bottle at a 45-degree angle, ensuring that the nipple is completely filled with milk to prevent the baby from swallowing air.
• Take breaks to burp: During feeding, pause every 5-10 minutes for the baby to burp so he can release the air trapped in his stomach, preventing discomfort and regurgitation.
• Promotes the expulsion of gas after feeding: Place the baby on your shoulder and gently pat him on the back while he burps for 10-15 minutes. You can also lay him face down on your forearm, tilting his torso slightly.
• Avoid sudden movements: Do not shake or rock the baby immediately after feeding, instead wait at least 30 minutes for the milk to settle in his stomach.
• Watch for signs of satiety: Pay attention to your baby's signs that he is full, such as disinterest in the bottle or breast, closing his mouth, or turning his head away. Don't force him to finish the feeding if he doesn't want any more.
• Choose the right nipple (if you use a bottle): Opt for a slow-flow nipple that requires greater suction, which reduces air intake and therefore regurgitation.
• Take care of your sleeping position: Raise the crib to sleep regression in babies. Slightly tilt the crib by raising the headboard a few centimeters (with a cloth or special wedge). This helps keep the baby upright and prevents milk from going up the esophagus.
• Dress the baby in loose clothing: Avoid tight clothing around the abdomen, as it can put pressure on the stomach and encourage regurgitation.
• Consult your pediatrician: If regurgitation is excessive, frequent or causes discomfort to the baby, it is important to consult with a pediatrician. The doctor will be able to rule out any underlying problems and give you personalized recommendations.

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Conclusion

In conclusion, regurgitation in babies is a normal part of their development and growth process. Although it may be very disconcerting for you as a parent, you should remember that, in most cases, your baby spitting up does not represent a significant health problem. By understanding the causes behind this phenomenon and following some simple strategies, such as feeding the baby in a semi-reclined position and pausing during feeding, you will surely be able to manage regurgitation effectively. Remember that as long as the baby is growing properly, gaining weight, and shows no signs of discomfort, there is no reason to worry. Now, if you have additional concerns or questions, don't hesitate to consult with a pediatrician for more specific guidance about your baby's health.