Why babies spit up! (Pedcast)

Parents are often concerned about a common infant symptom, “spitting up”. In today’s podcast, Dr Smolen discusses some of the main reasons why babies spit up and older children and adults, don’t.  Take a few minutes to listen to this practical and informative discussion.


Welcome to another edition of DocSmo.com, the home of the pediatric pod cast,
-Where we help parent raise their children all the way from the diapers to the diploma, from the beginning of gestation to after graduation
I am your host, Dr Paul Smolen
-Before we get started with today’s pod cast, I want to remind my listeners that this pod cast is informational in nature, and not intended to give medical advice for any individual child… if you are looking for tailored advice for your child, visit the wonderful person you call your child’s pediatrician.

-After 30 years of practice, I guess I have been asked everything…it certainly seems that way.
-One of the more common questions I get is why babies spit up so much
-For older children and adults, spitting up stomach contents on a regular basis would be abnormal, a sign of disease, … but most of the time this is a normal symptom for infants.
-Actually, many of the digestive symptoms that babies experience on a regular basis would be very abnormal for an adult… spitting up, pooping 8 times a day, having watery stools regularly, and lots of gas… Sounds terrible if that were you or me, but for most babies… all in a day’s digestive work.
-I guess that is why parents are so taken aback by these symptoms in their young children and feel that something must be wrong.
-Lets break down the spit up part in today’s pedcast…shall we

-If you have a baby handy, take a good look at them. What do you notice?
-How are they different from your older children or even yourself?
-Right, they are smaller and they are usually either laying or at best in a semi erect position.
-A babies stomach is only about 2 inches below their mouth…it is practically in their mouth.
-The other thing that you can’t see from the outside is that their stomachs are almost always filled with liquid food and a lot of air.
It takes about 3 hours for most babies to empty their stomachs and as soon as their little stomachs begin to empty, they demand to fill them right up again… hence always full.

-Ok, so we have a baby with only about 2 inches from the top of their stomach to their mouths, who is almost always laying down with a tummy full of milk and gas… Can you see why stomach contents are constantly being regurgitated into their throats or worse, your nice clothes?
– The only thing holding stomach contents in your infant’s stomach is their LES (lower esophageal sphincter) which is constantly opening to vent excess air from our stomachs and allow it to escape. Getting rid of air from their tummies is a good thing but unfortunately, with the air frequently comes liquid stomach contents…milk
-The same process is happening in older children and adults all the time.
The venting process is letting air escape into our throats, but the stomach contents only make it into the lower esophagus …and unless we have an inflamed esophagus, older children and adults are unaware of this process.
-Older children, usually older than a year of age along with adults are therefore actually “silent spitters” since they are unaware of this venting and regurgitation processes going on inside them almost constantly.
-But for babies, it’s a different matter… with only 2 inches to travel from their stomachs to their mouth, liquid not solid food in the tummy, and laying down to boot…the result is spit up, over and over and over.
-Shakespeare talked about the pukng babies so this is certainly not a new thing…it has nothing to do with modern life…its part of the baby experience.

-For most infants, the entire spitting up ordeal is a much bigger deal to their parents than for the baby. Most babies tolerate the stomach contents in their esophagus and throat without much problem. Doctors refer to these healthy babies as “Happy Spitters”
-That’s not to say that spitting can’t cause problems for babies… it certainly can.
-Some babies spit up so much that they get serious heartburn… others fail to gain weight… and some even choke on their stomach contents and aspirate them into their little lungs…that can’t be good.
-Additionally, lots of spitting may be an indication of a serious digestive disorder such as cow’s milk allergy, malformations of the intestines, liver disease etc etc.
-Your child’s doctor is always on the lookout for children where spitting is not the benign symptom it is in most children.
-If you are worried about your child‘s spitting, talk to their pediatrician.

-To minimize spitting, don’t forget to burp your child as often as every ounce of intake and hold them upright for a while after feeding to help their stomach’s empty in the right direction.
-For children with serious spitting issues, thickening feeds with cereal can be very helpful. Thick food doesn’t regurgitate nearly as easily as thin milk.
-But But But…the main thing is if your child is a happy spitter without the serious symptoms I mentioned earlier, just relax and wait for it to go away… which it almost always does by 1 year of age..

-So the next time you ruminate on why babies spit up so much, hopefully you will be able to regurgitate some of the reasons they do.
-Thanks again for joining me today.
-If you enjoy the DocSmo experience and find them useful, please take the time to make a comment on itunes or shoot a comment to the blog.
-I try and answer all relevant comments.
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-This is Dr Paul Smolen, continuing your free pediatric education, hoping you stay smitten even if your little baby keeps on a spittin.

Until next time.

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