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 Ask Dr. Jana
Concerned that Baby Is Spitting Up during Feedings | | | QUESTION | | | Dear Dr. Jana,
My baby is six weeks old. She started having gas and spitting up. Milk comes out her nose. What is wrong?— Worried Mom and Dad in East Bernard, Tx. | | | ANSWER |
April 26, 2001 | | | Dear Worried Mom and Dad,
While I can tell you that spitting up and gas are very common in young infants and that having milk come out of a baby's nose may be irritating but of no medical concern, it is still important for you to have a healthcare provider examine your newborn to make sure that all is well.
With regards to spitting up, some babies do it more than others, and most of the time it is nothing more than a nuisance. Sometimes, it is related to feeding a baby too much at one time, therefore it is a good idea to discuss both how much and how often you feed your daughter with her healthcare provider.
On occasion, spitting up is significant enough to be diagnosed as reflux (or more specifically, "gastro-esophageal reflux"), a condition where the muscle at the top of the stomach is not fully able to keep the fluid contents in the stomach from coming back up and out. Although most babies grow out of this without any intervention, it can be treated with both non-medical and, in some cases, medical treatment.
Regardless of the cause, when a baby is spitting up or having other feeding problems, it is particularly important to monitor how well she is growing. In some cases the amount of food an infant spits up can be alarming to even the most experienced parents (and pediatricians), but if the infant is gaining weight and developing on schedule, quite often nothing needs to be done - except to keep a lot of rags on hand.
I will mention that in rare instances spitting up becomes progressively worse, or more forceful (projectile) and in larger volumes, if a baby has a condition known as pyloric stenosis in which the muscle at the bottom of the stomach becomes increasingly and abnormally tight and does not allow liquid to pass out of the stomach into the intestines. Because this condition does not simply come and go, it is useful to know that intermittent spitting up with normal feedings in between is not usually consistent with pyloric stenosis. If you suspect your daughter's spitting up might fit the picture of pyloric stenosis, you should be sure to discuss this with your daughter's healthcare provider right away, since this condition can be treated effectively and will only worsen if left untreated.
As for having milk coming out of a baby's (or anyone's) nose while drinking, spitting up, laughing, or gagging, the liquid that comes up (and out) can irritate the nose but is not of any serious concern. This occurs because there is a direct connection between the back of the throat and the nose.
Lastly to answer your question about gassiness, let me assure you that this is one of the most common questions I am asked when seeing parents of young infants in the office. In most cases, the gas is not bothersome to the baby or only causes momentary straining and fussiness. If parents think the gas is particularly upsetting (to their baby or to themselves), there are safe over-the-counter infant gas medications that some (but not all) parents find effective. Be sure to check with your daughter's healthcare provider to determine if this option is appropriate for you. On occasion, breastfeeding moms are also able to pinpoint something in their diet that when eliminated reduces the baby's gassiness.
For my part, I will tell you that in an otherwise healthy baby who eats well, has normal bowel movements, urinates well, and is gaining weight, I am generally reassured that there is nothing wrong.
Congratulations on your new daughter and please continue to share your thoughts and concerns with us as she grows.— by Laura Jana, M.D., F.A.A.P. |
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