Spitting Up (Reflux)

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Symptom Definition

• The effortless spitting up or reflux of 1 or 2 mouthfuls of stomach contents
• Smaller amounts often occur with burping ("wet burps")
• Larger amounts can occur after overfeeding
• Usually seen during or shortly after feedings
• Occurs mainly in children under 1 year of age and begins in the first weeks of life

Cause

• More than half of all infants have occasional spitting up ("happy spitters")
• Poor closure of the valve at the upper end of the stomach
• Complications: choking on spit up milk, heartburn from acid on lower esophagus, poor weight gain

Reflux Versus Vomiting: How to Tell

• During the first month of life, newborns with true vomiting need to be seen immediately because the causes can be serious. Therefore, it’s important to distinguish between reflux and true vomiting.
• Reflux: The following suggest reflux (spitting up): infant previously diagnosed with reflux, onset early in life (85% by 7 days of life), present for several days or weeks, no discomfort during reflux, no diarrhea, hungry, looks well and acts happy.
• Vomiting: The following suggest vomiting: uncomfortable during vomiting, new symptom starting today or yesterday, associated diarrhea, projectile or forceful vomiting, looks or acts sick.

See More Appropriate Topic (instead of this one) If

• Large volume and comes out forcefully, see VOMITING.