The regurgitation of the newborn. When it’s normal and when to worry

The regurgitation of the newborn consists in the movement of small quantities of milk from the stomach to the mouth.

Regurgitation is often a cause for concern. All mothers will have seen the baby regurgitate even in large quantities at the end of a feed. The questions that arise are always the same. “Is this normal?”, “She regurgitated everything and do I have to breastfeed him again?”

We try to answer here all the doubts that may arise.

What is the cause of regurgitation?

Regurgitation is a common phenomenon in healthy newborns (about half of infants suffer from it and almost all regurgitate once in a while), which occurs mainly between the second and sixth months of life. This is an event that  should not worry if the child grows regularly.

It improves over the months and disappears around one year of age with the maturation of the lower esophageal sphincter, a muscle located between the esophagus and the stomach that serves to prevent the backflow of food from the stomach. In infants, this valve is not well developed and can allow food to travel up the esophagus and cause spitting up. Because the baby’s stomach is small, overfeeding or swallowing too much air can cause food to be pushed past the valve. As the child grows older and the valve completes its development, food is less likely to pass through the sphincter. Also, when the baby begins to eat solid foods with weaning , he usually stops regurgitating.

When does regurgitation occur?

Regurgitation usually occurs at the end of a feed, perhaps when the baby is being burped.

The amount of fluid she regurgitates is usually only a small fraction of a feed, but often appears to be much more. The baby appears to be fine and does not appear hungry until the next feed. A gentle pat on the back is all that is needed during a spit-up episode, other than cleaning of course.

What is the difference between regurgitation and vomiting?

The regurgitation often drips from the infant’s mouth and often comes out in conjunction with the burp. Vomiting, on the other hand, consists of a real jet of milk.

Does spitting up affect baby growth?

Regurgitation does not typically interfere with a baby’s well-being. As long as your baby seems comfortable, is eating well, and is gaining weight, there is no cause for concern.

What can you do to reduce regurgitation?

Try to hold your baby upright after feeding for about 30 minutes and try to feed your baby in a more upright position. Active play immediately after feeding should be avoided.

Avoid overfeeding your baby (this especially applies to bottle-fed babies) and always allow time for burping. Frequent burps during and after each feed can prevent air from building up in your baby’s stomach.

Fundamental breaks during feeding so that the child eats with less voracity.

Putting your baby to sleep on his back to reduce the risk of Sudden Infant Death Syndrome (SIDS). It is not recommended to put a baby to sleep on his stomach to prevent regurgitation. 

The newborn should not be placed in bouncers or baby eggs after feeding, in the “bagged” position because this position can favor regurgitation.

In the case of bottle-fed babies, the teats must not be modified in any way and the bottle must be held in such a way as to prevent air from forming in the teat.

If the baby is bottle-fed and the amount of regurgitation is severe, the pediatrician may recommend special anti-gurgitant milks that contain thickeners to prevent the baby from regurgitation after feeding.

When can regurgitation indicate a problem?

The pediatrician should always be contacted if the child does not gain weight, if the regurgitation becomes frequent and jet vomiting or with prolonged retching.

It should also be consulted if the child shows symptoms of distress (complains continuously or is in a state of constant agitation).