All babies spit up or throw up now and then. But some do so more often than usual. This is called reflux. Reflux is short for gastroesophageal reflux or GER.

Reflux is common among premature babies. Most babies outgrow it after a few months. Only 1 percent of babies are still spitting up after their first birthday.

Here's what happens with reflux

• Food first passes through the mouth and the esophagus into the stomach. (The esophagus is the tube that connects the mouth and the stomach.)

• Once the food is in the stomach, it comes back up the esophagus and out of the mouth.

Most babies with reflux are less bothered by it than their parents. They grow and develop normally. But for a few babies, reflux is more serious. The baby needs medication to make sure reflux is not dangerous.

Feeding Tips
If your baby had reflux in the NICU, the nurses may have shown you how to feed and position your baby to minimize spit up. These tips may help:

• Hold your baby upright during feeding.
• Try smaller, more frequent feedings.
• Burp your baby often, especially if you are feeding him with a bottle.
• Try a different nipple on your baby's bottle so he swallows less air.
• Ask your baby's health care provider if you can thicken the formula or expressed breastmilk with a small amount of rice cereal.
• Keep your baby still after feeding.
• Raise the head of your baby's bed 30 degrees or so.
• Keep a stack of cloth diapers or burp cloths handy. Use them to protect your clothes, your baby's clothes and your furniture.

When to Call Your Baby's Health Care Provider
These symptoms may mean that your baby has other problems digesting food:

• The spit-up is bright yellow or green.
• There is a large amount of spit-up.
• Your baby arches his back or cries during feeding.
• Your baby vomits with great force (projectile vomiting).

August 2009