March 2012

Spitting up (also known as reflux) in babies is very common and a frequent cause is over feeding. It may occur during the burping, during the feeding, and frequently will occur following the feeding. Sometimes it appears to be an entire feeding that has been spit up, but it very seldom is. These babies usually take much more than their stomachs can handle and will spit up the excess. They are characteristic in that they tend to gain weight more rapidly than the average infant despite the spitting up. As a “rule of thumb” any infant who is able to go two and a half to three and a half hours between feedings and who is gaining weight well is likely spitting up because of excessive feeding. However, if vomiting becomes forceful, if the child is not gaining weight properly, or if he does not seem to be satisfied between feedings, this should be evaluated. If spitting up seems to become quite painful for the infant, an evaluation is necessary as well.

When you were an infant, babies were fed formula for a short period of time, frequently only four to five months. Today, because of increasing evidence that babies do better on formula for a longer period of time (preferably twelve months), we recommend you continue formula through the first birthday. As this first birthday approaches, we will decide together whether to continue formula, switch to another formula preparation, or to whole milk.

Your friends or relatives may suggest that you change your baby to cow’s milk during the first year. This is not appropriate. Cow’s milk is low in iron, vitamin C, vitamin E, and essential fatty acids. It also has more salt than he/she needs which results in the need for additional water for the kidneys to excrete the salt and other wastes. Finally, cow’s milk contains more protein than he/she needs and this places additional unnecessary burdens on the kidneys. It can even cause intestinal bleeding and anemia. Please, do not use regular cowʼs milk during the first 12 months.

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