Spitting and reflux, tips on feeding your baby

I have a patient whose baby cries every time he eats.  He was perfectly perfect for the first 5 weeks, breast feeding contentedly and taking one bottle of pumped milk each day. For the last week, as soon as he starts to swallow, he gets upset, frustrated and wails in pain.  When she breast feeds,  the baby latches well and he also takes the evening bottle just fine.  She thought he might be spitting up a bit more than other babies.  No projectile vomiting, but definitely a spitter.  We watched her feed the baby and then the light bulb went off.  Ahhhh,  he might have reflux.

This is what we advised.  Keep him as upright as possible during and after each feeding, and for at least 30 minutes after a feeding.  Then elevate the head of the crib mattress.  (the easiest way to do that is by putting a rolled up blanket under the mattress or put the 2 feet at the head of the crib on a board or block.  We also asked the pediatrician to prescribe Zantac.  Guess what?  Happier baby.

Guess what else?  Even a teaspoon of spit up looks like a gallon.  It always looks like more than it is.  If you want to do an experiment in your own house, then spill a tablespoon full of apple juice onto a bib or burp cloth and you'll see how just 1/2 ounce looks like a quart.

Hmmmm.......here's the important point about this story.  If your baby has a feeding issue, talk to your pediatric health care provider and then have a professional and/or a lactation consultant watch a feeding.