When should I become concerned about spitting up????

[hlatreille]

Hi all,

I just gave birth last week to a little girl and DD has just today started throwing up after every bottle.  And I am not just talking about a little spit-up, it is like ALOT.  I try to burp her 1/2 way through a bottle (she is eating 3-4oz per bottle) but she isn't the greatest burper.  Some of you maybe thinking that this is alot of formula (I did too) but DD was not gaining weight and was screaming for more after 2 ounces, so the health nurse said to increase her amounts.  She has handled this amount for the past 3 days without puking, it is just now she has started to do this.

I never had this problem with DS so this is all new to me.  When should I become concerned?  It looks like she is throwing up 1/2 to 3/4 of what ever she eats.  She isn't projectile vomiting but just effortlessly she pukes.  She will be finished eating and sometimes 20-30 minutes even after she eats, she'll just be lying there...then BLAH!  It's not like she is being tossled around in order for her to up-chuck....it is bizzarre.  Today she has done it at every feed.....

Any advise would be helpful....I am becoming concerned.   

[KathrynK]

hi there
is she a big girl? If so don't be surprised she is taking 3-4 oz at a time, my 2 were just the same.

Alex did this exact thing at this age, he would yack up a whole bottle within minutes of finishing it.

Two things my health visitor suggested which helped:
1. she said he was very strong and so probably needed a faster flow teat- he was sucking sooo hard to try to get the milk out he was taking on too much air, hence the huge chuck- ups. We moved on to the no 2 teats straight away and he handled the faster flow just fine.

2. She also said he might have slight reflux (there were other symptoms too) so she recommended a special milk called Aptamil Easy Digest- it's formulated to be gentle on the digestive system, and is thickened to stay down in the tummy. (He's been on it until a few weeks ago when he grew out of his reflux and is now on Follow on milk). Don't know if you can get it where you are, here's a link
http://www.aptamil.co.uk/en/article.asp?chco_id=18290

I would have another chat with your health nurse as you are worried. The tell tale thing is whether she is putting on weight. If she is growing well, then there is less need to worry
hth x

[Mashi]

I think that it comes down to "you know your baby best."  Hate to be SO general and not helpful, but really, my own experience is that it can be more than one thing. Work closely with your health providers (health visitor if you are in UK, or GP, paed, etc) and if you feel that it is getting too much to handle and that it just doesn't "seem right" then push them to not brush you off (if that is what they are doing).

I got the "every baby possets, don't worry" for months.  DS was puking up entire breastfeeds mid-feed, all over me.  On formula, he was doing what you are describing. We were told he was crying from hunger so feed him more. Then my HV went down the reflux route, but GP refused to believe it was problematic, said he would outgrow it at 14 weeks. 

FFWD to 17 weeks and DS was finally diagnosed with milk intolerance, as that is what the puking up was from all along.

Now, the thing is, I don't want to say "oh that sounds like milk allergy/intolerance" because it could be that your LO is a very happy spitter and it's nothing. Or it could be reflux. Or, it could be a problem with milk.  But, there are a few different things that it COULD be and I would say it's best to keep notes, take pictures, watch her poops as well, and keep pestering your/her doctor if you don't feel that it's getting any better.

Hope that's not too vague or unhelpful . . . ?

[hlatreille]

Thanks ladies.

She is about 7lbs but today she was fine (with me) because I found that she is so hungry that she just sucks it and I figured that was part of the problem so when she was going too fast I would take away the bottle, burp her & just give her a minute.  But tonight DH fed her and although he knows to burpher often, I failed to tell him if she starts to guzzle, take it away from her and sure enough because I didn't tell him that, she puked all over for the first time today. 

I would hesitate to think it is GERD she does not have any other symptoms of that.  Her poop today was really runny like liquid brown poop, I wondered about milk intolerance, though I don't know what other symptoms would show up for that.  She does have a doctor's appointment tomorrow, her first check-up after being born so I will definately ask some questions tomorrow about it plus she has a pediatrician appointment in another couple weeks so if anything doesn't get better by then she will at least be seeing a specialist.

Thanks for the responses!  Much appreciated.