Spitty baby is probably one of the most common problems in young infants. It is also called gastro-esophageal reflux. Let me explain to you in more detail here.

When a person swallows, food goes through a tube called esophagus before entering the stomach. At the lower end of the esophagus, there is a muscle called “sphincter” which controls the opening into the stomach. In an older child or adult, this sphincter relaxes and allows food to enter the stomach, then quickly tightens up to prevent food from going backwards. In young infants, this sphincter is not very tight so that they can burp and remove swallowed air from the stomach. If air cannot escape this way, the stomach will become distended, which is very uncomfortable for babies.

In some infants, this sphincter is weaker than normal so that the opening to the stomach is always wide open. When this happens, milk can go from the stomach to the esophagus rather easily. If food goes all the way to the mouth, the baby will spit it out.

Although reflux is a very common and generally harmless condition, sometimes it is important to make sure that nothing more serious is going on. The condition that you are concerned about, blockage of the stomach (also called pyloric stenosis), is actually quite uncommon. Children with this condition are usually one to two months of age. The vomiting is often very forceful, sometimes described as “shooting across the room” by parents. In contrast, spitting from reflux is often a mouthful at a time, and not forceful.

If one suspects blockage of the stomach, a special ultrasound test can often make the diagnosis. Treatment of this condition is surgery to relieve the blockage.

There are many other medical conditions that can also cause spitting or vomiting. Whenever a child spits or vomits a lot, it is always advisable to bring this to your doctor’s attention. A physical examination may not be able to tell the cause of the problem. If the baby cannot keep any food down in the stomach, your doctor may have to worry about the possibility of dehydration.

If reflux is the problem that you are dealing with, my suggestion for you is to relax! Get ready a towel before you feed him. Some mothers have learned that they cannot wear fancy clothes when they take care of their spitty babies.

Most of the time, reflux does not affect a child’s health, and one can expect normal growth in weight and height. If you want to do something, you can keep your baby sitting up quietly for an hour or so after feeding. Whenever a baby gets excited or upset, this will increase the pressure inside the abdomen, and force food from the stomach into the esophagus. Obviously, this approach does not always work.

Some parents have tried adding rice cereal to the formula to “thicken” it. Again, this may or may not work, and the nipple opening needs to be widened so that the baby can feed. You can also try to give your baby cereal by the spoon after breast or bottle feeding if he has already managed swallowing some solid food.

I would not suggest giving your son baby food at the age of three months. The intestines of small babies are not matured enough to digest other solid foods as yet. Wait until he is four months or older.

Rarely, some infants will not gain weight because of excessive spitting. In that case, it would be useful to consider medications. Fortunately, most babies “outgrow” this reflux problem between six to 12 months of age, when they sit up most of the time and eat more solid foods.

[Note to Readers: Please read other newer columns about reflux and use of medications.  Recent research also suggests that solid food can be introduced between 4 to 6 months of age; this may reduce the chance of food allergy.]