Truth or Myth: Can a Baby Choke on Spit-Up?

A question many mothers ask is “Can a baby choke on spit-up?”. In this article, we’ll discuss whether it’s true or not and the things you can actually do to prevent spit-up.

Back- Sleeping & Spit-up

According to the American Academy of Pediatrics (AAP), the safest position for a baby to sleep in is on his back. Since the AAP first introduced this recommendation, the occurrence of sudden infant death syndrome (SIDS) has declined by over 50 percent.

Many parents still find themselves worrying this position could cause their baby to choke on spit-up. This is an understandable concern! As parents, we tend to dwell and worry about every possible scenario that may present a danger to our child.  However, the evidence shows that choking on spit-up can be marked off your danger list.

Choking on Spit-Up While Asleep

The AAP has seen no evidence of sleeping babies on their back choking than any other sleeping position. In fact, your baby’s body’s natural instinct is to steer any swallowed spit-up back down the esophagus and away from the airway, even when they’re asleep.

So while many parents are naturally worried about this, it is not really a threat and highly unlikely to occur.

Spitting-Up Frequently

If you notice your little one spitting up frequently or after every meal, it can cause a great deal of anxiety and worry about your baby’s health.

The good news is that most babies have a form of a reflux disorder called gastroesophageal reflux (GER for short) and it’s perfectly normal. Dr. William Byrne – chief of pediatric gastroenterology at Doernbecher Children’s Hospital in Portland – has stated that as many as 70 percent of infants under the age of three months spit up with a frequency of three times a day. He also says even spitting up ten-to-twelve times a day is considered normal for an infant.

This is because the muscle at the end of the esophagus that opens and closes to let food in isn’t fully developed in infants. This “valve” not closing means it much easier for the contents of the stomach to make its way back up. If your baby spits up but hasn’t been fed recently, then it may because he was coughing or crying. These two things can often cause spit-up as well.

Frequent spitting up can be alarming for parents but it’s usually not a cause for concern and not a choking hazard!

Ways to Prevent Spitting Up

If frequent spitting up is causing you to become concerned, you can minimize the likelihood of spitting up by addressing some of the common causes.

One of the main causes of Spitting up in babies is overfeeding, so avoid trying to give him the bottle again once he has indicated he is finished – even if he has not finished all of his milk.

Swallowing air can also be a cause of frequent spitting up so make sure that your baby is latching correctly and be sure to burp him before, during, and after each feeding to help any trapped air escape.

baby latched on

If you are bottle feeding you may want to consider purchasing liners or specialty bottles made especially for reducing the intake of air while feeding. You might also try feeding your baby in a more upright, or sitting, position as this can help to minimize air intake as well.

Some parents report changing to a soy-based formula such as Similac for Spit-Up or Enfamil A.R. can help. These formulas use rice starch to make the formula a bit thicker and help settle an infant’s stomach.

Also, the Paced Bottle Feeding method might also make a difference.

When Do Babies Stop Spitting Up?

It may seem like the constant spitting up is never going to end, but don’t worry – it won’t last forever. Most babies see a reduction in the frequency of spit-up by the age of six months old – when they begin eating more solid foods – and almost all babies are finished with spitting up by their first birthday.

Don’t become concerned if the spit-up has stopped and then begins to reoccur once he starts crawling, though – this is normal as crawling can cause his stomach contents to shift and come back up.

When to See a Doctor

While almost all babies suffer from a form of GER and require no treatment for it, there is a more worrisome condition known as gastroesophageal reflux disease (GERD) that can be cause for concern.

GERD occurs when frequent returning of stomach contents through the esophagus results in inflammation or damage to the esophagus, which can be caused by irritation from stomach acids. The symptoms of GERD in babies include refusing to eat, losing or not gaining weight, becoming irritable, vomiting (especially projectile vomiting), and respiratory problems caused by aspirating food.

If you notice these symptoms in your baby you should seek a consultation with his doctor, who can test for the presence of GERD and prescribe medication to treat the symptoms.

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