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Dr. A. Clark
Dr. A. Clark, Pediatrician
Category: Pediatrics
Satisfied Customers: 4437
Experience:  33 years of experience as a general pediatrician in private practice and in pediatric urgent care.
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My 3 1/2 month old son has always had issues with spitting

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My 3 1/2 month old son has always had issues with spitting up. When he was born we put him on soy formula (my daughter was on soy as well). While he always spit up he has generally been a happy baby and never had problems gaining weight. Over the past few weeks there has been an increase in the amount he spits up. We just switched him to Alimentum but he is still spitting up.

In addition, he has had trouble staying asleep during the night. Prior to this, he would get a bottle at about 11, and then sleep until about 4. We slowly started giving him his nighttime bottle earlier and now feed him around 7:30 and put him in his crib. That worked well for a couple weeks but now it seems that he will sleep until around 2, and then wake up very frequently (every 15 minutes or so) until the morning.

Are these issues normal for this age? He is generally a "happy" baby and is gaining weight but should we be worried about the spitting up? Also, are these sleep issues normal or could they be related to any possible stomach issues he is having?

Dr. A. Clark :

Hi. I'm Dr. Clark and I'm happy that you have asked me to assist you with your child and hope that you can benefit from my many years of helping parents like you.

Dr. A. Clark :

Your experience is not unlike what most parents go through with new babies, including my own three children and my grandchildren too.

Dr. A. Clark :

All babies spit up due to the fact that the little valve (really just a flap) that is at the top of the stomach that is supposed to keep milk in the stomach does not function well yet. Actually, it functions as it should considering the fact that babies swallow lots of air while eating and sometimes eat, or are fed, too much so they have to have a "safety valve" to let off pressure, so to speak.

Dr. A. Clark :

Spitting, or reflux, can only harmful in three ways: either they spit up too much and don't gain weight, they spit up and then aspirate, or choke, harming their lungs, or rarely the acid reflux damages their esophagus. All of these are very uncommon but you would not think that judging by what I (as a "seasoned" pediatrician) see done by less experienced pediatricians all the time. Namely, they tell parents to keep switching the formulas as if that has anything to do with spitting or reflux (really the same thing) or worse, they put babies on medications such as zantac, reglan, Prilosec, etc., which do NOTHING for spitting except frustrate parents but sometimes keep them busy until the spitting resolves on its own, as it ALWAYS does!

Dr. A. Clark :

The American Academy of Pediatrics just published a new set of guidelines on this very topic and in an nutshell, advised pediatricians to refrain from these measures since spitting in otherwise healthy and happy babies is essentially what I've always called it: a laundry problem - not a health problem!

Customer:

Oh ok... makes sense.

Dr. A. Clark :

I think your baby will do just as well on the cheapest formula you've used so far, as Alimentum is expensive and really designed for babies with GI problems that cause issues with absorption of complex proteins, carbohydrates and lipids.

Customer:

So you would suggest going back to the soy.

Dr. A. Clark :

Yes, soy is fine. Also, at his age, waking at night is likely simply due to the fact that he is hungrier now and you might start some cereal a couple of times daily to fill him up for a longer stretch, such as overnight.

Customer:

ok. thanks for the information.

Dr. A. Clark :

You are quite welcome.

Dr. A. Clark :

Start with a couple of tablespoons of rice cereal mixed with a little formula to make it runny and feed it with a spoon twice daily.

Customer:

Ok will try that.

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