New parents see it all the time – Baby’s been fed and then he spits up what looks like half of the food he just ate.

   Spitting up, or gastroesophageal reflux, is a normal digestive process in infants. Some babies swallow a lot of air when feeding, which causes them to burp and some of what they ate will come back up with the air. Some babies overeat, which means their little tummies may overflow. And on top of that, babies’ digestive systems aren’t fully developed. John LaCount, MD, a pediatrician with St. Elizabeth Physicians in Florence explains that the lower part of the esophagus works to act as a valve to stop spit-up from occurring.

   “It’s not really something to get worried about,” says LaCount, adding that babies often just need a chance to grow. (He also advises parents to not freak out if spit up comes out your baby’s nose!) But if your baby isn’t gaining weight, schedule an appointment with your doctor, as he might be struggling with gastroesophageal reflux disease, or GERD, which can cause painful irritation of the lining of the esophagus. Other symptoms of GERD to watch out for, according to LaCount, include forceful vomiting, yellowish or blood in the vomit, constipation or diarrhea, tenderness in the belly, and even recurrent pneumonia. Your baby will also be fussy and may not be getting much sleep.

   Interventions for reflux and GERD are usually non-medical to start, says LaCount, and mostly have to do with how parents position their babies during feedings. Holding him or her upright during and after feedings will help, as will aiming for smaller, more frequent feedings. Thickening milk or formula is another strategy. He adds that some babies may have a cow’s milk intolerance, so parents may need to switch to a different formula or avoid cow’s milk if breastfeeding. “By six months, solid foods will help keep things in the stomach,” he says, adding that positioning is usually the key to clearing up any issues. LaCount prefers to avoid medications when he can. He explains that medications can affect how food is processed in the stomach – if the medication takes acid away, for example, food can actually come back up more easily.

     The good news for concerned new parents is that referrals to GI specialists are rarely necessary, according to LaCount. “Time and growth will make a difference,” he says.