What do I do when my baby vomits after nursing?

Ask Anne…

Question: I have a darling three and a half week old baby boy and we have a problem that has me stumped.

At least once a day he vomits after nursing He will seem to be content and then get extremely fussy and agitated, and then he  vomits  – in great quantity, it looks like around 4 oz or so, so I assume it is his whole feeding.

I have spoken to our pediatrician who said to ignore the problem as he is gaining weight, but it is very upsetting and I do not know of anyone else whose baby vomits after nursing like this.

I have cut all caffeine and chocolate out of my diet, but he still vomits after feedings.   I think I have a lot of milk as I can express 4 ounces or so with a hand pump in less than five minutes.

Please let me know if you have any ideas on what to do when my baby vomits after he nurses.  I realize most children “spit up”but this goes way beyond this and I really need help.

 Answer: Babies who spit up what seems to be excessive amounts of milk need to be evaluated by their pediatrician to rule out medical problems. In most cases, if the baby is healthy and is gaining weight well, then there isn’t a lot that can be done about the vomiting. It sounds as though your baby has been seen by your doctor, and that he didn’t find any health problems.

Spitting up large amounts of milk is often associated with an oversupply of milk, and the extra milk that the baby takes in but doesn’t need comes back up after feeding. You need to be aware that even a small amount of milk looks like a lot when it is coming out – a tablespoon of milk can seem like an ounce – but if he were actually spitting up whole feedings several times a day, then he wouldn’t be gaining weight adequately. It sounds as though he’s getting what he needs, and getting rid of the excess.

It does sound like the problem may be that you have too much milk. The article Oversupply: Too Much Breast milk has information on how to regulate your supply to meet his demand.

I  doubt that your diet has anything to do with it at all. As long as he is gaining weight well and developing normally, and your doctor has ruled out medical problems, then this is probably related to your  over abundant milk supply and not to something you ate. Things should  level out as your supply adjusts to the point where he is getting what he needs and not a lot of extra milk.

In the meantime, his spitting up is more of a ‘laundry’ problem than a’ medical’ problem!

Anne Smith, IBCLC
Breastfeeding Basics