Preemies

What the heck?!

Ftm mom here, my son is a month old (born five weeks early) and has never had a problem with spit up until the past few days. Then just a little bit ago he spit up so much it came out his nose and mouth! He couldn't breathe! It was really scary. We had the bulb syring and him right next to us so we got him cleared out and breathing pretty quick but it felt like a life time. He's perfectly fine now but he's really hungry. I'm afraid to feed him again (it's only been 20 mins). I'm afraid to lay him down. I'm afraid to take my eyes off him! I'm still sort of in panic mode. Was that normal spit up or vomiting? How do I make sure it doesn't happen next time?

Re: What the heck?!

  • Is he breastfed or formula fed? If he's ff did he burp good, have you changed formulas recently? I've heard bf babies tend not to need to burp so if he's bf, not getting a good burp might not be relevant (I'm sure a bfing mom can clarify on that). I can only help from a ff stand point since I never produced enough to not need formula. If he's ff, I would just make sure to try and get him to burp in the middle and after a bottle, since he could have had some extra air in his tummy. Also a formula change could have upset his tummy a bit, some los have issues with certain formulas. If he ate more then normal, he could have just been too full too.
    Since it sounds like a first time occurance, I would just keep an eye on him the next few feeds and see if he does it again, it could be just a fluke. Dd had reflux for awhile so that was a normal occurance for us, but that doesn't necessarily mean your lo has reflux. Its hard not to, but I would try not to panic. If it keeps happening definitely talk to your pedi, hopefully it was just a one time thing. I'm sorry if this isnt very helpful, there's just a number of possible causes, so its hard to give an exact answer.
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  • I remember my LO burping up with milk coming out his nose when he was really young. I don't think he ever stopped breathing from it. I remember at the time I googled it and read something about their bodies not quite used to where everything goes/how everything works so burps coming out the nose wasn't a concern in the early days.
    My LO is BF but he still needed a burp mid feed and at the end when he was really little. They eventually kind of grow out of that need and stop burping regularly.

    Try to relax, just keep an eye and see if it happens again and if he really stops breathing or if it just seems like it. Burping up too much milk and spraying it out your nose is prob a little overwhelming for a little guy, so if he seems worked up about it and takes a min to settle I wouldn't worry. But just keep an eye to see if it happens often, I wouldn't worry yet tho. My LO stopped doing that, don't remember when but prob by a couple months.
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  • He's on 100% formula as of this week. Since we brought him home from the nicu my milk supply went down to nothing. Maybe the formula is upsetting his stomach? He has spit up once since the last episode which was a normal spit but now he's really conjested and sounds all phlegm-y.
    He sleeps in our room in a bassinet but I'm afraid to lay him flat on his back incase he does a silent choke. He hates sitting in his swing, I don't know where to put him so we both can get some rest.
  • Can you put blankets/towels under the mattress in the bassinet so it's on an incline, like in the NICU? Just make sure it's not at too much of an incline that he scoots down in the night and also that there are no empty spaces that he could fall into. Also, we rolled up little receiving blankets and put them under the sheet so he was sort of held in place and felt more secure. That's what we did and it helped a lot. Our pedi gave us the okay to do so. Did he just eat a super big meal before he spit up? The difference between spit up and vomit, so I've been told, is the amount spit up and if it projects or just drains out of their mouth. Our LO spit up like what you're talking about once and we think it's because he had just eaten too much. Try holding your LO upright for a good 20 mins before laying him down, to let his tummy settle from eating. And as PP said, make sure your burping him real good. Has your LO been diagnosed with reflux? Does he fuss a lot while eating and/or arch his back? Our LO has reflux but never really spit up a lot, he would swallow it back down but you can def tell he's having trouble. He will gasp for air sometimes after trying to swallow it back down but never stop breathing. Keep in mind when they are really young they are still perfecting the suck, swallow, breathe. And it can be a bit scary even for an adult when you have food come back up, imagine trying to remember to swallow and breathe when you're scared about what's happening. Also, my pedi said even young babies will turn their heads so the vomit/spit up can go out of their mouth, they will not choke on it. If you're uncomfortable, you could always try to prop him up on his side. I would be more nervous about that though, in case he rolled on to his tummy and couldn't get back. Also a lot of ladies in here use the Rock N Play because it's already at an incline. That's a thought too.
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  • He's on 100% formula as of this week. Since we brought him home from the nicu my milk supply went down to nothing. Maybe the formula is upsetting his stomach? He has spit up once since the last episode which was a normal spit but now he's really conjested and sounds all phlegm-y.
    He sleeps in our room in a bassinet but I'm afraid to lay him flat on his back incase he does a silent choke. He hates sitting in his swing, I don't know where to put him so we both can get some rest.

    Dh secured some wood to the bottom of dds bassinet for the incline, we were told prior to her coming home that she needed to be at a 30degree incline for her reflux. You can use recieving blankets under the matress or sheets instead of that though. Also holding him at an angle after feedings for about 20 mins will give his tummy time to settle. We had a bouncy chair that could be adjusted angle wise that we used when holding her that long wasn't an option. If his congestion and sounding phlegm-y doesnt clear up with some extra nose suctioning, call your pedi and find out what they recommend to help.
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  • I went through that with one of my twins... It was reflux. Projectile, even.  Didn't start having it until a few weeks after we got them home. She was given meds for it that helped so much and would have to be adjusted as she gained weight..

    ITA with @bromios   Try to keep him upright/at an angle, for a little while after his feeds, rather than being flat on his back. Burp burp, and burp again. If it happens again, I'd suggest calling your pediatrician to have him checked out.

    HTH

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  • Thanks so much for the advice! We've been holding him upright for about 30 mins after eating and instead of giving him more milk in one sitting were feeding more often- almost every two hours. He's had that scary, coming out the nose spit up twice since the first time and it seems to be either over eating or laying flat too soon. His pediatrician wasn't concerned and since it had only happened once when we saw her last she didn't talk much about it being reflux.
    I'm probably going to get a rock n play just so I can feed him and lay him back down at night.
    Another weird thing I've noticed at feedings is he'll stop sucking and make an upset scrunch face and let out a little cry then he opens his mouth wide looking for the nipple and eat ravenously for a few seconds before going back to sucking normally. He doesn't arch his back though, sometimes he'll kick his legs out and lock them all tense like. It sounds more like pain than frustration.
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