How much projectile vomiting is OK (sorry gross post title)?

[taffywelsh]

Hi womyn
My 2-week old baby has a habit of projectile vomiting (well, the "vomit" is really just spit-up, but it shoots right out, even traveling a couple of feet through the air) about once a day.
She has done this on occasions where I can look at her last feeding and see what I did wrong: once I way overfed her (she is only 6 lbs), once she was acting too hyper to latch well and she drank air, etc. But I can't really predict what will cause it. All I know is that she does it every once in a while, and that she will do it again. This forceful spitting is preceded by a "choking" face, and grabbing at her mouth for a second. It usually happens in the afternoon.
She has horrible periods of "colic" at night, between about 8 and 12 or so. She seems to writhe in pain and anger, but calms down if fed. Since I am concerned about overstuffing her, it is not always my first choice to feed her as soon as she screams, especially if she just ate (she is exclusively breast-fed). My fear is that she will end up with a crazy spit-up in the night which will choke her.
For what it's worth, my mother was here to witness one of these episodes yesterday and suggested I NOT call the pediatrician, because babies just do this. Since baby seemed otherwise pretty normal (other than her infrequent pooping schedule which I am writing about separately), I was fine with that, but what do you think.
thanks!
TW
ps. The baby is 6 lbs 2 oz, and has been frequently weighed and judged to be gaining about an ounce a day, which I have been assured is a good rate of weight gain

[HonkyTonka]

From what I've learned/heard from Doc, projectile vomiting is something that needs to be addressed, as it can be a sign of pyloric stenosis.

From Kellymom:
Although seldom seen in breastfed babies, regular projectile vomiting in a newborn can be a sign of pyloric stenosis, a stomach problem requiring surgery. It occurs 4 times more often in boys than in girls, and symptoms usually appear between 3 and 5 weeks of age. Newborns who projectile vomit at least once a day should be checked out by their doctor.

[PatioGardener]

I was told one projectile vomit a day is fine, but any more than that needs to be investigated. I guess it just depends on who sets the cut off!

Here is a public health info sheet on pyloric stenosis with info about symptoms: http://www.healthlinkbc.ca/kb/conten....html#hw180924

[dakotablue]

My DS projectile vomited 0-2x a day, but gained weight just fine.

He had an intolerance to dairy and soy. Once these were out of my diet for two weeks he stopped projectile vomiting. I would suggest looking into this. He was still a spit uppy baby, but no longer cried when spitting up.

[PuppyPanties]

My daughter had the same issue, she would projectile vomit at least 2 times a day - i had to buy more sheets and a waterproof mattress pad! I ended up taking her to my chiropractor - she stopped immediately! then she did it once, on the fourth and fifth day after being adjusted, then no more. Though she has been going every week since!!

[Llyra]

With pyloric stenosis-- the vomiting will usually occur within a half hour or forty-five minutes of the feed, and you'll notice it getting more and more frequent, until it starts to be with every feed. The quantity will be large, and it'll shoot out far enough to miss your lap and land on the floor.

I think with any projectile vomiting in a newborn, I'd check with a healthcare provider just to be sure.

But really-- it happens. My DD1 was a big puker. She used to let fly at least a few times a day, and it would shoot out all over the place. I remember her doing it once all over my couch, five minutes before DH's boss came for dinner. She was famous for doing it while I was carrying her over my shoulder, and making huge puddles all over the floor.

She grew out of it, slowly, as her system matured. By the time she could sit alone, it had almost entirely disappeared.

In the meantime, it can help to keep baby upright after a feed, and to keep lots of towels handy if you're burping baby. I would want to keep baby close to me while baby was sleeping, so you could be aware if baby was having difficulty. I used to have to keep a few towels under us at night, so I could change them if she spit up.

FWIW, fussy evenings are normal at this age. The best theory we have for colic is that babies nervous systems are immature, and they get overwhelmed with the big wide world. Go ahead and nurse at those times, if it seems to soothe baby. I always did. Babywearing during the day, to reduce baby's stimulation and help with good naps, can really help with the fussy evenings-- my kids always had easier evenings if they had a quiet day and napped a lot.

I wouldn't worry about spit up, even forceful, if baby seemed happy most of the day, and was gaining weight well. And fussy evenings wouldn't make me rethink this-- all of my kids fussed in the evening at this age. I would check with a healthcare provider about projectile vomiting, if it seemed to be getting more frequent, just to be sure about the pyloric stenosis, but I wouldn't worry overmuch.

[FillingMyQuiver]

y DH had pyloric stenosis. He had surgery to repair it at about 2mo. My ILs say that he spit up w/ such force it used to hit the wall. And it did start to increase in frequency, from 1-2x daily to almost ever feed.

And for the most part, he was a happy baby throughout the rest of the day.

[amrijane128]

My DD was the same as Llyras...she would puke a minimum of 3 feet away numerous times a day. She also outgrew it by the time she was out of the "little baby" stage. We never had her checked out for it, as I thought it was completely normal for babies to constantly be puking.

[MeepyCat]

My son was a champion upchucker - he had some physiologic reflux, and every little internal twitch would shoot spitup across the room. The worst was the night he nursed for an hour and then sneezed.

So my temptation is to say that it's a laundry problem and not a health problem. However, at 2 weeks, you're still having really frequent well-baby checks - bring it up with the pediatrician next time you have one. It can't hurt to see if there's a particular cause, and to keep an eye on it.

[whozeyermamma]

Oh this is so my DS, now 3 mo. Volcanic. For us it seems it's not the distance that is so alarming it's the volume. I can't imagine where it all comes from.

One thing you might want to consider - do you have an over-active letdown? When this happens, your milk comes out so fast your LO has a hard time keeping up, gulps a lot of air - hence the spitups.

Here is great info on this and what to do:

http://www.kellymom.com/bf/supply/fast-letdown.html

This is our problem to a T and we've pretty much solved it by how I time pumping, block feeding, lots of burping and upright time after feeds and - uh - luck. FWIW - we still have occasional massive urps - but he's growing like a weed (80th percentile) and healthy and happy otherwise.

[redvlagrl]

DS projectile vomitted a couple of times a day unti he was 3 mths. It was a huge quantity of liquid - 2-3 cups at a time!!!

We had an ultrasound at the hospital (ordered by Dr) and everything was fine. He outgrew it (now 5 mths and nothing outside of normal amounts of spitup)

[CorasMama]

Llyra has the wise on this. Pyloric stenosis has clear signs, like the increasing frequency and the timing.

Don't worry too much. The first time my DD1 vomited, she was a week or two old, and managed to get my roommate in the cleavage from several feet away, missing everything in between her and the cleavage! And this little one has been dubbed, "Fiona, Destroyer of Linens"