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Thursday, October 19th, 2017

Mucus/Use of the Bulb Syringe/Choking

For the first few days of life, your baby may have excess mucus which may cause him to gag and/ or spit up.  This may be more noticeable with feedings as young infants are less adept at clearing their oral secretions.  This tends to improve day by day.

If your baby gags or spits up mucus, turn him on his side and firmly pat his back as if to vigorously burp your baby.  You may need to use a bulb syringe to gently suction the mucus out of the lower cheek area or back of the throat or from the nose.  Place your baby in a modified position with the head slightly lower than the chest to let gravity help the drainage of the fluid.  Squeeze the bulb syringe before inserting it into your baby’s mouth to avoid forcing mucus/fluid into the lungs.  Take care not to traumatize the tissue of the nose with the tip of the bulb syringe or with forceful suction.  The mouth should be suctioned before the nose.  Always know where to easily and quickly find your bulb syringe.  While in the hospital, your nurse will demonstrate how to use the bulb syringe, but feel free to ask for extra reinforcement if needed.  To help prevent choking in your baby, try to avoid doing things that make him cry, for example, diaper changes or a sponge bath, when he has a full stomach.  Try to do these things right before feeding time. 

If you are feeding your baby and he begins to gag or spit up, stop the feeding and turn and pat your baby as described.  Once the baby has calmed down, the feeding may be continued.

Spitting up and vomiting

Almost all babies spit up during the first week or so.  This is usually a small amount of milk solids associated with a feeding, such as a wet burp.  The baby usually brings up only about a teaspoon of formula or breast milk.  If it has been awhile since a feeding, the milk may be partially digested and be curdled looking.  Your baby may only be spitting up because of air trapped in the stomach which is now coming up along with part of the feeding.  Be sure to burp your baby prior to feeding if your baby has been crying for a while, as crying puts a lot of extra air in the stomach.  Hold your baby slightly upright during feeding so that air can rise above the milk and be sure your baby has a good hold on the nipple when sucking so he doesn’t suck in a lot of air during the feeding.  Spitting up in a forceful way, causing milk to hit the floor as much as three or four feet away, is called projectile vomiting.  Out office should be notified if this type of vomiting occurs regularly or any time your baby has a fever or diarrhea along with vomiting.

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