How much spit up is too much spit up?
The unexpected math lessons in parenting
There’s a lot of math involved in becoming a parent. And when you’re clinically sleep deprived, even basic math feels like a real feat. First comes milliliters, the obsession over how many mLs of breastmilk or formula from these tiny little vials we brought home from the hospital. Then just as soon as you’re adding 24 mLs breastmilk + 32 mLs formula, it’s time to graduate to ounces.
I remember when my husband stayed stuck in the mL phase when I had progressed on to the ounces phase, and suddenly, we were speaking two different languages. We had a paper chart from the hospital where we wrote in every drop of input and output, taking turns to write in breastfeeding, pumping, bottles, and diaper changes around the clock. I started writing in ounces while my husband was still calculating milliliters, and not to mention, he loved how the nurses used military time to document the exact moment when everything happened. Meanwhile, that level of math beyond 12 was way beyond my capabilities and I almost ripped up the whole paper in frustration trying to interpret 15:22 after approximately 15 minutes of sleep in the last 22 days.
After using 15 burp cloths in half a day (which my own mother insisted on calling “diapers” and it drove me mad), I wish I could count how many times I googled, “How much spit up is too much spit up?”
Somewhere I read that 1-2 tablespoons of spit up exceeded the normal limit, so naturally, I went to the kitchen and pulled out the tablespoon. I filled it with water and dumped it into a bowl, desperate to comprehend what 1-2 tablespoons really looks like spewed out everywhere on a play mat during tummy time. I seriously contemplated, should I dump this all over myself to see what it looks like coming out? Should I just drink the water and spit it out to imitate my son’s reflux? Maybe I need to puke up milk for the full simulation.
“He spit up a whole ounce this morning!” my mom reported. Great, now what the heck does an ounce look like spilled out everywhere? Is that more or less than 1-2 tablespoons? Did he spit up more or less than he took in?
And it’s not just about the amount. It’s also a matter of how it comes out of him. Was it projectile? Because if it’s projectile, then there’s something catastrophically wrong and you should call the doctor immediately. Does it count if it’s just a little bit projectile? What distance and force qualifies as projectile?
I remember the exact moment in our gray rocking chair in the corner of our nursery, my son sound asleep on my chest and suddenly, without a doubt, he projectile vomited all over me. No burp cloth in sight. Helpless and soaked, I cried. What was I doing wrong?
How often? What quantity? How much force? What color? How about the texture? Did you smell it? Was he gaining enough weight? Did he still seem happy?
And then, one day, I looked at the stack of clean burp cloths piled high on his dresser, untouched for some time and gathering dust. There were none to wash in the daily laundry because there wasn’t any more spit up. The spit up days had come and gone without any ceremonial endings. I don’t remember thinking, this is the last time you spit up and the last time I wiped it up and the last time I wondered how much is too much spit up. He was still breastfeeding when it stopped, but he was eating solid foods that helped keep it all down and he basically learned to burp himself at that point.
He didn’t need my two fingers resting under his little chin or my hand patting his back to burp him. He didn’t need the pile of white burp cloths anymore which waited to be needed again with that clean scent of baby Dreft. (Gosh, did he even need me anymore now that he could hold up his own head?) I left the burp cloths out for a while, but finally packed them away with all the tiny baby clothes that he quickly outgrew. How much time had even passed?
We’re still paying attention to ounces of whole milk these days, but the calculations are fewer, and we don’t write every detail down on a paper chart or a note in our phone or an app. I’d like to think I google for answers less often, but that’s not the case. The measurements and the expectations simply keep recalibrating.
Give these a try…
The burp cloths that saved us during spit up days. When a friend suggested I put several 10-packs on our baby registry, I remember thinking, psh, that seems excessive. Now? Nope. Order enough to have 50 on hand.
I knew nothing about bottles pre-baby and definitely thought they were one-size-fits-all. At five months old, my son started seeing a speech-language pathologist (SLP) who specializes in feeding. She recommended these Dr. Brown’s narrow nipple bottles that helped slow down his intake and replicate the shape of his mouth for breastfeeding.
This app came in handy during the days when I moved from a paper chart to a running note in my phone to finally an app that my cousin’s wife recommended. You can hit start and stop during breastfeeding sessions to track the time. I will say these apps can cause obsession with measuring and motherhood math that can drive you a little more insane than you already feel, but that’s a story for another day…
“If I could just go back and tell myself as a first time Mom how truly temporary all the contact napping would be, and wrap my arms around her and tell her to keep doing it as much as I wanted, worry free, I would. Because one day it really would just be a memory. A photo we pull up on the phone and smile at, reminiscing about those breaks in the day that we spent in the gray rocking chair by the window…”
-Katie, Certified Baby Led Sleep and Well Being Specialist, Be Well Bebe