#asktheexpert
Hi Dr
Sometimes my daughter gets sleepy during feeding time and falls asleep hence not ready to take burp as she is sleepy and later she spit out milk from her mouth and gets irritated for longer time. What should i do in such case ?

Question

#asktheexpert 
Hi Dr
Sometimes my daughter gets sleepy during feeding time and falls asleep hence not ready to take burp as she is sleepy and later she spit out milk from her mouth and gets irritated for longer time. What should i do in such case ?

Accepted Answer

that is very normal that small children after taking breastfeeding will regurgitate small amount of milk.

if the amount of milk is less than 10 ml no need to worry.
 this curd like milk is normal and no treatment is required. 
but if the quantity of milk is more than you have to rule out any gastric problem the child might be having (can give drops domstal 3 drops then wait for half hr and then give milk)
you can decrease the the regurgitation by giving more burping time to the child.

also due to common pathway at the back between nasal cavity and the oral cavity the milk can come out through the nasal cavity also dufring the regurgitation and vomiting which is normal
meet your dr if vomiting is in large quantity and happening again and again

Accepted Answer

If your daughter often falls asleep during feeding and doesn't burp, leading to spit-ups and irritation, here are some steps you can take to manage the situation:

### 1. **Encourage Active Feeding:**
   - **Keep Her Awake:** Try to keep your baby awake during feeding by gently tickling her feet, rubbing her back, or talking to her. If she starts to get drowsy, gently stroke her cheek or change positions to help her stay alert.
   - **Frequent Burping:** Burp your baby more frequently during feeding, especially if she's prone to falling asleep. For example, you can burp her after every few minutes of feeding or after she finishes one breast before moving to the other.

### 2. **Post-Feeding Positioning:**
   - **Keep Her Upright:** After feeding, hold your baby in an upright position for at least 20-30 minutes. This can help reduce the chance of spit-up by allowing gravity to help keep the milk down in her stomach.
   - **Gentle Patting:** If she falls asleep without burping, try gently patting her back while she's upright to encourage burping without waking her up too much.

### 3. **Smaller, More Frequent Feeds:**
   - If your baby is consistently falling asleep during feeds, consider offering smaller, more frequent feeds. This can prevent her from becoming too full and reduce the likelihood of spit-up.

### 4. **Use a Different Feeding Position:**
   - Experiment with different feeding positions to see if one works better for your baby. For example, feeding her in a more upright position might help.

### 5. **Be Patient:**
   - If your baby does fall asleep during a feed, try to wake her gently for a burp before laying her down. If she’s very sleepy and doesn't burp, hold her upright for a longer period before laying her down to minimize the risk of spit-up.

### 6. **Manage Spit-Up and Irritation:**
   - If she does spit up, clean her up gently and comfort her. You can try holding her upright again and offering a pacifier to help soothe her if she’s fussy.

If this continues to be a problem or if she seems uncomfortable frequently, you might want to consult with your pediatrician to rule out any underlying issues, such as reflux.

#asktheexpert Hi Dr Sometimes my daughter gets sleepy during feeding time and falls asleep hence not ready to take burp as she is sleepy and later she spit out milk from her mouth and gets irritated for longer time. What should i do in such case ?