Hi ClareBear,

My DD would spit up a great deal when she was little, and would occasionally "choke" in a way similar to what you're talking about. In fact she still sometimes does the same thing when she's trying to drink water from a cup and gulps too big a sip at once. I didn't ever have to tip her upside down to help though. I'm sorry that you're going through that - it must be awfully scary for you and your DS

What I understood to be happening for my DD is that if she vomited whilst she was lying down, or vomiting quite forcefully when burping it would come up her throat and also into her nose (she was often vomiting through her nose). When she would try to take a quick breath straight after vomiting (often from the shock of the vomit) she wouldn't be able to breathe properly for a moment as there was vomit in her nasal passage. She would then sometimes panic as her airway was blocked until the vomit would clear (swallow it back down or it would come out her nose/back down her throat). I think when she gulps too big a sip of water now, some of it goes up the back of her nose again and shocks her, causing her to try and get a quick breath when her airway is blocked with water again.

I was told that some babies can often vomit through their noses as the reflex that blocks the nasal passage to the back of their throat when eating (or vomiting) is not anywhere near as well developed as an adult's.

It doesn't sound like reflux for your son, as reflux is associated with pain and arching of the back, but it does sound like he might a weak sphincter between his tummy and oesophagus - which is what my DD has had. It's pretty common! I was told to think of it this way: the top of your baby's stomach is like a purse string, and in some babies that purse string is simply just not tight enough when they are really young, allowing milk to come back up really easily. It should get better as your baby grows up (my DD rarely vomits anymore now and she is 7 months old) and there are some things you can do to help:

1. Try feeding him more upright, and try to feed him his bottle with breaks. i.e. sucking for maybe half a minute, and then have a break for a few seconds. Could could even do this at a smaller interval - say drinking for 10 seconds or so and a break for a few seconds. This will help him take in the milk in a way that isn't filling him too quickly, (and possibly ending up overfilling at times).

2. Keep your baby upright for at least 20 minutes after a feed - gravity can help to keep the milk down a lot as he's starting to digest it.

3. And similar to above, try propping his cot/crib at an angle with the head higher than the feet, or when you lie you baby down somewhere not long after a feed, lie them at an angle. This definitely helped my DD a great deal. It meant that when she did vomit lying down and in her sleep (which was often) gravity would help stop it projecting too forcefully/quickly and ending up her nasal passage again.

In saying all this and sharing my experience, I really hope it's helpful for you, and I do think it would be a great idea to speak to your GP about it, as they are going to give you the best reassurance and have the most knowledge about it, and certainly be able to tell you if it's something else.

Good luck - I know it's scary when it seems like your baby is choking (been there lots of times) - hopefully the advice is helpful, and that your GP may be able to shed a little more light on it if needed.

Miss C