Hi J.,
I worked Maternal-Child Health (RN) for 3 years (recently) and am now working with Hospice. The information and suggestions I'm going to give you come from experience in the field and being a mom myself to 3 great kids.
You've actually mentioned several things going on, so I'll break each of them down - hopefully, it will be easier to understand this way. But first, I want to say, congratulations on your new bundle of joy - it certainly appears that you are very in tune to your baby to recognize how he is responding to the spitting up and the hipcups. And... the best thing you've noticed is not to lie him down flat (except for diapering). In a baby, the distance between the stomach and the mouth is very short and if the muscle on the top of the stomach (the spincter muscle) doesn't shut all the way during and after feeding, the possibility of spitting up formula is much greater. So good for you for recognizing this!
1. You say he doesn't spit up during the night and it's only in the day. So my first question would be, what are you doing differently in the nighttime versus the daytime? I'm thinking because it may not appear apparent, it may be the fact that nighttime is much quieter and there are no external stimuli to distract him or over stimulate or cause anxiety for him. I know that may sound funny, anxiety in a baby, but my last child would basically 'shut down' if there was too much going on around her - she's going to be 6 soon and will remove herself if there is too much stimuli around her.
2. Hipcups tells me he may be getting the formula too fast - perhaps the hole in the nipple is too big. This is one cause for the hipcups... and the stomach cannot handle it that fast. Another thing is you may need to burp him more often. Offer him an ounce, burp him, then continue to feed taking opportunities in between to burp him. The BEST BOTTLE ON THE MARKET (in my opinion and the moms I cared for that had the same problems you are having - and I had myself with the spitting up) are the DR. BROWNs. They have an inner tube that helps to eliminate the amount of air that gets in the belly through the bottle. My second choice are the Avent bottles.
Bottles and formula can make a HUGE difference in your baby's comfort. And with mentioning formula.....
3. Have you tried any other formulas? You baby may not be digesting the formula well - is it milk based? Some babies cannot tolerate this - then you would try Soy. I had to use Soy on my first daughter because she was so miserable on regular formula, but once I changed it to Soy, I had a much happier little girl! My second daughter had to have Neutramagin - which is even broken down more than the Soy and twice the price! Not to worry with Soy, it's fine for the baby and has the same amount of iron. According to a nutritionist I knew, she told me that Soy has the same amount of iron and that a baby should never be a low iron formula unless the baby has a blood condition and the doctor prescribed it, that iron is very important to a baby's diet.
4. I see that he is now on reflux meds at 6 weeks. Did the doctor suggest you try anything else first - like changing formulas or bottles or positioning.... anything? When he vomits, and it appears it's hurting him because he's crying, it could be a couple of things. One, it really does hurt because you know how reflux feels as an adult, imagine a baby! and/or Two, he's vomiting and some of it is probably coming out of his nose, which is quite uncomfortable and scary. I'm just wondering since the reflux med doesn't seem to be working, maybe it's not reflux, maybe you need to change the formula and give that a try, if you haven't already.
5. Last, but not least, don't worry about your bundle sleeping in the swing. I think my son spent his first six months in the swing b/c he wasn't a good sleeper and I worked full time at the time - I needed sleep! Just make sure his head is supported. You can even tilt the swing seat back a bit so that his head has more support thanks to gravity and it's not cocked forward with his chin lying on his chest.
6. Giving him gas drops won't hurt him although it doesn't sound like it's helping much right now, either. Just from what you're telling us, I would take a look at what the difference is between day and night and also the formula used and the type of bottle. Hopefully, it's something as simple as this.
Of course, any opinions and advise you get that doesn't set right with you, than go with that feeling and/or check with your MD. I truly believe that there is nothing a mother's instinct - you will never be without it again! Not all mothers are born with it, but after "hearing" what you have noticed, you are very in tune to your little bundle. Don't doubt yourself, even if your doctor tries to 'sluff' you off, if you truly believe there is a problem, or something is 'just not right' keep going after it - you'll be glad you - I guarentee, you'll be glad you did in the end - I've had to do it a couple of times, even b/f I became a nurse, and was right each time. Believe in you!!!
Let us know how you make out and the very best of luck to you and your baby- J.