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Why Your Baby Spits Up and Vomits

Every baby spits up or vomits at least every now and then. Some do that often, or even with every feeding.

Most babies who spit up are "happy spitters" who don't need medicine. If your baby is content, comfortable, growing well, and has no breathing problems caused by vomiting, then he's a "happy spitter." If not, tell your doctor what you've noticed so she can check to see what the problem is.

Why Spit-Up Happens

After your baby swallows milk, it glides past the back of his throat and goes down a muscular tube, called the esophagus, to the stomach. There is a ring of muscles connecting the esophagus and stomach. It opens to let the milk go into the stomach, and then it closes back up. If that ring, called the lower esophageal sphincter, doesn't tighten back up, the milk can come back up the esophagus. That's reflux.

Infants are especially likely to get reflux because their stomachs are small -- about the size of their fists or a golf ball -- so they fill up easily. Also, a valve where their esophagus meets their stomach may not be mature enough yet to work like it should. That valve usually matures before your baby's first birthday, around age 4-5 months. When that happens, he may stop spitting up.

If It's Gastroesophageal Reflux Disease (GERD)

Unlike happy spitters, babies with GERD may have:

Discomfort and pain caused by the reflux

  • Breathing problems of any kind (gagging, choking, coughing, wheezing, and, worst-case scenario, pneumonia due to inhalation of the stomach contents into the lungs, called aspiration)
  • Sometimes poor growth, because vomiting stops them from getting nutrients

If your baby has any of those symptoms, talk to your pediatrician, who can check to see if your baby has GERD.

3 Tips to Try

1. Keep your baby upright for a half-hour or so after a feeding to let gravity help keep things down.

2. Make sure there is no pressure on his stomach after a feeding. For example, wait at least 30 minutes after feeding before you put your baby in his car seat.

3. Try to burp your baby after every feed.

Sometimes these simple steps help enough to keep your little one a happy spitter. If not, your pediatrician may suggest medications that can help. Each has potential benefits and side effects, and only your pediatrician can decide which, if any, is right for your baby.

WebMD Medical Reference

Reviewed by Roy Benaroch, MD on January 20, 2015

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