What Is Baby Spit-Up?
Spit-up is what happens when the contents of your baby’s tummy come back up easily – not forcefully – through their mouth. It often comes along with a burp. It’s not the same as vomiting, which is when your baby throws up their stomach contents with force and muscle contractions.
If you’re a parent, you’ve probably dealt with your fair share of spit-up. Every baby does it at least every now and then. Some do it often, even with every feeding.
Most babies who spit up are "happy spitters.” They’re content, comfortable, and growing well, and they have no breathing problems caused by vomiting. If that sounds like your little one, they don’t need medicine. If not, tell your doctor what you've noticed so they can look for possible problems.
Causes of Spitting Up
After your baby swallows milk, it glides past the back of their throat and goes down a muscular tube, called the esophagus, to their stomach. A ring of muscles connects the esophagus and stomach. It opens to let the milk go into the stomach, and then it closes again. If that ring, called the lower esophageal sphincter, doesn't tighten, the milk can come back up. 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 to work the way it should. That usually changes around age 4 to 5 months. After that, they should stop spitting up.
Gastroesophageal Reflux Disease (GERD) and Spitting Up
Unlike happy spitters, babies with GERD may have:
- Discomfort and pain caused by the reflux
- Breathing problems like gagging, choking, coughing, wheezing, and, in seriouse cases, pneumonia from inhaling their stomach contents into their lungs
- Poor growth, because vomiting keeps them from getting enough nutrients
Your baby may also have serious GERD or another condition that needs treatment if they:
- Regularly have projectile vomiting, which is when their stomach contents shoot out of their mouth
- Have green or yellow spit-up
- Won’t eat
- Have blood in their poop
- Start spitting up after they’re 6 months old
- Arch their necks backward
- Are very cranky after they eat
If your baby has any of these symptoms, talk to your pediatrician. They can check to see if your baby has GERD or another serious but treatable problem, such as a blocked digestive tract.
See the doctor right away if your baby's spit-up shows streaks of blood or causes choking or gagging. Call 911 if the gagging or choking doesn't stop.
Tips to Reduce Spitting Up
These tips may help your baby spit up less often:
- Don’t feed too much at once. Instead, give them smaller amounts more often.
- Make sure the nipple size is right. Too big and they'll drink too fast; too small, they'll swallow air.
- Keep feeding times calm. Fewer distractions can reduce spit-up.
- Burp them often. Burp your baby during and after meals to help them get rid of gas that can add to problems with spitting up.
- Keep your baby upright for 30 minutes after a feeding. Gravity helps keep things down.
- Don’t bounce them or do other active play right after feeding. Keep your baby calm for about 20 minutes after they eat.
- Make sure there’s no pressure on their stomach after they eat. For example, wait at least 30 minutes before you put your baby in their car seat.
- Try a different formula. A few babies are allergic to milk or soy in formula. Your pediatrician can suggest a formula without these ingredients. You can try it for a week or two to see if it cuts down on spit-up.
- If you breastfeed, consider a change to your own diet. Your baby may spit up less if you cut out dairy or other foods.
- Don’t put your baby to sleep on their stomach. Place your baby on their back to sleep to reduce the risk of sudden infant death syndrome (SIDS). You can elevate the head of your baby's mattress or crib a few inches to keep their head higher than their stomach.
Sometimes, changes to your feeding technique help enough to keep your little one a happy spitter. If not, your pediatrician will try to get to the root of the problem. If it's GERD, they may have you try giving them an acid-blocking medication for a few weeks or months until your baby's esophageal muscle is better developed.
It's rare, but forceful vomiting might mean your baby has a serious condition called pyloric stenosis. That's when the valve between their stomach and small intestine doesn't let food through. It can be fixed with surgery.