Why Your Baby Spits Up and Vomits

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 pretty often, even with every feeding.

Most babies who spit up are "happy spitters" -- they’re content, comfortable, growing well, and have no breathing problems caused by vomiting. If that sounds like your little one, he doesn’t need medicine. If not, tell your doctor what you've noticed so she can 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 his stomach. A ring of muscles connects 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 again, 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 yet to work like it should. That usually happens around age 4-5 months. After that, 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, like gagging, choking, coughing, wheezing, and, worst-case scenario, pneumonia from inhaling their stomach contents into their lungs
  • Sometimes poor growth, because vomiting keeps them from getting enough nutrients

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

3 Tips to Try

1. Keep your baby upright for 30 minutes after a feeding to let gravity help keep things down.

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

3. Burp him after every feeding.

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 possible benefits and side effects. The doctor can help you decide which, if any, is right for your baby.

WebMD Medical Reference Reviewed by Dan Brennan, MD on April 10, 2018



Nelson Textbook of Pediatrics: "Gastroesophageal reflux disease (GERD)."

American Academy of Pediatrics: "Reflux and GERD."

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