Most baby spit-up is normal and not cause for concern — infants commonly spit up several times a day because the muscle at the bottom of the esophagus is not yet fully developed. As long as your baby is gaining weight well, seems comfortable, and is not showing distress, frequent spit-up is generally a laundry problem, not a medical problem. Call your pediatrician if your baby is spitting up forcefully (projectile vomiting), appears to be in pain, is not gaining weight, or has blood in the spit-up.
For many first-time parents, baby spit up can be a bit terrifying. There is a very fine line between what is “normal” and when you should seek help from your pediatrician. Dr. Jessica Long helps to clear up some common spit up misconceptions…
When I found out I was pregnant with my first daughter, I daydreamed about lazy mornings cuddling with her, taking long walks together through our neighborhood, introducing her to all of my favorite childhood spots in DC, and of course all of the adorable clothes. What did not play a starring role in my motherhood fantasy was the amount of spit up that would end up on her, me, my husband, the dog, and really anything within a four foot diameter after she ate. Her spitting caused her no distress and certainly did not slow down her impressive weight gain but wow did it lead to a lot of laundry.
Spit up is an incredibly common baby phenomenon. In fact, more than half of babies younger than 3 months old spit up daily. For most babies, gastroesopahgeal reflux (GER) is a natural occurrence that, while annoying, causes no health problems and improves with time. However, in some babies it may cause complications – in which case we call it GERD (gastroesophageal reflux disease) – and requires evaluation by your pediatrician.
For all of those parents out there with “happy spitters” who smile while you grab your tenth burp cloth of the morning, there are thankfully some simple things you can do to help reduce the amount of curdled milk you are scrubbing off the sofa.
First off, there’s only so much room in that tiny baby belly and if it gets overfilled with milk there is nowhere for it to go but out. Do your best to not overfeed your baby. Also, try to minimize gas in your baby’s belly so that, as a gas bubble escapes, it doesn’t bring up half the meal as well. Some babies need to take burp breaks in the middle of their feeding as well as at the end in order to not have a wet burp down your back shortly after eating.
While tummy time is important for motor development and can help to relieve gas, it is best to avoid it right after feeding. That extra pressure on the stomach is more likely to send its contents all over the living room rug. Holding your baby upright for 20-30 minutes after eating also helps to keep everything in her stomach right where it belongs.
Still spending more time with the laundry machine than enjoying that sweet social smile of your baby? It is important to have regular follow up with your pediatrician to ensure that gastroesophageal disease is ruled out. Talk with your pediatrician to see if diet changes would be helpful. Some breastfed babies may be sensitive to dairy or egg and having mom avoid these foods could cut down on spit ups. Similarly, a formula fed baby might prefer a hydrolyzed formula. Adding a small amount of oatmeal to bottle feedings has also been shown to help reduce the amount of spit up. However, chat with your baby’s doctor before altering anyone’s diet.
With spit up, time is the best remedy. As your child grows, spitting up will be less of an issue and your little one will be on to new and exciting problems such as desperately wanting to play with electrical outlets and finding every choking hazard accidentally left around your house. Parenthood is a journey and spit ups will soon be a distant memory. The overabundance of laundry in your home will unfortunately be an ongoing problem.
Frequently Asked Questions About Babies and Spit Up
How much spit-up is normal for a baby?
What is the difference between spit-up and vomiting in babies?
Spit-up flows easily or dribbles out, often without the baby noticing. Vomiting is more forceful — it shoots out with significant force and is often accompanied by crying or distress. If your baby is vomiting forcefully, especially repeatedly, call your pediatrician.
When should I call the pediatrician about my baby’s spit-up?
Call Spring Valley Pediatrics if your baby is projectile vomiting, is not gaining weight or has lost weight, appears to be in pain when spitting up, has blood in the spit-up or vomit, has green or yellow vomit, or has persistent cough or respiratory symptoms that may be related to reflux.
Could my baby have acid reflux (GERD)?
GERD is different from normal reflux in that the stomach acid causes significant discomfort. Signs that suggest GERD include arching the back during feedings, crying and apparent pain, refusing to eat, poor weight gain, and chronic cough or wheezing. If you notice these signs, discuss them with your pediatrician.
Does feeding position affect how much my baby spits up?
Yes. Keeping your baby in a semi-upright position during and for 20–30 minutes after feedings can help. Avoid vigorous play immediately after feeding. If bottle feeding, make sure the nipple flow rate is appropriate — a nipple that flows too fast can lead to overfeeding and more spit-up.
When do babies stop spitting up?
Most babies significantly reduce spit-up around 4–6 months as the lower esophageal sphincter matures, and the majority have stopped spitting up entirely by 12 months.
