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Spit-Up vs. Vomit in Babies

Spit-Up vs. Vomit in Babies

The similarities and differences between spit-up, reflux, and vomit—and when to see your doctor.

Spit-up and vomit may look similar, but there are some clear differences. While spit-up is typically nothing to worry about, vomit can indicate a health concern. Here’s a deeper look at these tummy issues, including their potential causes and triggers, tips for identifying them, and when to talk to your pediatrician.

Spit-up vs. reflux vs. vomit – what’s the difference?

Spit-up—also called reflux—and vomit all involve stomach contents coming up from a baby’s esophagus and out of their little mouth. Let’s explore a breakdown of these digestive issues.

Spit-up and reflux

Spit-up is a common occurrence in healthy babies under a year old. You may also hear the condition called reflux, acid reflux, or gastroesophageal reflux (GER).

When spit-up is severe, it’s called gastroesophageal reflux disease (GERD). GERD is not considered typical reflux, and if you suspect your baby may have it, it’s important to see your pediatrician.

Spit-up occurs when a tablespoon or two of breastmilk or infant formula flows out a baby’s mouth (and sometimes their nose) and dribbles down their chin. The gentle rush of liquid may be preceded by a burp.

A baby may spit up within two hours after eating, but often reflux occurs right after feeding. The good news is that, in most cases, spit-up won’t bother your baby. In fact, they may be what’s known as a “happy spitter.” Your baby may give you a big smile as you wipe off their face. The mild regurgitation, which could occur once or several times a day, shouldn’t interfere with your baby’s development either. The spit-up stage typically subsides by the time a baby reaches their first birthday.

Severe reflux and GERD in babies

Mild spit-up and reflux are common in babies, but severe spit-up is not. If your little one is experiencing extreme or worsening reflux or if the issue continues past 12 months, it could point to gastroesophageal reflux disease (GERD). In addition to spitting up, babies with GERD may:

  • Lose weight or not gain weight
  • Refuse to feed or have difficulty swallowing
  • Choke or gag while feeding
  • Vomit liquid that appears yellow, green, or tinged with blood
  • Cry and seem uncomfortable or sick

Reach out to your pediatrician if your baby is experiencing the above or if you suspect they may have GERD. The condition can usually be managed with some behavior and dietary changes and sometimes medication. Avoid giving your baby any medicines or making dietary changes to your diet or your baby’s without consulting your doctor first.


Vomiting is more forceful than spit-up. Your baby may projectile vomit, meaning the stomach contents will shoot out fast and furious and land a few inches away from their mouth. Unlike spit-up, vomit can be uncomfortable, and your baby may appear ill or unhappy. If your baby is vomiting, it could indicate a potential virus, food allergy or sensitivity, or other health issue, so you’ll want to talk to your pediatrician to figure out what’s going on.

Common reasons why babies spit up and have acid reflux

Still-developing digestive function

A newborn’s gastrointestinal system is still learning to work on its own, so some digestive functions are not quite developed yet.

Not sitting up yet

Babies spend a lot of time on their backs, which can exacerbate reflux.


Bouncing, tummy time, and other playful activities right after feeding can lead to reflux.


Your baby’s tiny tummy can fill up fast. What can’t fit may come back up.

Swallowing air

Swallowing too much air while feeding can trigger reflux.

Liquid diet

Your little one’s belly may be a bit unsettled from their all-liquid breast milk or infant formula diet. Spit-up sessions often start to ease as they begin to eat solid foods.

Smiling mom holding sleeping newborn

A newborn’s gastrointestinal system is still learning to work on its own, so some digestive functions are not quite developed yet.

Common reasons why babies may have GERD


Preemies have a narrow and shorter esophagus that may not close properly yet, allowing gastric fluids from the stomach to come back up.

Food intolerance or sensitivity

Cow’s milk protein allergy, the most common food allergy in infants, is a potential GERD contributor.

Eosinophilic esophagitis

An inflammation of the esophagus may lead to GERD.

When to talk to your doctor about your baby’s spit-up or vomiting

Some spit-up is normal, but vomiting and serious spitting up could indicate a more serious health issue. Talk to your healthcare provider if you notice the following, as these could indicate GERD, a potential food allergy, or other medical concern.

  • Little to no weight gain or weight loss
  • Crying and fussiness
  • Refusing food
  • Spit-up that looks neon yellow, green, red, or like coffee grounds
  • Choking or gagging while feeding
  • Vomiting
  • Rash
  • Respiratory issues such as wheezing
  • Profuse spit-up
  • Spit-up that worsens or continues past 12 months
  • Stool changes such as diarrhea or constipation

Ask your doctor about Enfamil A.R. for easing baby spit-up

While mild reflux is a normal part of baby development, call your pediatrician if your little one is spitting up profusely or if you have any questions or concerns. If you’re using infant formula, consider asking your doctor about switching to one designed to help ease spit-up issues. Enfamil A.R. formula is specially formulated with added rice starch for a thicker consistency to reduce reflux and spit-up by over 50%* in one week.


Earn rewards on Enfamil baby formulas for sensitive tummies

Enfamil has a range of infant formulas tailored to help ease tummy troubles, such as spit-up. Talk to your doctor about how our infant formulas could help your baby feel better and be sure to join Enfamil Family Beginnings to earn rewards on Enfamil purchases and get discounts, free baby formula samples, and baby freebies! You’ll also get custom baby content and tips delivered to your email.


*Based on a clinical study of Enfamil A.R. infant formula before the addition of DHA, ARA, and prebiotics with infants who spit up frequently (5 or more spit-ups per day), comparing frequency and volume of spit-up after feeding Enfamil A.R. to the same babies at the beginning of the study.

All information on Enfamil, including but not limited to information about health, medical conditions, and nutrition, is intended for your general knowledge and is not a substitute for a healthcare professional's medical identification, advice, or management for specific medical conditions. You should seek medical care and consult your doctor or pediatrician for any specific health or nutrition issues. Never disregard professional medical advice or delay seeking medical treatment, care, or help because of information you have read on Enfamil.