Why do babies spit up?
Spit-up, also known as infant reflux, usually happens when food backs up from a baby's stomach. If your baby is a "happy spitter" and isn't bothered by the reflux, there's no need to worry. Spit-up occurs when a baby's stomach contents back up into the esophagus after a meal. With infants, when the lower esophageal sphincter opens, stomach contents often back up into the esophagus and come out of the mouth, resulting in spit-up. It may also occur when babies cough, cry or strain themselves.
What contributes to spit-up?
Spit-up is very common in healthy babies. In fact, more than half of all babies spit up in the first 3 months of life. Spit-up occurs mostly in children under 1 year of age and begins in the first weeks of life.
Common experiences include:
- The effortless spitting up of 1 or 2 mouthfuls of milk or formula
- Spit-ups usually occurring during or shortly after feedings
- Smaller spit-ups occurring with burping
- Larger spit-ups occurring after overfeeding
- Normal spit-up does not cause any crying
Though these experiences don't usually indicate a severe medical problem, if you are concerned about your baby spitting up, you should talk to your baby's doctor.
What are some ways to reduce spit-up?
If you notice your baby spitting up frequently, consult her doctor. She may benefit from switching to a formula specially designed to help reduce spit-up.
To reduce spit-up you can also try the following:
- Position your baby's head higher than the rest of her body when feeding
- Burp your baby after every 1-2 fluid ounces of formula, but wait for her to take a break—don't interrupt her feeding. For breastfed babies, burp after feeding on each side.
- If your baby is drinking from a nipple that flows too fast, they'll gulp too quickly. Check that you have the right formula flow (a bottle held upside down allows one quick drop at a time, but not a steady stream) and burp your baby often.
- Avoid tight diapers as they put added pressure on the stomach.
- Don't play vigorously with your baby right after a feeding.
- Reduce pacifier time. Constant sucking can pump your baby's stomach up with swallowed air.
- If your baby is frantic, stressed or is rushing through feeding, calm her down first. Then try feeding her again.
- Hold your baby upright for 30 minutes after a feeding.
- Give smaller, more frequent feedings to reduce the chances of spit-up.
Most of the time, spit-up is normal, and you don't need to worry. However, sometimes, spit up could be an indication of food intolerance. Some babies spit up because of a protein in cow's milk, even if they're getting it through breast milk. Your doctor might suggest that you switch up your diet to eliminate dairy products for awhile if they suspect your baby is intolerant.
In addition, if your little one starts arching their back while spitting up, becoming irritable and angry, or has difficulty eating, check with your doctor to see if your baby has more serious reflux issues. In very rare cases, spit-up can be an indication of an allergy, a blockage somewhere in your baby's digestive system, or gastroesophageal reflux disease (GERD), according to the Mayo Clinic.
GERD is serious but treatable, so keep an eye out for issues like these:
- Projectile vomiting (forceful spit up)
- Blood or green or yellow fluid in spit up
- Not eating, not gaining weight
Want to learn more about why babies spit up? Read What Causes Babies to Spit Up: The Latest Research
*Formula for spit-up defined as rice-thickened formula
✝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