Why Do Babies Spit Up? Learn Your Baby’s Cues

What makes a baby spit up?

Did you know that half of all babies regularly spit up in their first three months of life? Baby spit-up is a perfectly natural occurrence and is medically referred to as infant reflux.

If your baby is spitting up, it’s likely because their lower esophageal sphincter needs time to develop. This means that even with the smallest burp, your baby’s last meal can easily come back up and out their esophagus. Occasionally it makes it back to the mouth. When this happens, it is much more difficult to swallow it again.

Whether you’re breastfeeding or bottle-feeding your baby, you can expect baby spit-up. Especially if your baby feeds to the point that their stomach is completely full, or if they ingest too much air while they’re feeding.

If your newborn is spitting up a little bit after being fed, it’s probably nothing to worry about. If your baby is spitting up a lot, you might be wondering “how much spit-up is normal?”

How to know how much spit-up is normal

As a new mom, it’s common to have many questions about what’s considered “normal” for your newborn.  Remember that the most important thing about spitting up is not how often and how much a baby spits up, but whether a baby is a "happy spitter," i.e., whether they feed well, gain weight normally, and are not unusually irritable.

If your baby has other symptoms like weight loss or diarrhea, it could be a sign of a more serious gastrointestinal problem like gastroesophageal reflux disease (GERD), and you should speak with your baby’s doctor. GERD occurs when acidic content of the stomach damages the esophagus. Apart from spitting up, symptoms of GERD include vomiting, coughing, irritability, poor feeding, poor growth, blood in the stools, and breathing problems.

Tips to reduce spitting up

If you notice that your baby is spitting up with every meal, or they’re spitting up more than expected, here are some simple tips you can try to help reduce it.

Change up their feeding routine

The first tip you can try to reduce spitting up is to change how and how often you feed your baby:

• Choose a breastfeeding position where your baby is upright so that their head is elevated above the rest of their body. Keep them upright for at least 30 minutes after they’ve eaten.
• Feed smaller amounts more frequently.
• If your baby is formula-fed, you can try adding some oatmeal to their formula if it’s not already included in the ingredient list. However, a consultation with your pediatrician is needed before introducing oatmeal to the diet. Sometimes changing formula is necessary because spitting up maybe a sign of a food intolerance. Always discuss this option with your baby's doctor. 

Burp them often

Help your baby burp to release air that they may have ingested during feeding. You can even take burping breaks during feeding to help keep air out of their stomach and food in.

Watch what you eat

If you’re breastfeeding, take note of what you might’ve eaten in situations where your baby seems to be spitting up more than normal.  Sometimes reflux is related to milk and soy intolerance. In this case, breastfeeding mothers need to eliminate all milk and soy products from their own diet, but only after consulting a doctor. 

Some other tips you can try are to avoid bouncing or moving your newborn around a lot after they’ve eaten for at least 30 minutes and to make sure their diaper isn’t on too tight around their belly to take the pressure off their abdomen. If your baby keeps spitting up after following these tips, speak with their pediatrician.

Baby spit-up vs. vomit: how to tell the difference

Now that you know why babies spit up, we’re here to help you figure out the difference between baby spit-up and vomit.

Spit-up will come up easily and in small amounts, whereas vomit is a more active process with muscle contraction, and your baby may show signs of being in distress while it happens. Vomit will project outwards from your baby’s mouth, but spit-up will simply dribble out of their mouth.

When to be concerned about spit-ups

If your newborn’s spit-ups get worse instead of better in the first few months of their life, they may be suffering from gastroesophageal reflux disease (GERD).

Other symptoms to watch for in your baby that you should be concerned about include:

• Yellow or greenish color or blood in the spit-up
• Not gaining weight or not reaching healthy growth milestones
• Difficulty eating
• Noticeably distressed or unusually inconsolable

In rare cases, a newborn who is a few weeks old and who forcefully vomits after every feeding may have hypertrophic pyloric stenosis, which is narrowing of the opening from the stomach to the duodenum (the first part of the small intestine). The main symptom of pyloric stenosis is persistent vomiting (after every meal) with weight and fluid losses. As a result, the baby is always hungry because cannot pass food to the intestines. 

If all this has you wondering when babies stop spitting up, you’ll be glad to know that most babies’ digestive systems mature enough by 10-12 months of age that they no longer spit up.

Baby spit-up is a typical symptom of your newborn’s developing digestive system. Follow the above tips to help reduce spit-up and contact your baby’s doctor if you have any concerns.