Why is my baby spitting up curdled milk. Is baby spit-up normal. How can I reduce baby spit-up. When should I be concerned about baby spit-up. What are the signs of GERD in babies.

Understanding Baby Spit-Up: What Parents Need to Know

Baby spit-up is a common occurrence that often concerns new parents. It’s essential to understand that spitting up is typically a normal part of infancy, especially during the first few months of life. Spit-up refers to the regurgitation of stomach contents, which primarily consists of breast milk or formula.

The appearance of spit-up can vary depending on when it occurs after feeding. If your baby spits up immediately after feeding, it will likely have a smooth, milky texture. However, if some time has passed, allowing the milk to mix with stomach acid, the spit-up may appear curdled.

Spit-Up vs. Vomit: Recognizing the Difference

It’s crucial to differentiate between spit-up and vomit:

• Spit-up: Generally has a slower flow and stays close to the baby’s body
• Vomit: More forceful and projectile, potentially indicating illness

If you suspect your baby is vomiting rather than spitting up, it’s advisable to consult your child’s healthcare provider.

The Science Behind Baby Spit-Up: Why Does It Happen?

To understand why babies spit up, we need to look at their anatomy. Between the stomach and esophagus, there’s a muscle ring called the lower esophageal sphincter (LES). In infants, this muscle is not fully developed, which can lead to frequent regurgitation of stomach contents.

Additionally, babies have small stomachs that can quickly become full. Parents often overestimate the amount of spit-up, as even a small amount of liquid can spread and appear more substantial than it actually is.

Factors Contributing to Baby Spit-Up

Several factors can contribute to the frequency and volume of baby spit-up:

1. Overfeeding
2. Swallowing air during feeding
3. Lying flat after feeding
4. Certain foods in the mother’s diet (for breastfed babies)
5. Formula intolerance (for formula-fed babies)

Reducing Baby Spit-Up: Practical Tips for Parents

While some degree of spit-up is normal, there are steps parents can take to minimize its occurrence:

• Feed your baby in an upright or semi-upright position
• Offer smaller, more frequent feedings
• Experiment with different formulas if your baby is formula-fed
• For breastfeeding mothers, consider eliminating dairy from your diet

Interestingly, while burping after feeding is often recommended, a 2015 study found that it may actually increase the risk of spit-up in infants up to three months old. However, more research is needed to confirm these findings.

Safe Sleep Practices and Spit-Up

Despite concerns about spit-up, it’s crucial to always place your baby on their back to sleep. This position significantly reduces the risk of Sudden Infant Death Syndrome (SIDS). Avoid placing your baby on their stomach to sleep, even if you’re worried about spit-up.

When to Be Concerned: Red Flags for Baby Spit-Up

While most cases of baby spit-up are harmless, certain symptoms may indicate a more serious condition, such as gastroesophageal reflux disease (GERD). Contact your child’s healthcare provider if you notice any of the following:

• Blood in the spit-up
• Green or yellow spit-up
• Spit-up resembling coffee grounds
• Refusal to eat
• Sudden onset of spit-up after six months of age
• Blood in the stool
• Failure to gain weight
• Persistent cough or difficulty breathing
• Lethargy
• Sudden decrease in wet diapers

Gastroesophageal Reflux Disease (GERD) in Infants: What Parents Should Know

While occasional spit-up is normal, some babies may develop GERD, a more serious condition that requires medical attention. GERD occurs when stomach contents frequently flow back into the esophagus, causing irritation and potential health complications if left untreated.

Symptoms of GERD in Babies

Common signs of GERD in infants include:

• Frequent and forceful spit-up
• Arching of the back during or after feedings
• Irritability and fussiness during feedings
• Difficulty gaining weight
• Choking or gagging
• Frequent coughing or wheezing

If you suspect your baby may have GERD, consult your pediatrician for proper diagnosis and treatment options.

The Role of Diet in Baby Spit-Up: Breastfeeding and Formula Considerations

For breastfeeding mothers, certain foods in their diet may contribute to increased spit-up in their babies. Common culprits include:

• Dairy products
• Caffeine
• Spicy foods
• Citrus fruits
• Chocolate

If you suspect your diet may be affecting your baby’s spit-up, consider keeping a food diary and eliminating potential triggers one at a time to see if it makes a difference.

Choosing the Right Formula

For formula-fed babies experiencing frequent spit-up, switching formulas may help. Consider trying:

• Hypoallergenic formulas
• Formulas designed for sensitive stomachs
• Thickened formulas (with pediatrician approval)

Always consult your pediatrician before making any significant changes to your baby’s diet.

Growth and Development: How Spit-Up Changes as Babies Grow

As babies grow and develop, their digestive systems mature, and spit-up typically becomes less frequent. Most babies outgrow frequent spit-up by 12 to 18 months of age. This reduction in spit-up is often due to several factors:

• Strengthening of the lower esophageal sphincter
• Increased stomach capacity
• Introduction of solid foods
• More time spent in an upright position

Milestones That May Affect Spit-Up

Certain developmental milestones may temporarily increase or decrease spit-up:

1. Starting solid foods (around 4-6 months)
2. Learning to sit up (around 6 months)
3. Crawling and increased movement (around 7-10 months)
4. Walking (around 12-15 months)

Each of these milestones can affect your baby’s digestion and potentially impact the frequency of spit-up.

Coping with Baby Spit-Up: Practical Tips for Parents

Dealing with frequent spit-up can be challenging for parents. Here are some practical tips to help you cope:

• Keep plenty of burp cloths and bibs on hand
• Use waterproof mattress covers and change bedding frequently
• Dress your baby in easy-to-change clothing
• Consider wearing clothing that’s easy to clean or change
• Keep a change of clothes for both you and your baby when going out

Emotional Support for Parents

Dealing with frequent spit-up can be emotionally taxing. Remember:

• It’s normal to feel frustrated or overwhelmed at times
• Reach out to other parents or join support groups for advice and encouragement
• Don’t hesitate to ask for help from family or friends when needed
• Consult your pediatrician if you have ongoing concerns or need reassurance

By understanding the causes of baby spit-up, implementing strategies to reduce its occurrence, and knowing when to seek medical attention, parents can navigate this common aspect of infancy with greater confidence. Remember, most babies outgrow frequent spit-up as they develop, and it’s rarely a cause for significant concern when your baby is otherwise healthy and gaining weight appropriately.

Why Is My Baby Spitting Up Curdled Milk?

Written by WebMD Editorial Contributors

In this Article

• What Is Baby Spit-Up?
• Why Do Babies Spit Up?
• Methods for Reducing Baby Spit-Up
• When to Be Concerned About Baby Spit-Up

If your baby is spitting up after feeding, you might wonder if this is something you should be concerned about. Spitting up can be even more jarring when the milk has a curdled appearance.  

‌As long as your child is showing no other signs of illness, is alert, and is gaining weight, spit-up is not typically a cause for concern and generally slows down by 12 to 18 months of age. 

Spitting up refers to what happens in the first few months of your baby’s life when they regurgitate some of their stomach contents. Because a baby’s diet consists of primarily breast milk or formula, the spit-up is likely to be a white texture but can vary depending on how long after feeding your baby spits up. 

Spit up that looks like curdled milk is no reason to be alarmed, and there is an explanation.  If your child spits up during or immediately after feeding, it is likely to have a smooth, milky texture. If your baby spits up after the milk has had time to mix with your baby’s stomach acid, the spit-up is likely to appear curdled.  

Baby spit-up differs from vomit in that the flow of spit-up is usually slower and stays closer to the baby’s body, while vomiting is more forceful and projectile and can indicate illness. If your child is vomiting, call your child’s health care provider. 

There is a muscle ring between the stomach and the esophagus called the lower esophageal sphincter (LES). In babies, this muscle is not as developed as it is in adults and older children, resulting in frequent spitting up of stomach contents. Some babies spit up more than others, and it is important to remember that babies’ stomachs are very small and can become full quickly. 

Parents often think that their babies are spitting up more than they actually are. A puddle of spit-up or a large spit-up stain can look like a lot of liquid, but it is important to consider how much liquid spreads. Imagine spilling just a tablespoon of water on a table. It would look like a lot more liquid than it actually is. 

If your baby is spitting up frequently, and you would like to try to reduce how much they are spitting up, there are a few things that you can try to see if they help: 

• You can feed your baby in an upright or semi-upright position. 
• You can try to feed your baby smaller amounts of milk in each feeding. 
• If your baby is formula-fed, you may want to try a different formula to see if that helps 
• If you are breastfeeding, you can try to experiment with your own diet to see if that helps. Some mothers find that eliminating dairy from their diet can reduce spit-up.

Though burping after feeding is frequently recommended to new parents, one study in 2015 found that burping increased the risk of spit-up in infants up to three months old. 

Avoid following advice that directs you to place your baby on their stomach while they sleep to prevent spitting up. It is important to place your baby to sleep on their back, as this reduces the risk of sudden infant death syndrome, also known as SIDS. 

Most of the time your baby spitting up is nothing to be concerned about as long as they are happy and gaining weight. However, there are instances where you should call your baby’s health care provider. 

Some babies develop gastroesophageal reflux disease (GERD). GERD can cause health complications if left untreated. Consult your child’s doctor if you notice any of the following symptoms, as they could indicate GERD or other serious health conditions: 

• There is blood in your baby’s spit-up.
• Your baby’s spit-up is green or yellow in color.
• Your baby’s spit-up resembles coffee grounds.
• Your baby is refusing to eat.
• Your baby suddenly begins spitting up after six months of age.
• There is blood in your baby’s stool.
• Your baby has stopped gaining weight.
• You notice a persistent cough or difficulty breathing.
• Your baby seems lethargic.
• The number of wet diapers has decreased suddenly.

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Baby Spitting Up Curdled Milk: Causes and Treatments

Don’t you sometimes wish that your newborn came with an instruction manual? It would take the guesswork out of some of those pressing questions of the first few weeks: Are they eating enough? Crying too much? Too hot? Too cold? Why are they spitting up when I feed them?

Let’s focus on that last one for a minute. It’s important to remember that for the first few months, spitting up is very normal for babies. And even if the consistency of what comes out seems a little different than what went in, it’s still generally nothing to worry about.

Here’s why your baby might be spitting up curdled milk — and what you can do about it.

Babies spit up all the time because of their undeveloped digestive system. It happens when milk or food comes back up the baby’s esophagus from the stomach. (The esophagus is the organ connecting the stomach to the mouth).

Spitting up and vomiting are separate actions. Vomiting requires force and can be painful in babies. When it comes to spitting up, however, it’s likely your little one won’t even notice when they’re doing it.

Normal spit-up for breastfed and formula-fed babies will usually look quite similar to the milk or formula that the baby just had — more about the curdling in a minute.

Your baby will be relatively comfortable and content during and after spitting up — they may even look pleased with themselves! If they’re not done eating, they’ll have no problem accepting more food after a spitting session.

Spit-up, just like vomit, can contain stomach acid. Babies’ spit-up becomes curdled when milk from breastfeeding or formula mixes with the acidic stomach fluid.

Time also plays a role here. Immediate spit-up after feeding will probably look like regular milk. If your little one spits up after some time as passed, it’s more likely to look curdled milk.

There are a few possible reasons why your baby may be spitting up curdled milk:

Difficulty with digestion

Your baby may have trouble digesting breast milk for a few reasons. The most common — at least for newborns — is just that their digestive system needs more time to develop.

Some babies may have an allergic reaction to cow’s milk or formula that contains cow’s milk. Rarely, they may have lactose intolerance or a milk protein allergy. But keep in mind that these come with other symptoms, like diarrhea. Talk to your pediatrician if you suspect an allergy or intolerance.

Your pediatrician may recommend a shift in your baby’s diet to reduce spit-up. Options include:

• soy protein formula
• extensively hydrolyzed formula (EHF), a type of formula that contains broken-down proteins from cow’s milk that are unlikely to cause allergic reactions
• amino acid-based formula (AAF), or an alternative formula for babies that have trouble with EHFs

Keep in mind, though, that babies typically grow out of digestive problems with age.

Acid reflux

Babies may have acid reflux, especially if they’re newborns. Acid reflux happens when stomach acid travels up the throat from the stomach. It can be painful.

Before switching formulas (or switching from breastfeeding to formula), try these home remedies:

• avoid feeding your baby too fast or too much at once
• feed your baby in an upright position.
• if you’re breastfeeding, avoid foods like citrus, tomatoes, spicy foods, carbonated drinks, and foods high in fat (these can affect your breast milk and lead to reflux)

Pyloric stenosis

Pyloric stenosis is rare, affecting about 3 out of 1,000 babies in the United States. The pylorus is the lower part of the stomach that food and other substances pass before entering the small intestine.

The muscles in the pylorus may become enlarged in infants, which causes the pyloric channel to narrow and prevents food from leaving the stomach. Most babies that experience pyloric stenosis are 3–5 weeks old and require treatment and surgery.

Some signs of pyloric stenosis include projectile vomiting of milk, weight loss, and constipation. Pyloric stenosis is a serious condition that requires immediate treatment.

There are several reasons that may lead to your baby spitting up stomach acid. Spit-up may appear curdled if your baby hasn’t digested milk from feeding. This isn’t always a health concern, but it’s important to pay attention to any changes in your baby’s spit-up.

Talk to your baby’s doctor if you are concerned about your baby’s spit-up or have questions about healthy feeding alternatives.

Frequent vomiting in babies: normal or not

Every caring parent is attentive to the health of their child, so as not to miss the first symptoms of serious diseases. If the child is the first, the reactions of his body, in particular regurgitation, cause concern. Most often it occurs for a physiological reason.

There is a sphincter between the stomach and the esophagus. In children from birth to a year, it is underdeveloped and is not able to keep food in the stomach. Any careless movement leads to the fact that the contents of the stomach pour out through the esophagus, that is, the child burps. To avoid this, pediatricians recommend carrying the child in the “column” position for half an hour after eating. Even in this position, regurgitation is possible, since pressure on the chest and stomach of the child cannot be completely eliminated. There is nothing to worry about, but in some cases regurgitation indicates the presence of serious diseases.

What is normal

If the child spits up only a small part of the food, is active, feels good, there is no reason for concern. In the presence of temperature, capriciousness, lethargy, regurgitation can be one of the symptoms of the disease. For babies up to six months, the norm is spitting up small portions of food up to 6-8 times a day. The curdled consistency of regurgitation is not a cause for concern. This is milk curdled under the influence of a special enzyme contained in the gastric juice, and prepared for further digestion.

The so-called “fountain” regurgitation should alert parents and force them to closely monitor the baby’s condition. It is necessary to drink it with warm boiled water, for some time vilify vertically. If such regurgitation was a one-time occurrence, the crumbs do not have a temperature, you should not worry. If the situation recurs, you should consult a doctor.

Causes of regurgitation

Newborns do not realize how much food they need and often overeat. Parents misinterpret the crying of the baby, and begin to feed him on demand. The baby may not be hungry, but simply demand the attention of the mother, her warmth. Excess food is not retained in the stomach, and the child burps.

When breastfeeding, the baby sometimes does not grasp the nipple correctly, and swallows air along with milk. It will come out with a little milk. Another common cause of regurgitation is excess gas. Food moves to the intestines more slowly than necessary, and part of it is ejected through the esophagus.

Serious problems that are manifested by frequent regurgitation include congenital defects of the gastrointestinal tract and central nervous system, intestinal obstruction.

Troubleshooting

Most causes of spitting up are easy to fix, but the situation can be more serious. Some children suffer from lactose intolerance, which is genetically determined. The sooner this is detected and the necessary treatment is started, the better the child will develop. Lactose intolerance can be suspected if the baby spits up breast milk, and this problem is not observed when feeding with mixtures. Timely diagnosis of genetic lactose intolerance allows you to avoid a large number of problems with the health of the child in the future.

If parents are concerned about the frequent regurgitation of the baby, it is worth taking an analysis in one of the modern laboratories and consulting a doctor with its results. The modern level of laboratory diagnostics makes it possible to accurately determine the cause of the problem, and knowing it, the doctor will select the optimal treatment. no.

Savchenko Svetlana Petrovna

Expert in the field of laboratory diagnostics, healthcare organization, diagnostics and treatment of therapeutic diseases.

Article publication date:
02/16/2018

Updated:
08/19/2022

Spitting up and vomiting in babies

Spitting up and vomiting in babies is a common reason to see a doctor.

Regurgitation and vomiting is a reflex action that occurs when receptors located in various anatomical zones are irritated, incl. in the stomach, esophagus, pharynx, oral cavity. The signal is transmitted to the vomiting center, which is located in the medulla oblongata and a gag reflex occurs.

What is the difference between regurgitation and vomiting?

The difference lies in the volume and kinetics (movement) of the gastric contents expelled to the outside. When regurgitation occurs, leakage occurs without the participation of the diaphragm and abdominal muscles, i.e. passively. There is little content, up to about 10-15 ml. If the child does not swallow it, it quietly expires from the oral cavity. When vomiting, a wave-like bending of the upper half of the body occurs as a result of contraction of the muscles of the diaphragm and the anterior wall of the abdomen, the volume of vomit is greater, and they are erupted with pressure from the oral cavity with an ejection trajectory of up to 50 cm. In children of the first year of life, this is defined by the term “fountain vomiting” .

Regurgitation is observed only in children of the first year of life and, mainly, up to 6 months. Contribute to this anatomical and physiological features of the esophagus and stomach of the baby. Their esophagus is short and wide, the angle of connection of the esophagus with the stomach is less pronounced, and its obturator function is weak. These regurgitations are physiological. They can be after each feeding, up to 15 ml, do not affect the well-being and weight gain of the baby. They can also be caused by excessive feeding, aerophagia (swallowing air while sucking), straining during intestinal colic. The frequency and volume of such regurgitation decreases with the growth of the child. With the introduction of complementary foods, and this is a thicker food, regurgitation stops or becomes much less frequent.

If regurgitation persists in a child older than 1 year, then this is a sign of a pathological process.

Vomiting, unlike regurgitation, is accompanied by vegetative symptoms – increased salivation, pallor of the skin, palpitations. This is due to the fact that next to the vomiting center there are additional centers of autonomic regulation, which are reflexively excited, and active biological substances such as serotonin, dopamine, histamine and others are released into the blood.

Regurgitation and vomiting, from the moment of eating, may occur during feeding, after feeding for the first 20-30 minutes or delayed, sometimes after several hours.

Regurgitation and vomiting that occurs immediately after feeding unchanged breast milk or formula may be due to narrowing of the esophagus. If they persist until the next feeding, and the milk / mixture is curdled, has a sour or musty smell, then this is the result of a long standing food in the stomach. The reason for this may be the low tone of the muscle layer of the stomach and, as a result, its peristalsis or narrowing of the output section due to an anomaly in the development or high tone of the sphincter of the lower stomach. With narrowing of the duodenum, bile is present in the regurgitated masses.

Gastroesophageal reflux is a common cause of regurgitation in infants. It is likely that there is a complex problem here, starting with the immaturity of the gastrointestinal tract and disorders of the central nervous system. Perinatal injuries of the central nervous system accompany every second child. Their manifestations are varied. Regurgitation and vomiting can be facilitated by an increase in intracranial pressure, disorders in the segment of the cervical spine, and so on. Therefore, quite often, when carrying out rehabilitation measures for neurological dysfunctions, a positive effect is manifested in the form of a decrease or cessation of regurgitation. A hernia of the esophageal opening of the diaphragm will also manifest itself in a similar way.

We should not forget about allergic gastrointestinal reactions in the form of regurgitation and vomiting. The most common cause of this is cow’s milk protein. With intolerance to cow’s milk protein, inflammation of the mucous membrane of the esophagus, stomach and intestines occurs. And, as a result of this, regurgitation and vomiting, pain and increased gas formation, diarrhea or constipation.

Rare endocrine disorders (adrenogenital syndrome) are manifested by vomiting in children from the first weeks of life. In such cases, vomiting is frequent, there may be an admixture of bile, the child loses weight due to loss of fluid and nutrients, and severe metabolic disorders develop.

Vomiting can also be caused by an intestinal infection. Viral gastroenteritis is now common. It must be remembered that the younger the child, the more severe the disease. Within a few hours, the child’s condition can go from satisfactory to extremely serious.

As you can see, the causes of regurgitation and vomiting in children of the first year of life are quite diverse, but most often these are transient conditions that disappear with the growth of the child.

Prevention of regurgitation in children of the first months of life is quite simple. Don’t overfeed your baby. If he cries, it does not always mean that he is hungry. Excess feeding leads to increased gas formation and colic, during which the child is worried, straining, thereby increasing the likelihood of spitting up. After feeding, hold the baby more upright so that he can burp the swallowed air.