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Chunky spit up breastfed baby. Chunky Spit Up in Breastfed Babies: Understanding the Causes and Solutions

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What causes a breastfed baby to spit up curdled milk? How can parents reduce excessive spit-up and when should they be concerned? Find expert insights and practical tips.

Understanding Baby Spit-Up: What is it and Why Does it Happen?

Spit-up, or regurgitation, is a common occurrence in the first few months of a baby’s life. It happens when a baby brings up small amounts of milk or formula from their stomach. This is different from vomiting, which is a more forceful and projectile expulsion of stomach contents.

The reason babies spit up is due to the immaturity of their digestive system, particularly the lower esophageal sphincter (LES) muscle. In adults and older children, the LES acts as a valve to prevent food and stomach acid from flowing back up into the esophagus. In infants, this muscle is not yet fully developed, allowing stomach contents to easily flow back up.

Why Does Breastfed Baby Spit-Up Appear Curdled?

Spit-up from a breastfed baby may appear curdled or lumpy in texture. This is not a cause for concern and is simply due to the natural process of digestion. When breast milk enters the baby’s stomach, the stomach acid causes the milk to curdle or coagulate. If the spit-up occurs sometime after feeding, the curdled appearance is normal and expected.

In contrast, spit-up that occurs immediately after feeding is more likely to have a smooth, milky appearance, as the milk has not had time to mix with stomach acid. The curdled texture is simply a result of the digestive process and does not indicate any problem with the breast milk or the baby’s health.

Reducing Excessive Spit-Up in Breastfed Babies

While some degree of spit-up is normal, there are strategies parents can try to help reduce excessive or frequent spit-up in breastfed babies:

  1. Feed in an upright or semi-upright position: Keeping the baby in a more upright position during and after feeding can help prevent the milk from flowing back up.
  2. Try smaller, more frequent feedings: Offering the breast in shorter, more frequent intervals can prevent the baby’s stomach from becoming overfull.
  3. Experiment with your own diet: Some mothers find that eliminating dairy or other foods from their diet can help reduce spit-up in their breastfed babies.
  4. Avoid excessive burping: Contrary to popular belief, one study found that burping increased the risk of spit-up in infants up to 3 months old.

When to Seek Medical Attention for Baby Spit-Up

In most cases, occasional spit-up in a thriving, growing baby is not a cause for concern. However, there are some signs that may indicate a more serious underlying issue, such as gastroesophageal reflux disease (GERD), and warrant a consultation with the baby’s healthcare provider:

  • Blood in the spit-up
  • Green or yellow-colored spit-up
  • Spit-up that resembles coffee grounds
  • Refusal to eat
  • Sudden onset of spit-up after 6 months of age
  • Blood in the stool
  • Failure to gain weight
  • Persistent cough or breathing difficulties
  • Lethargy or decreased number of wet diapers

Key Takeaways

Spit-up in breastfed babies, including curdled or chunky spit-up, is a common and normal occurrence. It is caused by the immaturity of the digestive system and the natural process of milk mixing with stomach acid. While strategies like upright feeding and smaller, more frequent meals can help reduce excessive spit-up, some degree of it is expected in the first year of life. Parents should seek medical attention if they notice any concerning symptoms that could indicate a more serious condition.

Frequently Asked Questions

Is it normal for my breastfed baby to spit up curdled milk?

Yes, it is completely normal for a breastfed baby to spit up milk that appears curdled or chunky. This is simply a result of the milk mixing with stomach acid and does not indicate any problem with the breast milk or the baby’s health.

How can I reduce excessive spit-up in my breastfed baby?

To help reduce excessive spit-up, try feeding your baby in a more upright position, offering smaller, more frequent feedings, and experimenting with your own diet to see if eliminating certain foods helps. Avoid excessive burping, as this can actually increase the risk of spit-up.

When should I be concerned about my baby’s spit-up?

You should contact your baby’s healthcare provider if you notice any of the following: blood in the spit-up, green or yellow-colored spit-up, spit-up that resembles coffee grounds, refusal to eat, sudden onset of spit-up after 6 months, blood in the stool, failure to gain weight, persistent cough or breathing difficulties, lethargy, or a decrease in the number of wet diapers. These could be signs of a more serious condition like GERD.

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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My baby is frequently spitting up – it seems like it’s all of my breast milk! I never thought breastfed babies spit up this much. This can’t be normal, can it? Is there something wrong with my baby?

Don’t worry – we get these questions often. Caring for a baby who spits up can be stressful for parents, creating worries about the baby’s health and proper growth. Spitting up is a very common occurrence in healthy babies, and usually won’t cause any issues in regards to the baby’s growth or development. This often happens because the baby’s digestive system is so immature, making it easier for their stomach contents to flow back up into the esophagus.

Several different factors can contribute to babies spitting up, including:

  • Babies regularly spit up when they drink too much milk, too quickly. This can happen when the baby feeds very fast, or when mom’s breasts are overfull. The amount of spit up can appear to be much more than it really is.
  • Food sensitivities can cause excessive spitting up in babies. Products with cow milk in the mom or baby’s diet can be a common food sensitivity.
  • Some babies can become distracted when feeding at the breast, pulling off to look around. This can cause babies to swallow air and spit up more often.
  • Breastmilk oversupply or forceful let-down (milk ejection reflex) can cause reflux-like symptoms in babies.

If your baby seems comfortable, is eating well, gaining weight and developing normally, there’s typically little cause for concern. “Happy spitters” will grow and thrive, despite spitting up frequently. As babies grow and get older, they usually spit up less. Most will stop spitting up by 12 months of age.

Consider these tips:

  • Keep your baby upright. Try feeding your baby this way and keep them upright for about 30 minutes after feedings.
  • Avoid engaging in immediate active play for at least 30 minutes after feedings. Active play includes use of a bouncy seat, vibrating seat, infant swing or bouncing the baby while walking/holding.
  • Frequent burps during and after each feeding can keep air from building up in your baby’s stomach.
  • Avoid overfeeding. Feeding your baby smaller amounts more frequently might help decrease spitting up.
  • Put your baby to sleep on his or her back. Placing a baby to sleep on its tummy to prevent spitting up is not recommended.
  • Monitor your diet closely if you’re breastfeeding. If you feel there are certain foods that might be upsetting your baby’s stomach, try avoiding them for a while.
  • If you notice weight loss, forceful spit up, fussiness or other symptoms, talk to your child’s pediatrician about your concerns.

Lactation Support Services at Texas Children’s Hospital offers a variety of services to mothers with questions and concerns regarding breastfeeding, pumping, medications and more. Click here to learn more.

Why does the baby spit up after feeding

Why does the child spit up after feeding – Gazeta.Ru

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Moderate regurgitation in children of the first year of life is not considered a pathology, but worries many parents. Olga Nikolaevna Glushko, a pediatric gastroenterologist at the Semeynaya clinic network, told Gazeta.Ru about the dangers and prevention of regurgitation.

When regurgitation should alert

After feeding, one or sometimes several times a day, curdled breast milk or formula may leak from the baby’s mouth. This phenomenon is called regurgitation or regurgitation – involuntary reflux of stomach contents into the esophagus and mouth after eating.

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The reason for such regurgitation is the peculiarities of the structure of the gastrointestinal tract of babies in the first year of life. As a rule, it does not bother children, does not affect their well-being, appetite and weight gain. But there are situations when regurgitation should alert and cause a visit to the doctor. These include:

• Profuse regurgitation in large quantities several times a day.

• Poor weight gain – the baby is not getting better or even losing weight.

• Fewer than six urination times per day – baby’s diaper is dry most of the time.

• High or low temperature, pale or bluish discoloration of the skin.

• Anxiety, refusal to breastfeed if baby is breastfed or bottle fed if baby is bottle fed.

• Vomiting in a fountain when there is no stool or after falling and hitting the head.

• Atypical color of contents when spitting up – yellow or bloody.

Regurgitation can be symptoms of diseases such as esophagitis (inflammation of the lining of the esophagus), anemia, diseases of the upper respiratory tract, aspiration pneumonia.

What is the rate of spitting up in an infant

The rate of spitting up in babies is about one to two tablespoons and from one to five times a day. Normally, regurgitation disappears by a year or earlier. If they become more frequent or suddenly begin in a child older than six months, this also requires contacting a pediatrician.

What are the dangers of spitting up in newborns and how to avoid it

If the baby is healthy, spitting up in itself is not dangerous to health, but if the baby is not in an upright position at the time of spitting up, he may choke. To prevent this from happening, take the following preventive measures:

• When feeding, hold your baby at a 45° angle to the breast or bottle. Breastfed babies should fully grasp the nipple and areola.

• Before feeding, lay the baby on his stomach, and after eating, hold the “column” for ten minutes – to release the air that he could swallow during feeding.

• Avoid tight swaddling, do not disturb the child in the first half hour after eating, do not play active games with him.

• Do not overfeed your baby or give him food or breasts as comfort.

• If you experience frequent spitting up, consult your doctor about anti-reflux mixtures.

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Why does the baby spit up after feeding?

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Regurgitation is a common condition in newborns and infants and is most often a normal variant. However, it is not uncommon for parents to worry if their baby is spitting up frequently, believing that it is due to nutritional or health problems in general. Sometimes these fears are not unfounded, and regurgitation really has a pathological origin. What is its cause and when should you really consult a doctor about this?

Regurgitation — Return of a small amount of food (uncurdled or partially curdled milk) from the stomach up the digestive tract: into the esophagus and further into the oral cavity. According to statistics, at least 1 time during the day can spit up at least 50% of babies from 0 to 3 months, more than 60% of children 3-4 months, and 5% of children spit up until the year 1 .

Regurgitation in newborns is considered a physiological process. It is caused by a number of factors, including:

  • Features of the structure of the upper digestive tract in babies
  • In newborns and infants up to a year of life, the stomach has a spherical shape. It holds a small amount of food, besides, the release from it into the duodenum is slower in comparison with children after the year 2 .
  • Weakness of the lower esophageal sphincter that separates the esophagus from the stomach
  • Normally, the lower esophageal sphincter should tightly “close” the esophagus, allowing food to pass into the stomach and not allowing it to enter back into the upper digestive tract. However, in young children (up to a year), the muscles of the esophageal sphincter are poorly developed, and it does not do its job very well 2 .
  • Slow progression of food through the gastrointestinal tract
  • The neuromuscular system of newborns is immature. It does not ensure the proper movement of food through the esophagus, causing regurgitation.

One of the important risk factors contributing to regurgitation in newborns is aerophagia. This is the swallowing of large amounts of air during feedings. This happens when the baby is not properly attached to the breast, the mother has a lack of breast milk, or the bottle is in the wrong position in the child who receives the mixture. The size of the opening in the nipple also matters – if it is too large, the newborn swallows a lot of air 3 .

With aerophagia, the baby becomes capricious, restless immediately after feeding. Noticeable bloating. If the baby spits up immediately after a feed, the milk (or formula) remains practically fresh, uncurdled 3 .

Promotes post-feeding regurgitation and baby’s predominantly horizontal position during the day, combined with relatively high intra-abdominal pressure 4 . Therefore, the correct position of the baby after feeding is so important. To avoid regurgitation of an excessive amount of stomach contents, after feeding, it is necessary to hold the baby in an upright “column” position for some time (10-20 minutes), lightly patting on the back and allowing excess air to “exit”.

Regurgitation in many newborns can be triggered by other situations in which pressure in the abdominal cavity increases and stomach contents are thrown into the esophagus, in particular 3 :

  • tight swaddling;
  • stool disorders, in particular constipation;
  • long, forced cry and some others.

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How can you tell the difference between normal spitting up and vomiting?

Sometimes regurgitation is considered a manifestation of disorders in the digestive tract of children. Due to the constant reflux of acidic stomach contents into the upper sections, inflammation and other complications may develop, including growth retardation, a decrease in hemoglobin levels, and others. Therefore, it is important for parents to understand where the line is between physiological and pathological regurgitation 1 .

If the mother is worried that her baby is spitting up, keep track of when this happens and count the total number of spit ups per day. Normally, regurgitation usually occurs after eating (the child burps after each feeding), lasts no more than 20 seconds and repeats no more than 20-30 times a day. With pathology, the problem manifests itself at any time of the day, regardless of when the baby was fed. Their number can reach 50 per day, and sometimes more 1 .

The amount of discharge during regurgitation also matters. With normal, physiological regurgitation, it is approximately 5 – 30 ml. If this volume fluctuates between 50 and 100 ml, it is already defined as profuse vomiting. With a jet of vomit up to 50 cm, doctors talk about “vomiting a fountain.” A variant of atonic vomiting is possible, when the contents of the stomach flow “sluggishly”. It occurs with atony of the stomach (decrease in muscle tone of the stomach wall) and disruption of the esophagus 1 .

Vomiting in babies is a warning sign. Doctors are especially alarmed by repeated vomiting, a fountain, with an admixture of bile, in combination with constipation. Vomiting can lead to the development of dehydration, acid-base imbalance and other consequences, therefore, if it occurs, you should urgently contact a pediatrician to find out the cause and begin treatment. A doctor’s consultation is necessary if the child is spitting up a lot (more than 15-30 ml at a time), with a frequency of more than 50 episodes per day 1.3 .

Physiological regurgitation: symptoms

Neonatal regurgitation, which is considered normal and not of concern to pediatricians 3 :

  • usually lasts for a certain period of time;
  • is characterized by slow, “passive” leakage; if the baby spits up a fountain, it is better to consult a doctor;
  • has a sour smell of curdled milk;
  • occurs without the participation of muscles – the baby does not strain during regurgitation;
  • does not affect the general well-being of the baby.

How to help a newborn who spit up often?

If the baby is healthy, no medication is prescribed for spitting up. To help the child allow simple measures based on lifestyle changes and feeding.

  • Frequent feeding of the baby
    It is known that babies are more prone to spit up if their stomach is full. To improve the situation, it is recommended to feed the baby more often, avoiding oversaturation, best of all – on demand 5 .
  • Correct feeding technique
    Every feeding, the mother must ensure that the baby does not swallow too much air during suckling. When sucking, there should be no loud, smacking, clicking sounds. You also need to control that the baby captures the nipple along with the areola.
  • Choosing the right bottle and nipple
    If the newborn is bottle-fed and receiving formula, it is important to choose the right bottle and nipple. The hole in it should be such that the milk flows out in drops, and not in a stream. The nipple must not be filled with air 4 .

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    • Baby standing upright after eating

    To allow air that has entered the digestive tract during meals to escape, it is important to hold the newborn upright for 10-20 minutes after feeding 4 .

    • Ensure the correct position of the baby during sleep

    To reduce the negative impact of stomach acid on the esophagus, put your baby to sleep in a supine position. The side or prone position, which many pediatricians used to recommend, is no longer recommended. It was found to be associated with an increased risk of sudden infant death syndrome 5 .

    If parents notice alarming symptoms, such as spitting up too often or large volume, etc., it is important to consult a pediatrician without delay. This will allow you to identify the real problem in time and help the baby grow up healthy and happy.

    References

    1 Zakharova I. N., Andryukhina E. N. Regurgitation and vomiting syndrome in young children // Pediatric pharmacology, 2010. T. 7. No. 4.

    2 Nagornaya NV, Limarenko MP, Logvinenko NG Experience in the use of domperidone in suspension in infants with regurgitation syndrome //Health of the child, 2013. No. 5 (48).

    3 Zakharova IN Regurgitation and vomiting in children: what to do? //Pediatrics. Supplement to Consilium Medicum, 2009. No. 3. S. 58-67.

    4 Zakharova I. N., Sugyan N. G., Pykov M. I. Regurgitation syndrome in young children: diagnosis and correction // Effective pharmacotherapy, 2014. No. 3. P. 18-28.

    5 Vandenplas Y. et al. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) //Journal of pediatric gastroenterology and nutrition.