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Why Does My Baby Spit Up So Much? Top Baby Spit Up Concerns & What’s Normal

There are some things about newborn care that no amount of parenting classes can prepare you for: cleaning your first diaper blowout, sucking snot from plugged-up infant nostrils and the sheer amount of baby spit up you’ll encounter.

About half of all babies spit up at some point during their early lives. While it might feel concerning to see your little one spitting up — you’re probably wondering whether she’s actually keeping enough breast milk or formula in her stomach — know that spit up is normal and expected.

Keep reading for the full lowdown on baby spit up, plus when to talk to your doctor if you’re concerned about how much your little one is spitting up.

Why do babies spit up?

Baby spit up, or the dribble of stomach contents that can come out after feeding, is messy, frustrating… and perfectly normal.

An infant’s digestive system is still developing, and her lower esophageal sphincter — a ring of muscle that keeps food in the stomach — isn’t fully functional for several months. This makes it very easy for food that she’s just eaten to come back up. If your baby’s stomach is very full after a feeding or you’ve changed her position suddenly after eating, for example, that can force food out of her stomach and up her esophagus in the form of spit up.

Babies also might spit up when they burp, drool, cough or cry. The fact that your infant is on an all-liquid diet (you know, breast milk or formula) also makes it easy for the contents of her stomach to come right back up.

In very rare cases, your baby’s formula might be contributing to excessive spit up. According to the American Academy of Pediatrics (AAP), an estimated 5 percent of babies have milk-soy protein intolerance, meaning that they cannot properly digest the proteins present in milk- or soy-based formulas. (Spit up is one of several signs that could indicate this condition.) If your baby is diagnosed with this condition, her doctor might recommend a hydrolyzed formula.

Possible causes for baby spit up

Although spit up is normal, there are a few reasons why your little one might be emptying the contents of her stomach.

Spit up 

Normal spit up looks a lot like whatever baby is eating, which is either breast milk or formula before she starts solids (usually sometime around 6 months). Both breastfed and formula-fed babies spit up, and the act of spitting up usually looks effortless. It often comes out through the mouth and/or nose, but doesn’t cause pain and isn’t forcefully done. In fact, most babies typically don’t mind or notice spit up. 

Reflux

 (infant GERD)

Technically, spit up is reflux. But sometimes, if it’s accompanied by other symptoms or poor weight gain, spit up might indicate that your baby has a condition called gastroesophageal reflux disease in babies, also known as infant GERD.

With infant GERD, the lining of the esophagus becomes irritated and damaged by all of the spit up. It can cause pain and fussiness during and after feeding, and make it harder for baby to feed and gain weight. Other signs of GERD include excessive drooling, uncontrollable crying, poor sleep and erratic feeding patterns. Talk to your child’s pediatrician if you notice these symptoms.

Baby spit up vs. vomit: How can you tell the difference?

Spitting up and vomiting might seem similar. They’re both messy, and both involve your baby’s stomach contents ending up on your clothing.

But unlike spit up, vomit is forceful (and in more serious cases, even projectile). It is also caused by a virus, bacteria, food poisoning or some other kind of specific health issue. Sometimes, vomit can be green (which hints that there might be an infection) or red (which indicates there’s some kind of blockage or gastrointestinal bleeding). Other causes of baby vomit might be motion sickness, certain prescription medications, or disturbing sights or sounds.

In rare cases, true vomiting might indicate that your baby has something called pyloric stenosis, which is when a muscle in the stomach thickens, preventing food from moving to the small intestine. This can cause projectile vomiting and dehydration, and needs to be treated immediately. Symptoms typically start when baby is between 2 weeks and 2 months old.

How much baby spit up is normal?

Yes, spit up means laundry day happens a lot more often during baby’s first few months of life. But it’s usually perfectly normal. And while you might feel like your baby is spitting up all of her breast milk or formula, that is usually not the reality.

Some babies rarely ever spit up; others spit up after nearly every meal. And volumes of spit up can vary. Most often, spit up is a mix of food and stomach acid, and it’s hard to quantify how much is actually being spit up — which is why doctors rarely use volume on its own to tell whether spit up is normal or a sign of something more serious.

Instead, doctors typically consider the following when assessing a baby’s spit up: 

  • Is the spit up forceful? 
  • Is it colored red or green?
  • Does baby appear to be uncomfortable or in pain?
  • Is baby still feeding normally? 
  • Is baby still gaining weight normally? 

Those kinds of questions help practitioners figure out whether a baby is spitting up normally or if something else might be contributing to her spit up. But as long as your baby is still otherwise healthy and gaining weight, spit up is likely normal.

Some parents also wonder if it’s typical for babies to spit up hours after eating. While spitting up typically happens during or shortly after a feeding, if your baby is otherwise healthy, happy, gaining weight and doesn’t have any of the red flags above, this is also probably normal, but ask your child’s pediatrician if you have any concerns.

When do babies stop spitting up?

Spit up happens in most infants, so know that it’s normal — and it gets better as they get older!

Babies typically spit up until they’re around 12 months old. You can expect spit up to get more frequent until about 3 months of age, and then it should gradually start to get better as baby gets stronger and can sit up on her own.

However, if your baby starts spitting up for the first time after 6 months of age or her spit up turns to vomiting, that could be a sign that something more serious is going on.

Tips to minimize spitting up in babies

Again, spit up is normal — but to prevent it from happening as often, there are a few steps experts typically recommend.

  • Don’t overfeed. Babies’ stomachs are small, and it’s easy to overload them. (This tends to be more of an issue with bottle-fed babies, since it’s easier for babies to get milk from a bottle nipple than from the breast.) Try feeding more often at smaller volumes if you notice that your baby often spits up during feedings.
  • Hold baby upright for 30 minutes after feeding. Sitting chest-to-chest on you for at least a half hour after each feed might minimize the amount of spit up your baby experiences.
  • Burp frequently. Burping gently during and after feeds — for bottle-fed babies, at least once halfway through a feeding or after every 2 or 3 ounces, and when you switch from one breast to the other for breastfed babies — can help reduce spit up.
  • Limit post-feeding activity. Going straight from a feeding to playtime might cause milk to come back up, for example.
  • Use a slow-flow nipple. If you bottle-feed, try using a slow-flow nipple. These are designed to slow down feeding and reduce the amount of air baby takes in while eating — which may help reduce spit up risk. 

When to call the doctor about baby spit up

Spit up is usually normal and healthy. But in rare cases, your baby’s spit up habits might indicate a more serious health problem. Be sure to talk to your doctor if you notice any of the following: 

  • Not gaining weight well or losing weight
  • Crying or arching her back while feeding
  • Refusing to feed
  • Spit up that starts after 6 months or continues past 18 months
  • Yellow, green or red spit up
  • Frequent forceful or projectile vomiting 
  • Spit up accompanied by other symptoms such as bloody stools, wheezing or coughing, fewer wet or dirty diapers, lethargy and/or fever 

Like dirty diapers, spit up is a normal part of early parenthood. While you should keep an eye out for any abnormal symptoms, spit up is usually something to ride out. In the meantime, thank goodness for burp cloths and stain removers! 

Reflux (Spitting Up) | | Pediatrics Day and Night

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Baby Spit Up: How Much Is Too Much?

Everyone tells you you’ll be doing more laundry when baby arrives, but nobody tells you it’s because of baby spit up! You’ll wonder: Why is baby spitting up this frequently? Does baby have reflux? Is baby getting enough to eat?

New parents have enough to worry about, so let’s get to the bottom of these questions, and more. Read on to find out:


What Is Baby Spit Up?

First thing’s first: In most cases, spitting up is very common.

This is more of a laundry problem than a medical problem and seldom bothers baby. — Dr. Sears

Some experts estimate that nearly 40% of normal, healthy babies spit up after feedings. If baby spits up right away, it may look just like milk; if baby spits up once he/she has begun to digest it might look curdled and smell slightly sour. 

If you’re worried about the quantity of baby spit up, you’re not alone. Many parents see what looks like a lot of spit up and wonder if their baby is getting enough to eat. You might take comfort in knowing that baby spit up is made up mostly of saliva and gastric juices—there’s usually only a small amount of milk in spit up.

Although that puddle can still be off-putting, Dr. Sears estimates that most baby spit up is only about a teaspoon of liquid. To put your mind at ease, he suggests trying this simple experiment: Pour a tablespoon of milk on the countertop and compare the resulting puddle to the stain on your clothes from your baby’s spit up. You’ll likely notice that the puddle on the counter is much larger.

Baby spit up usually dribbles or spurts out of their mouth. Occasionally baby’s spit up looks forceful, like projectile vomiting. Without other signs of illness, more forceful baby spit up may be a sign of reflux, possibly as a result of food sensitivities (something mom is eating or from the type of formula) or an anatomical issue. (More on this below.)


Why Do Babies Spit Up?

Still, you’re probably wondering why this happens—and why some babies spit up as frequently as they do. The most common causes of baby spit up are:

1.

Immature Digestive System

It’s also important to remember that part of the reason your baby spits up is because…well, they are a baby. Baby’s digestive systems just aren’t as mature as ours are.

“In infants, the ring of muscle between the esophagus and the stomach—the lower esophageal sphincter (LES)—is not fully mature, allowing stomach contents to flow backward,” explains Dr. Andrew E. Mulberg, a pediatric gastroenterologist.

2. Improper Latch

Beyond basic biology, the simplest and most common cause of baby spit up is one that is actually relatively easy to fix. Sometimes a baby isn’t latched on snugly enough to the breast or bottle, and takes in an excessive amount of air. To reduce baby spit up, breastfeeding mamas can remedy this by ensuring baby has a deep, close latch; bottle-fed babies should have a tight seal around the nipple teat.

3. Fast Letdown

Likewise, a fast letdown during breastfeeding can make it difficult for a young baby to keep up with the flow of milk. This can cause some of that milk to come back up. It can also cause baby to take in excess air, as they struggle to swallow all of the milk. If you’re having trouble with an overactive letdown, try different breastfeeding positions (laid-back nursing works with gravity to help keep the flow at a manageable pace) or get help from a lactation consultant. If you are bottle-feeding, make sure you have a slow flow nipple and practicing paced bottle feeding.


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Baby Spit Up vs. Vomit

So we know that baby spit up is normal. But at some point you’ll probably wonder: Is my baby spitting up… or is he/she vomiting? Here’s how to tell the difference between baby spit up and vomiting: 

Quantity

Though it can look like much more, baby spit up is generally only about a teaspoon at a time. Vomit, on the other hand, is likely to be persistent, adding up to much more.

Force

If baby is sick, it is usually more forceful. In babies, vomiting is generally projectile. Spit up, on the other hand, is more likely to slide or dribble out of baby’s mouth.

Color

Vomit tends to be green or yellow (this indicates bile is present), whereas baby spit up is usually white, off-white, or light yellow in color.

Smell

You might argue that baby spit up doesn’t smell so great, but it’s usually just a bit sour. Vomit, on the other hand, has a more foul smell.

Mood

You will notice your baby cry or look sick (red, watery eyes and/or change in complexion) when they are about to vomit. She may also have a fever. If baby is generally happy and asymptomatic, it’s more likely that he/she is spitting up.

Spit Up

Vomit

Quantity
Spit up is generally only about a teaspoon at a time Vomit is more persistent, adding up to much more
Force
Spit up is more likely to slide or dribble out of baby’s mouth Vomiting is more forceful and generally projectile
Color
Spit up is usually white, off-white, or light yellow Vomit tends to be green or yellow
Smell
Spit up doesn’t smell so great, but it’s usually just a bit sour Vomit has a more foul smell
Mood
Baby is generally happy and asymptomatic Baby may cry or look sick (red, watery eyes and/or change in complexion) when they are about to vomit


What to Do if It Seems Like Baby Is Vomiting Due to Illness

If your baby is less than 12 weeks old and seems to be vomiting, call your pediatrician immediately.  In rare cases this can be a sign of a serious condition called hypertrophic pyloric stenosis, which prevents food from reaching the intestines.

If your baby is a bit older, a viral infection is the most common cause of vomiting, and will usually pass on its own. Still, it’s always a good idea to give your doctor a call to discuss symptoms, concerns, and treatment, especially if it’s accompanied by a fever.

The most common complication in babies older than 12 weeks is dehydration. Here are the signs of dehydration in an infant:

  • Fewer wet diapers
  • Lethargy or weakness
  • Lack of tears when crying
  • Sunken eyes or soft soft
  • Decreased saliva


My Baby Is Spitting Up More Than Usual

So your baby wasn’t spitting up, but now it seems like they can’t keep anything down? That’s normal, too. Sometimes babies will begin spitting up much more than usual, seemingly out of the blue.  Here are some reasons your baby may be spitting up more often:

1. Change in diet

Some babies spit up more frequently after starting solids, especially if they are eating too much too soon. Cut back on solids to see if that helps. Others will react to a change in a breastfeeding mom’s diet. Revert back to old eating patterns to see if that clears things up.

2. Teething

Sometimes teething babies, who are producing more saliva than usual, will spit up excess saliva along with their milk.

3. Illness

Babies may also spit up more when they have a cold, as baby is trying to rid his/her body of the extra mucus.


How Can I Tell If My Baby Is Getting Enough Food?

Ask yourself these questions:

  • Is your baby generally happy and healthy?
  • Is your baby gaining weight?
  • Is your baby wetting diapers?
  • Is your baby growing well?

If you answered yes to these questions, you probably don’t need to worry—even if you’re dealing with a lot of baby spit up. But remember: You know your baby best. If something seems off, call your pediatrician.

Otherwise, if your baby is unusually fussy, seems to lack energy, or if the baby spit up has blood in it, or looks and smells like vomit, it is time to call the doctor.


Can Babies Choke on Their Own Spit Up?

It’s very unlikely for a baby to choke on their own spit up. Babies have a reflex that causes them to cough out or swallow any fluid they spit up or swallow, even while sleeping.

If you are worried or simply want to ease baby’s discomfort, you can prop up the end of the entire crib with blocks to elevate baby’s head. (Never use pillows or anything inside the crib to prop up baby!)

Baby Spit Up: How Much is Too Much? – Crib Propped Up

(image source)


When Do Babies Stop Spitting Up?

Most instances of spitting up end with the conclusion of the “fourth trimester,” at about 3-4 months. (Paloma stopped spitting up around 4 months old.) Other babies begin spitting up less starting at 6 months, once they start solids, which can often help them “hold down” their food and settle their stomachs. Other babies decrease the instances of spitting up by 9-12 months. And some are late bloomers, and don’t stop spitting up until closer to a year. But don’t fret: By that one year mark, most babies are done spitting up on a regular basis.


Resist the Urge to Feed Baby Infant Rice Cereal

Some may recommend mixing milk with rice cereal as early as 6 weeks (!) to thicken baby’s food and help it stay down, it’s not a good idea—for lots of reasons. Mainly, rice cereal it’s low in nutrients and hard on digestion. Baby’s digestive system really isn’t ready for solids, and particularly grains, until at least 6 months. Rice cereal is also full of yucky preservatives and toxins. Read more about baby cereal here.


When to Call the Doctor

Although baby spit up generally isn’t cause for concern, excessive baby spit up can occasionally be tired to anatomical dysfunction or metabolic disorders. Call your pediatrician if: 

  • baby is losing or not gaining weight
  • baby spit up increases significantly
  • baby is coughing, gagging, or otherwise struggling to eat
  • spit up is green or has blood in it
  • normal baby spit up becomes projectile
  • baby is unusually fussy or, conversely, baby is lethargic


Could My Baby Have Reflux?

Sometimes babies can develop a condition like GERD, or acid reflux. In these cases, the backflow that often happens as a result of an immature digestive system can cause babies pain or discomfort.

There are two forms of reflux in babies: acid reflux and silent acid reflux. Acid reflux usually causes projectile vomiting and intense crying; silent reflux, a more subtle condition, usually causes sour breath, hiccups, and physical stiffness or discomfort.

Signs of reflux include:

  • Discomfort or crying after eating
  • Coughing
  • Refusing the breast/bottle
  • Arching back after eating
  • Resistance to laying on back
  • Gagging or choking
  • Excessive gas
  • Foamy bowel movements
  • Persistent crying or colic
  • Sour breath
  • Frequent burps and hiccups
  • Failure to gain weight

Read more about baby reflux, including my experience with it, here. 


Natural Ways to Relieve Baby’s Reflux

The good news is that if spitting up is becoming a serious issue for your baby—or if your baby is showing signs of reflux—there are things you can do to make your baby feel better.

1. Try probiotics

Some mothers report seeing positive changes once they give their baby a probiotic—or if they are breastfeeding, if they take a probiotic themselves. A 2014 study published in JAMA Pediatrics supported this claim. The researchers found that babies who took probiotics for the first three months of life showed improvements in colic symptoms, acid reflux, and constipation. 

I don’t normally suggest giving babies supplements, but L. reuteri, a probiotic that has been clinically shown to reduce crying time by 50% in colicky breastfed infants, made a big difference for Paloma. Here are other great probiotics for babies.

2. Keep baby elevated

A baby with reflux needs a little extra TLC during and after feedings. Keep baby in a sitting position while feeding them (a boppy pillow can offer extra support) and hold baby upright for at least 30 minutes after meals (babywearing can make this an easier task for mama). 

3. Try cell salts

Some newborns don’t make enough Nat Phos, a natural cell salt that helps with digestion. A tablet of Nat Phos 6X, a homeopathetic remedy, can be split in half and dissolved in breastmilk and administered with a syringe or dissolved under baby’s tongue. (It’s important to check with your doctor before administering cell salts to your baby.) 

Other simple “hacks” for naturally helping your baby deal with reflux or excessive spitting up include:

  • avoid putting excessive pressure on your baby’s belly
  • limit car rides, rocking, or other motion after feedings
  • burp your baby after feedings

Mostly, take note of what seems to bother your baby, and what soothes them. It is not a “one-size-fits-all” approach, and you know your baby best.

4. Try an elimination diet

When all else fails, a breastfeeding mama can try an elimination diet. The biggest culprit is usually dairy and cutting it out of your diet can make all the difference for your baby. (The proteins in dairy can irritate a baby’s underdeveloped digestive tract.)

That is usually all that is needed. However, some mothers may find that eliminating these foods and beverages also help:

  • Dairy (as mentioned above)
  • Soy
  • Gas-producing vegetables like broccoli, cabbage, onions, and peppers
  • Acidic food like coffee, tomatoes, and citrus
  • Wheat
  • Nuts
  • Eggs
  • Shellfish
  • Gluten

See how to start an elimination diet.

5. Try another formula

If baby is formula-fed, saying goodbye to all that baby spit up might be as simple as switching formulas. Try a cow-milk free formula if you think that might be the culprit. See the best baby formula here.

How About You?

Did you have a baby who spit up? What helped your baby feel better? And what would you tell a new parent who is worried about baby spit up?

What’s The Difference Between Spit-Up & Vomit? Experts Explain The Symptoms

I’m embarrassed to say that the first newborn I interacted with for any amount of time was my own. Sure, I’d held babies at showers and parties, but you really don’t know a thing about infancy until you spend at least 24 hours with an infant. And then, expect it to be a pretty harrowing 24 hours. Is she eating enough? Pooping enough? Everything that goes into, or comes out of, your baby’s body is a potential source of anxiety. I remember asking, “What’s the difference between spit-up and vomit?” It turns out the difference is stark.

“Generally babies are unconcerned after they spit up,” explains Kristin Gourley, International Board Certified Lactation Consultant (IBCLC) with Lactation Link, LLC, in an email interview with Romper. “It is white, but appearance can vary and can be curdled or look like straight milk.” Often, babies spit up directly after a feeding. Sometimes yellow mucus comes up, which sounds frightening. However, the key word here is unconcerned. As you may have noticed, babies are super chill after they spit up. It might even be their superpower.

“Spitting up is a relatively normal physiologic process in babies; it’s harmless,” writes pediatricain Dr. Jarret Patton, MD in an email interview with Romper. “The cause can be from overfeeding or inefficient burping.” He goes on to note that when a baby spits up, they throw up only a portion of what’s in their tummies. In contrast, vomiting is more forceful, with larger quantities coming up. While overfeeding can sometimes cause vomiting, viruses, formula intolerance, or gastroesophageal reflux disease (GERD) may also be behind it, according to Patton. “If at anytime the stomach contents appear bloody or green colored, your baby should be seen by a physician immediately,” he says.

According to BabyCenter, babies spit up so much because they’re still new to the world of eating, ingesting, and digesting. Essentially, they’re swallowing pockets of air with that breast milk or formula and coughing it up as a result. The medical term for spitting up is reflux, and on average, babies have the most reflux around 4 months. Mayo Clinic even calls spitting up “a rite of passage” for babies — at least, it’s certainly a test for your washing machine. But spitting up shouldn’t really bother your baby. Like I said, it’s a superpower.

Vomiting, on the other hand, is unpleasant for grown people and babies alike. When a baby is vomiting, they might heave without spitting up anything, and you’ll probably notice other issues, too. “In general, baby will likely feel unwell and may have diarrhea or other symptoms like a persistent cough as well,” writes Gourley.

So how much spit-up is normal, and how much is too much?

“Normal spit-up amounts range by a lot,” writes Gourley. “It can look like baby has spit up their whole feed, but it’s much more likely that it simply looks like a lot of milk when it really isn’t that much.” Gourley suggests pouring a tablespoon of water onto the table and comparing that with your baby’s usual spit-up. On a flat surface, even a tablespoon of fluid will look like a lot. Basically, you don’t have to worry about how much your baby is spitting up, as long as they seem relaxed and content.

Of course, there are some symptoms parents should always be on the lookout for. Here’s Gourley:

“Concerning symptoms might be extreme, inconsolable fussiness, abnormal bowel movements, not gaining weight, dehydration, or distress or fussiness while eating. If baby is happy, healthy, and growing well, then spit-up is generally just a laundry problem, even if it sometimes looks like a lot.”

The human race hasn’t lasted this long by keeping illness quiet and mysterious. When a baby is sick, chances are they’ll let you know — loudly, and throughout the night. When in doubt, however, it’s always OK to call your pediatrician. I promise you’re not the first parent to ask about the difference between vomit and spit-up, nor will you be the last.

Check out Romper’s new video series, Romper’s Doula Diaries:

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Baby Throw Up Curdled Milk

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Baby Spitting Up Curdled Milk: Causes and Healthline

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

Estimated Reading Time: 4 mins

Website: Healthline.com