Learn how to manage and prevent spitting up after feeding.
It's not uncommon for babies to spit up occasionally as their digestive systems develop. If you notice your baby spitting up, there is probably no need to worry. It's rarely a serious medical issue. In fact, a baby who's spitting up a lot, yet has no pain associated with spitting up and otherwise seems content is frequently called a happy spitter.
How common is spitting up in babies?
Infant reflux, also called spit-up or gastroesophageal reflux (GER), is very common in healthy babies. In fact, more than half of all babies spit up in the first 3 months of life. Reflux usually begins in the first weeks of life, tends to peak between 1 and 4 months of age, and by 12 months of age, most babies stop spitting up.
Why do babies spit up?
Infant reflux, occurs when a baby's stomach contents back up into the esophagus after a meal. With babies, when the lower esophageal sphincter opens, stomach contents often back up into the esophagus and come out of the mouth, resulting in spit-up.
If you think about how small a newborn is, this makes a lot of sense. A one-day old has a stomach about the size of a cherry. At day 10, your baby's stomach is only about the size of an egg. So when you feed this very small stomach even just an ounce or two, it's easy to over fill it and get some back. As the motor coordination and muscle tone strengthen, especially in the stomach and esophagus, food is held down better. Infant reflux may also occur when babies cough, cry or strain themselves.
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 infant reflux usually 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?
How much spit-up is too much? There really aren't any rules. Minimum spitting-up doesn't hurt but if you feel it's causing your baby some discomfort, you might try these tips:
- Keep baby in an upright position. To reduce spitting-up, try holding your baby upright for 20 to 30 minutes after feeding...and if your arms get tired, it's fine to use a front pack, backpack, or infant seat.
- Burp your baby about every 5 minutes throughout feeding time. Taking the time to burp your baby frequently both during and after a feeding will keep air from building up in his digestive tract.
- Avoid too much activity after a feeding. Active play right after eating, like putting your baby in a jumper or infant swing, can keep the food from settling in your baby's stomach. Giving your baby's food time to digest will help keep it down.
- Turn her bottle upside-down to check the flow. It should come out one drop at a time, not a steady stream. Change the flow by adjusting the tightness of the bottle-top screw ring, or by changing to a slower flow nipple.
- Avoid tight diapers as they put added pressure on the stomach.
- 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 him down first. Then try feeding him again.
- Try to avoid disruptions like bright lights or unusual noises during a feeding.
- Give smaller, more frequent feedings to reduce the chances of spit-up.
If his spit up continues, ask your doctor about switching to Enfamil A+® Thickened, specially designed to help reduce spit-up.
Enfamil A+® Thickened is specifically designed for babies who spit up frequently, containing a smooth rice starch that becomes thicker in your baby's stomach- a gentle way to help her keep formula down. Enfamil A+® Thickened is shown to significantly reduce frequent spit-up†. It also contains DHA, an important building block of your baby’s rapidly developing brain.
† Study used Enfamil A.R.® before the addition of DHA and ARA. Enfamil A.R.® is compositionally similar to Enfamil A+ Thickened. Study with infants who regurgitate frequently (5 or more regurgitations per day), comparing frequency of spit up after feeding Enfamil A.R. to the same babies at the beginning of the study.
Is it spit up or vomit?
Vomiting is forceful, usually upsetting and produces a much greater volume than just spitting up. Vomiting can be a sign of a viral infection in the stomach, an allergic reaction or it could be another gastrointestinal problem. If your baby is vomiting, you should consult with your baby's doctor.
When is it a problem?
A small percentage of babies experience reflux with complications. If spit-up accompanies these symptoms, talk to your baby's doctor.
- Poor weight gain
- Vomiting associated with irritability
- Feeding refusal
- Difficulty swallowing
- Arching of the back during feedings
- Sleep disturbance
- Respiratory symptoms
Learn more: About Kids Health