Spitting up in babies: What’s OK, what’s not

You’ve just fed your baby breast milk or formula only to watch the baby spit up what seems like all of it. Is spitting up OK? Find out more about spitting up and what you can do about it.

Spitting up is common in babies. During their first three months, about half of all babies do it. The food backs up from the baby’s stomach through the same tube that carries food to the stomach, called the esophagus. This condition is called gastroesophageal reflux, infant reflux or infant acid reflux.

A muscle between the esophagus and the stomach keeps food in the stomach. The muscle is called the lower esophageal sphincter. Until this muscle has time to mature, your baby might spit up. This happens mainly when the baby’s stomach is full.

It can be hard to tell the difference sometimes. Most often, spitting up is the easy flow of food from the baby’s stomach back through the mouth. The baby also might burp. Vomiting might happen with spit up, but it comes out with force. It shoots out of the mouth rather than oozing.

Most often spitting up doesn’t affect a baby’s growth. Does your baby seem well? Is your baby eating and gaining weight? Then there’s little cause for worry.

Keep in mind that when you see how much your baby has spit up based on the size of a spit-up stain, it’s easy to think there’s more than there is. Babies most often spit up only one or two mouthfuls of breast milk or formula.

Most babies stop spitting up by age 12 months.

Try these tips:

• Keep your baby upright. Keep your baby’s head higher than the rest of the body for each feeding. Keep your baby upright for 30 minutes after each feeding. Don’t do active play or use an infant swing right after feeding.
• Don’t overfeed. Feed your baby smaller amounts more often.
• Burp your baby more. Burping during and after each feeding can keep air from building up in your baby’s stomach.
• Watch what you eat. If you’re breastfeeding, your baby’s healthcare professional might suggest not eating dairy or certain other foods.
• Keep tobacco smoke away from your baby. Tobacco smoke adds to gastrointestinal reflux in adults. Besides maybe making your baby’s spitting up worse, being around smoke is bad for the baby’s health in many ways.

Even if your baby spits up, put your baby to sleep on the back. This is to lower the risk of sudden infant death syndrome, also called SIDS. Don’t put your baby to sleep on the stomach to try to keep the baby from spitting up.

Certain symptoms might mean an underlying condition or something more serious than just spitting up. Contact your baby’s healthcare professional if your baby:

• Isn’t gaining weight.
• Spits up with force.
• Spits up green or yellow fluid.
• Spits up blood or what looks like coffee grounds.
• Refuses to feed.
• Has blood in the stool.
• Has trouble breathing or other signs of illness.
• Begins spitting up at age 6 months or older.
• Cries more than usual or is more cranky than usual.
• Has fewer wet diapers than usual.

Treatment depends on what’s causing your baby to spit up. There might be ways of feeding that can help. Sometimes, a healthcare professional might prescribe medicine to treat reflux.