Is your baby spitting up more than usual? It is important to know what is normal, when to be concerned and when you need to call your doctor about spit up and vomit.
Many parents have at least one war story involving a baby, an enormous amount of spit up, and inconvenient timing. Spitting up is so common for babies that it’s sometimes difficult to convince a pediatrician or family doctor that your baby is spitting up an usual amount or at an unusual frequency.
How do you know if your baby is just giving you a few memories that you’ll later report with pride? What if there’s something that warrant concern right now? For starters, if you’re worried that something is wrong with your baby’s spitting up, it’s worth paying attention and taking action. Start by reading this page to learn why babies spit up, the signs that something is possibly wrong, and when you need to seek medical attention.
Why Do Babies Spit Up?
Babies often spit up in the first few months of life because their digestive systems just need time to gain strength and efficiency. The lower esophageal sphincter is a muscle that rests between the stomach and the esophagus. That muscle is designed to close after food is consumed, trapping the food in the stomach. When that muscle is undeveloped or weak, it can easily open back up enough to allow food to travel backwards.
Most babies improve operation of that muscle over time, and they gradually stop spitting up. In those normal occasions that spitting up is a factor, it flows gently out of the mouth without much force and little to no stomach contraction. The ease of it flowing out is often a good sign because it isn’t the same as forceful vomiting.
When Spitting Up Is a Sign of Trouble
Since there are legitimate reasons that your baby may spit up, it’s difficult to determine when you’ve crossed a line into abnormal behavior. Understanding some of the conditions that present spitting up as a symptom may help you make that determination.
* GER/D – Also known as Gastroesophageal Reflux or simply acid reflux, this condition allows the lower esophageal sphincter to open so that stomach contents travel back up the esophagus to the mouth and possibly out the nose. The condition is normal for many young babies but may turn into Gastroesophageal Reflux Disease, or GERD, if your baby experiences too much discomfort or pain during and after feedings.
* Aerophagia – This is a condition that involves gulping down excess air during feedings. It can lead to an abnormal amount of gas and pressure in the belly and chest, leading to spitting up and discomfort. Some babies experience this from supplemental bottle feedings because they take the breast milk in too quickly, but there are other possible causes.
* Pyloric Stenosis – This condition impacts babies under six months old and involves forceful vomiting with muscle contractions. Vomiting is often projectile and causes pain or discomfort for the baby. The muscle contractions are what distinguish the vomiting from simple spitting up.
* Esophagitis – When the esophagus becomes inflamed, it can lead to spitting up, abdominal pain, nausea, trouble swallowing and other stressful symptoms. This may occur after a long period of acid reflux, but there are other possible causes.
Babies may also spit up excessively as a reaction to something in their breastmilk. Something as simple as your breastfeeding position could lead to spitting up, so we’ll provide some troubleshooting tips that may make it better in just a moment.
What’s Considered Abnormal Spit Up?
How do you know if your baby is showing signs of abnormal spitting up? If you notice any of the following symptoms, it’s worth further investigation:
- Stomach contractions during spitting up
- Sudden change in spitting up activity
- Discomfort or pain
- Bloody or discolored spit up
- Arching back during feedings
- Crying or fussing during and/or after feedings
Read below for a more extensive list of symptoms that should lead you to seek medical attention, possibly right away.
What Can You Do About Spit Up?
You don’t always need to seek medical attention to get the spit up situation under control. Start by implementing some of the following measures to see if it helps. Also read below to determine if your baby does need a trip to the doctor ASAP.
* Avoid transitioning between positions too quickly after a feeding. Babies often spit up when they have full tummies and are moved to a new position too quickly. Take it easy for about a half hour following every feeding to help your little one keep as much of that nourishment down as possible.
* Make sure that your baby doesn’t consume too much milk at a feeding. If you put too much in the tank, some of it is bound to come flying back out for the comfort of your baby. Shorter and more frequent feedings are often better for babies prone to spitting up.
* Spend more time burping your baby after and between feedings. Spitting up is often caused by excess air in the stomach or chest. You can work that out with a thorough burping session. Many parents skimp on the burping because they’re in a hurry to get back to daily life, but you could save yourself a few messes by simply learning to burp
* Choose upright positions for feeding, burping and post-meal playtime or naptime.
* Choose loose fitting clothing, and don’t wrap the baby’s diaper too tight across the stomach. Anything that presses into the stomach can encourage spitting up during and after a feeding. It may also become uncomfortable as the stomach expands, so go with something soft and forgiving.
* Slow the flow of feedings. Breastfeed if at all possible because the breast often has a slower pace than artificial bottle nipple. You can purchase slow-flow nipples if you supplement with bottles.
* Analyze what you’re eating to see if your baby is possibly sensitive to something in your breast milk. Dairy products are a good possibility.
* Make sure no one is smoking around your baby. Most parents know that secondhand smoke is bad news for babies, but some babies are still exposed from routine caregivers. It can have a negative impact on overall health, including the ability to feed properly.
When to Seek Medical Attention
If you think your baby is sensitive to your something in your diet, it’s worth seeing a doctor to discuss how to address this. Sometimes spitting up is fixed just that easily, but not always. If your baby exhibits any of these signs of trouble, seek medical attention right away:
- Any amount of blood in the spit up or on baby’s mouth afterwards
- Forceful stomach contractions
- Spitting up green or yellow fluid
- Spit up containing what appears to be coffee grounds
- Difficulty breathing
- Not producing wet and/or dirty diapers as expected
- Signs of weight loss or failure to gain weight
- Signs of dehydration
There are also some signs that you may notice over time or that may warrant a visit to a doctor but not necessarily on an emergency basis:
- Signs of discomfort in baby after each feeding
- Starting to refuse feedings or feed less often
- Sudden increase or start to spitting up after six months of age
- Signs of any medical condition highlighted above
If you worry that your baby is spitting up but your doctor doesn’t seem to understand the amount, take advantage of technology. You can record your baby’s eating and spitting up process to show exactly what’s happening. A good visual should get your baby the attention that is deserved.
Finally, listen to your parental instinct. If nothing else, it may improve your peace of mind to check with a doctor to see if there’s anything to worry about. Doctors hear about issues with spitting up regularly, and they will help you determine whether your baby is healthy and thriving or not. As long as your baby isn’t in an extreme amount of pain or discomfort and is gaining weight as expected, you likely have nothing to worry about.