Wednesday, January 18, 2012

5 Tips About Your Baby's Spit-Up

Many of us parents worry about our baby spitting-up milk and/or formula. Sometimes it can seem like our little regurgitators don't keep anything down at all! I often get asked questions about this constant concern, and in my recent poll it was voted the topic of most interest to you. However, since many of the questions I am asked don't have to do with how to minimize spit-up, I decided to take this opportunity to simply answer some of the most common questions many parents have on the topic.

1. Is spit-up dangerous during sleep?
Laying your baby on his back to sleep is considered the safest position. But this obviously leads to the concern that your infant may choke on his own spit-up. This is not a common problem for most babies. Most babies will turn their head slightly to the side during sleep, and even if they don't they have reflexes that help them avoid choking on their spit-up. If you have ever dripped water on your little splasher's face during his bath, you might have seen him arch his head and body backward while waving his arms. This reflex is to help your baby roll onto his side if any thing obstructs his breathing. He will do the same thing, even while asleep, if his airway is not clear. Even swaddling will not keep your baby from arching his back and turning his head. The only time when night-time spit-up might be dangerous is if your baby has a cold that is producing a lot of mucus. If your baby is having trouble breathing anyway, there is a chance some spit-up could be sucked into the lungs on accident. There are some dangers that this could cause, so if you suspect that this has happened I would contact your pediatrician right away. Signs that your baby might have inhaled some spit-up are, excessive coughing, coughing while crying, and a rattling sound to their breathing between coughing.

2. Why does my baby spit up when laying down?
Many babies have trouble keeping their food down when laying flat, because there is a valve that is often under developed or not yet very strong at the top of the stomach that is meant to keep food down once swallowed. When this valve is so underdeveloped that it hardly functions it causes the condition known to most of us parents as "infant reflux". Even if your baby doesn't have reflux, when there is still liquid in her  belly and you lay her down, the food will sometimes leak back into her throat (which can be painful because there will probably be some stomach acid mixed in) and stimulate the gag reflex, which causes spit-up. It helps clear food out of the airway before it is accidentally inhaled into the lungs, but also causes a bit of a mess. Most of the time digestion of breast milk and formula is pretty fast, and almost all of your baby's food will be gone within 10-15 minutes after a feeding. However, every baby is different, and as your little one grows she will change as well. Sometimes this means that digestion will take longer, or that there is something about the feeding that disagrees with your finicky nibbler's tummy, and there may be a bit more left to toss back up the pipes than normal. As a good rule of thumb, try to keep your baby's head elevated a few inches above her stomach for at least 20 minutes after feeding to try and ensure that most of the food has been digested before you lay her down flat.

3. Is white chunky spit-up normal?
There are several different types of spit up. The most common is fairly watery with a few chunks of white cheesy-creamy stuff in it. This kind is usually seen pretty quickly after a feeding, and most often in infants that are having a bit of excess drool. The reason the spit-up is watery with little white chunks is usually because the spit-up was triggered by a burp which brought up both bits of partially curdled milk (curdling is a natural reaction to your baby's stomach acids, and is part of the digestion process), and mixed it with the excess saliva that was both in your baby's throat, and in his mouth. Another common kind is a large amount of milky-white chunky stuff. This usually comes right up from the tummy, and is often the result of a strong gag reflex getting triggered accidentally by a burp (...or a finger, or a toy, or a pacifier). It can also be caused by a bit too much horsing around too soon after eating. And, more rarely, it can be caused by nausea from a sickness. In general, white chunky spit up is absolutely normal. Other common types of normal spit-up are mostly milky (few chunks) and mostly watery (no milk or curdled milk chunks).

4. Is my baby spitting-up too much?
Almost always the answer to this question is "no". If your baby is eating regularly, having a normal number of wet and dirty diapers, and is continuing to gain weight, then she is getting enough to eat. It can seem like your baby is spitting up an awful lot, but it is extremely rare for a baby to spit up an entire feeding. The reason for this is, that digestion begins as soon as your baby swallows her first mouthful. And for a baby who is 3-4 months old digestion proceeds at an average rate of 1 ounce (30 ml) every 10-15 minutes. So if your baby eats approximately 5-6 ounces (150-180 ml) and a feeding lasts around 15-25 minutes, a great deal has been digested by the time your adorable little lactarian has finished. Even if your baby occasionally empties everything left in her stomach within 5-10 minutes after eating, the most that would come up would be around 2 ounces (60 ml). Now, don't get me wrong, 2 ounces (60 ml) can seem like an awful lot when poured down your neck, but as far as it being a sign that your little tulip isn't getting enough nutrition, it is unlikely. However, trust your instincts, and if you feel like something is really wrong with your baby, always check with your pediatrician.

5. How can I tell if my baby's spit-up is not normal?
In some cases there are conditions that cause strange spit-up. Some signs that you should immediately bring to your pediatrician's attention are:
  • If your baby's spit-up is discolored (Yellow, green, red, blue, etc).
  • If your baby spits up something that looks like coffee grounds.
  • If your baby is not gaining weight appropriately.
  • If your baby is forcefully expelling spit-up type fluid (projectile vomiting) frequently.
  • If your baby resists feedings and is still spitting up large amounts.
  • If your baby spits up constantly throughout every feeding.
  • If spitting up seems to be causing your baby sharp pain (screaming and crying immediately after spitting up on a regular basis).
 Unless you see one of these strange types of spit up, your baby's spit up is probably normal.

Although there are many things to worry about with your new baby, generally spit-up shouldn't be one of them. The worst thing about spit-up for most parents is the inevitable spoiling of a favorite shirt, or getting some splattered on  your face. If you have found these tips helpful, please forward them to any new, or expecting parents you know. As always questions and comments are always welcome! Happy Parenting!

There is a NEW post from NAOMI up today (9/5/14)! Check it out HERE.


  1. What a wonderfully helpful (and comforting) post. Our daughter's spitting up has really been stressing us out but i feel quite reassured after reading this that it's normal, and that we just need to ride it out. Thank you!

  2. Lovely blog post. I love your post regarding baby health and I have found many important tips from here. I also found some great info from which is really amazing to me. Because I always concern about my baby and his health. Thanks again for your nice work.


  3. Nice article. What a relief to know this stuff. Forwarding it.

  4. I agree with the other posts. This blog has eased by worry about my baby boy. Thank you

  5. Thank you for this post!! I am often a silent reader but felt a need to post a much deserved comment (at 4 am while nursing my newborn, no less :) ). I found your blog via a google search. My daughter has been spitting up every time I lay her down even after keeping her upright for 30 min! Your easy to read post helped me understand what's going in that little tummy of hers and more importantly, gave me reassurance that it is normal. Thanks again!

  6. great post really helped me and my 1 month son

  7. I found this extremely helpful and can say that most of what I wad concerned about seems to be normal. Thanks so much!

  8. Thanks for the advice i have been getting a bit concerned but everything i have read seems to be normal thanks for the reassurance lauren

  9. Thanks for the helpful comments. My 5 week old daughter has been doing some peculiar. She has thrown up about 60ml at night around 8pm after a feed. This has happened twice in a row. She is not crying afterward, but it is scary. She does not have diahhear so I dont think it is a bug. I will try to keep her upright more after feeds, but any other suggestions? Maybe smaller evening feeds? Thanks.

    1. It sounds like she is having a sudden contraction of the stomach trigger. I'd suggest breaking the evening feed in two. Feed her half as long as you normally would, then give her a half hour break, burping, and changing her diaper or some other activities that aren't too stressful (baths can sometimes be stressful, as well as vigorous burping techniques or general roughhousing.) Then offer another feed, and see if she will finish up. Smaller amounts are less likely to trigger those big throw ups, also it gives any burps that are hiding in the tummy to make their way up.

  10. My baby had one watery nappy 2 days ago and now it seems to of settled! He is now being sick after every feed. he is 3 months. he isn't unwell in himself as he has no fever. Just the being sick after every feed has all of a sudden come on. And he can be sick a few times after a feed not once or twice. Also he gets very fidgety after feeding like he knows something is going to come up. He also isn't resting to sleep because he wakes himself up to be sick. i linked the watery nappy and being sick together thinking it was a bug. But he wasn't pooing frequently said he had diahrrea. So I dont know what may be the matter. Any help would be appreciated .. Thankyou

  11. Thank u for your post u might have just saved a life I am very thankful for this

  12. Hi all
    My breastfed darling daughter would spit up and it is very painful to see them curdle is a thing that has stopped my daughter to have curdling. I have mint juice a glass of water add 1 tablespoon of mint leaves paste lime juice salt n sugar. I started with taking it twice a day and after a few weeks reduced it to a glass a works miraculously.