Why does my baby spit up so much?
He's probably just getting the hang of feeding. And he's not alone: Almost half of young babies spit up regularly. The peak age for spitting up – also known as reflux – is 4 months.
When your baby swallows air along with his breast milk or formula, the air gets trapped in with the liquid. The air has to come up, and when it does, some of the liquid comes up too, through his mouth or nose.
Babies take in a lot of nourishment in relation to their size, and some of them really like to eat, so sometimes they become overfilled and, well, overflow.
A newborn's digestive system isn't fully developed, either. The muscles at the bottom of your baby's esophagus, which control whether food is coming or going, may still be getting up to speed. It's no wonder your baby creates so much laundry.
Is there anything I can do about it?
Try these tips to help your baby keep his food down:
- Hold your baby in a fairly upright position when you feed him. Feeding him while he's slouched (curled up in your arms or sitting in a car seat, for example) doesn't give the formula or breast milk a straight path to his tummy.
- Keep feedings calm. Minimize noise and other distractions, and try not to let your baby get too hungry before you start feeding him. If he's distracted or frantic, he's more likely to swallow air along with his breast milk or formula.
- If your baby's drinking formula or pumped breast milk from a bottle, make sure the hole in the nipple isn't too small, which will frustrate your baby and make him swallow air. On the other hand, if the hole's too large, he'll be gagging and gulping because the fluid will come at him too quickly. Read our advice on choosing nipples and bottles.
- Burp your baby after each feeding. In fact, if your baby takes a natural pause during a feeding, take the opportunity to burp him before giving him more food. That way, if there's any air, it'll come up before even more food is layered on top of it. (Don't forget to put a soft cloth on your shoulder first!)
If you don't get a burp up within a few minutes, don't worry. Your baby probably doesn't need to burp just then.
- Keep the pressure off his tummy. Make sure your baby's clothing and diaper aren't too tight, and don't put his tummy over your shoulder when you burp him. Try to avoid car trips right after feedings, because reclining in a car seat can put pressure on your baby's stomach, too.
- Don't jostle your baby too much after he eats, and try to keep him in an upright position for half an hour or so. This way he'll have gravity on his side. You can carry him, put him in a pack, or prop him next to you against some pillows if he's big enough.
- Don't overfeed him. If your baby seems to spit up quite a bit after every feeding, he may be getting too much to eat. You might try to give him just a bit less formula or breastfeed him for a slightly shorter time, and see whether he's satisfied. (He may be willing to take less formula or breast milk at a feeding but want to eat more frequently.)
- If you're breastfeeding, ask your doctor if there's something in your diet that may be making your baby spit up more (sometimes cow's milk is the culprit).
- If your baby tends to spit up while sleeping, elevate his head. It's unsafe for your baby to sleep with a pillow, but you can place a foam wedge under one end of his mattress or put the head of his crib safely on blocks.
When will my baby stop spitting up?
As your baby's muscles develop and get stronger, your baby will be able to keep food in his belly. Most babies stop spitting up by around 6 or 7 months of age, or once they learn to sit up on their own, but a few will continue until their first birthday.
How can I tell if he's spitting up or vomiting?
Vomiting is usually more forceful and of greater quantity than if your baby is just spitting up some of his latest meal. If your baby seems distressed, he's probably vomiting. Spitting up doesn't faze most babies at all.
Is spitting up ever a sign of something serious?
Spitting up is usually just par for the parenting course, but if your baby isn't gaining weight as he should be, schedule a visit with his doctor. Babies who spit up so much that they don't gain enough weight or have difficulty breathing may have gastroesophageal reflux disease, or GERD.
Call your doctor immediately if your baby begins projectile vomiting. Projectile vomiting is when the vomit flies out of a baby's mouth forcefully — shooting across the room, for example. This could be a sign of a condition called pyloric stenosis, in which the muscles at the bottom of the stomach thicken and prevent the flow of food to the small intestine. This typically happens at about 1 month of age.
Also phone your doctor right away if you see green bile in your baby's vomit. This could be a sign of a blockage in your baby's intestines, which would require a visit to the emergency room, a scan, and possibly emergency surgery.