Breastfeeding and Infant Spit Ups

Why Babies Spit Up and How to Deal with It

mother burping baby over shoulder in kitchen
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It's normal for babies to spit up, even breastfed babies. Infants spit up after feedings, sometimes after every feeding, and often bring up some milk when they burp. Newborns tend to spit up more often and it usually happens less as they get older.

Reasons Babies Spit Up

There are several reasons babies spit up. These include:

  • Immaturity: The digestive system in newborns is still developing, so there is more spitting up in the first few months. By six months of age, many infants do not spit up as much.
  • Swallowing air: Babies swallow air during feedings, especially if you have a strong let-down reflex or an overabundant milk supply. If the baby is drinking very quickly, he may gulp air along with the milk.
  • Overeating: Babies have small stomachs. A baby who is taking too much milk at each feeding might fill up and then spit up the extra milk that his belly can't hold.
  • Sensitivity or allergy: Babies can be sensitive or allergic to certain foods or drinks in your diet that are transferred into breast milk. The food can disagree with your baby and cause your baby to spit up.

Burping and Spit Ups

Breastfed babies tend to swallow less air than formula-fed babies. For this reason, some breastfed babies do not always burp after every feeding. However, if you have an abundant milk supply or a very fast flow of milk, your baby may swallow a lot of air during a feeding. In this case, the baby may burp and even spit up with every feeding.

When you burp your baby during and after feedings, you are helping your baby release the air that he or she swallowed during the feeding. After a burp, your baby will be more comfortable, and removing air may make more room in your baby’s stomach to continue the feeding.

Sometimes babies spit up from burping. If there is milk on top of the air, when the air comes up out of your baby, some of the milk comes up with it.

Things You Can Try to Decrease Spitting Up

There are several things you can do to decrease the likelihood or frequency of your baby spitting up:

  • Quiet time: Make feeding time calm and quiet. Try to limit distractions, noise and bright lights. Calmer feedings may lead to fewer spit ups.
  • Feed your baby more often: If you wait too long between feedings and your baby is very hungry, she may feed too quickly and take in excess air.
  • If you have a strong let-down reflex: If you have a forceful let-down reflex, your milk may be flowing too fast for your baby. Try to feed your baby in a reclined position so that the baby is taking in the milk against gravity. You could also try to pump or express some milk from your breasts before beginning a feeding to help slow down the flow.
  • If your breasts are engorged: If you have too much milk or your milk supply has not yet adjusted to your baby’s needs, your breasts might be engorged. Engorgement can make it difficult for your baby to latch onto your breast properly. It can be difficult for the baby to get a good seal around your nipple if your breasts are full and hard. The baby will take in air as he tries to latch on and suck. Use a pump or express some milk before feeding your baby to relieve some of the engorgement and soften the breast to allow the baby to latch on properly.
  • Burp your baby: Burp your baby during and after each feeding to remove any air in your baby's belly.
  • Try different feeding positions: Try to feed the baby with his head elevated.
  • Keep your baby's head elevated after the feeding: Do not lay the baby down flat after the feeding. Hold your baby upright or place her down with her head higher than her belly. Gravity can help to keep the feeding down.
  • Play gently after feedings: Do not bounce or engage in very active play immediately following a feeding.

When Is it Vomiting?

Spitting up is normal for babies. It is not dangerous or painful and does not cause your baby to lose weight. When your baby spits up, the milk usually comes up with a burp or can be seen gently flowing out of your baby’s mouth. Even if your baby spits up after every feeding, it is not usually a problem.

Vomiting is different. Vomiting is forceful and often shoots out of your baby’s mouth. A baby may vomit on occasion and that's okay. But if your child is vomiting repeatedly or for longer than 24 hours, you should contact the baby’s doctor. It could be a sign of illness, infection or something more serious.

When to Call The Doctor:

  • If you are concerned that your baby is spitting up too much or too often.
  • The baby is vomiting for longer than 24 hours.
  • The vomit is green or has blood in it.
  • The baby appears to be in pain.
  • The baby is losing weight or not gaining weight.
  • The baby is not keeping down any feedings and is showing signs of dehydration.
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Article Sources
  • American Academy of Pediatrics. Your Baby’s First Year Third Edition. Bantam Books. New York. 2010.