Breastfeeding and Infant Spit Ups

Why Babies Spit up and Tips to Relieve Discomfort

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. Doctors may use the phrase "happy spitter," to describe a baby that spits up but is generally comfortable, has no breathing problems, and is thriving and growing well.

As baby feeds the milk goes down the throat to the esophagus and all the way down to the stomach. The esophagus is connected to the stomach by a ring of muscles called the lower esophageal sphincter that open to let the milk go into the stomach, and then immediately close back up. If that ring doesn't tighten back up then the term "reflux" is used since the spit-up coming back up may be accompanied by some of baby's stomach juices and acids. Reflux can cause considerable discomfort in some babies.

Reasons for Spitting Up

In general, the digestive system of newborns is still developing and so there is more spitting up in the first few months. By six months of age, many infants do not spit up as much because the sphincter opening between the esophagus and the stomach starts to mature and work as it should.

There are three distinct reasons that babies spit up, which include:

  • Swallowing air during feedings. A baby that is drinking very quickly is also gulping air along with the milk. This is especially true if you have a strong let-down reflex or an overabundant milk supply.
  • Overeating can be a culprit because 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 allergies to certain foods or drinks in your diet can be transferred into breast milk and disagree with your baby and cause your baby to spit up.

For the babies that are not happy spitters, the spit-up may actually be caused by Gastroesophageal Reflux Disease (GERD), which can cause the following symptoms:

  • Pain and discomfort from reflux
  • Gagging, choking, coughing, wheezing, or other breathing problems from inhaling reflux
  • Poor growth (can be rare) due to vomiting

Discussing your baby's spit up patterns with your pediatrician can help you figure out if GERD may be the culprit behind your baby's discomfort and if medication may be necessary.

Ways to Reduce It

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.

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.

Other Tips

  • Burp your baby during and after each feeding to remove any air in your baby's belly.
  • Try different feeding positions.
  • Don't lay baby down for at least 30 minutes after a feeding and try to keep your baby's head upright and elevated.
  • Play gently after feedings and don't bounce or engage in very active play immediately following a feeding.


Some breastfed babies do not always burp after every feeding as they tend to swallow less air than bottle-fed babies. However, if you have an abundant milk supply or a very fast flow of milk, your breastfed 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 has been 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 itself. 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.

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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