How Much Baby Spit Up is Normal

Spit-ups are common enough in babies that pediatricians take them quite seriously. “Seventy percent of infants under 3 months will spit up three times a day, and it’s even perfectly normal for them to be spitting up as often as 10 or 12 times,” says William Byrne, M.D., chief of pediatric gastroenterology at Doernbecher Children’s Hospital, in Portland, Oregon.

Seventy percent of infants under 3 months will spit up three times a day. It’s even perfectly normal for them to be spitting up as often as 10 or 12 times.

Some babies spit up more than others, and there’s usually no need to stress.

Most babies spit up, and it’s perfectly normal—as long as your baby is gaining weight and is otherwise healthy, Dr. Byrne reassures.

Pump it real good: While you can’t stop spit-up from coming back up, “breastfed babies may spit up more frequently if their mothers pump,” says Jaime Friedman, M.D., a pediatrician in San Marcos, California.

Spitting up is a normal occurrence for many babies, two out of three, in fact. If your baby is spitting up more than usual, or if it seems like what’s coming up is off-color, talk to your pediatrician.

Tired of packing three changes of baby clothes every time you have to leave the house? Here’s the lowdown on baby spit up, including when it typically stops and tips to reduce it.

Why Do Babies Spit Up?

If your baby keeps spitting up within two hours of feeding and yet seems perfectly happy, they probably have gastroesophageal reflux (GER). The condition peaks around 4 months old, when two thirds of infants have symptoms, according to the National Institutes of Health. The ring of muscle separating the bottom of a baby’s esophagus from the stomach is still developing, allowing stomach contents to slosh back up. 

Babies need to consume a lot of calories to support their rapid growth—three to four times as many as an adult per pound of bodyweight. Plus, they have a tendency to swallow air while sucking. As a result, their stomach becomes very full, and they’re prone to spit up what they eat (they can also spit up after crying or coughing forcefully). 

Is My Baby Eating Enough? 

Even if your baby spits up after every feeding, they’re probably taking in enough. Your pediatrician will evaluate your infant’s weight gain at their well-baby checkups. If everything’s on track, they’re getting the calories they need. It may seem like their whole meal is coming back up, but it’s likely less than a tablespoon, says Dr. Byrne. So don’t “top off” your baby with more milk if they spit up after eating. In fact, overfeeding can lead to even more reflux.

When Do Babies Stop Spitting Up?

Don’t worry, the day will come when you won’t need to do laundry after every feeding. GER symptoms tend to decrease around 6 months, once your baby’s digestive system has matured and they start sitting upright and eating solid foods. The problem usually disappears by your baby’s first birthday, when the muscles at the bottom of the esophagus become stronger (a few babies continue spitting up until 24 months though). Don’t be surprised if GER gets worse before it gets better; some children’s symptoms reappear when they learn to crawl and their stomach contents shift around, causing the baby to spit up more than usual.

Dealing With Your Baby’s Spit-Up

Even though you can’t really prevent GER, you can minimize the mess by investing in extra bibs and following these tips.

Avoid overfeeding. An overly full belly is a major cause of reflux, so avoid overfeeding your baby, says Aeri Moon, M.D., a pediatric gastroenterologist in New York City. 

Burp your baby. Swallowing too much air while eating leads to gas bubbles in the stomach that can trap some food. When the air comes back up as a burp, so does the breast milk or formula. Ensuring that your baby is latched on correctly and burping them before, throughout, and after each feeding can help reduce this problem.

Use products for formula-fed infants. If your baby is spitting up formula, consider using a product that reduces bottle-induced gas, such as Playtex Drop-Ins (the liners collapse as your baby sucks). If your baby is 4 months or older and your pediatrician approves, you can try thickening the formula to help it sit better in their stomach (mix in a tablespoon of rice cereal for every 4 ounces of formula).

Keep your baby upright after feedings. Gravity is on your side when it comes to reflux, and it can make a big difference in helping food stay down. Position your little spitter at roughly a 30-degree angle while feeding. Then keep your baby upright for at least 20 minutes afterward, either in your arms or in a carrier, so that the food can travel out of the stomach and into the small intestine. You can also buy a wedge to place under the head of the mattress, which will decrease the chances of your baby spitting up in sleep (but don’t put a pillow in the crib because this increases the risk of sudden infant death syndrome).

Does My Baby Have GERD?

GER isn’t something to worry about—even the healthiest babies have it. But for about 2 percent of full-term babies and a higher percentage of preemies, reflux causes pain and medical problems. In these cases, a doctor may diagnose gastroesophageal reflux disease (GERD). Telltale signs include a lack of interest in eating, extreme fussiness during feeding, wheezing, coughing, hoarseness, and failure to gain weight. 

GERD is reflux in the extreme: So much acid splashes back up from the stomach that it irritates the lining of your baby’s esophagus. Your baby might try to relieve the discomfort by coughing, arching their back, or pulling their legs up to their tummy. If your baby has these symptoms, contact their pediatrician The doctor may recommend smaller, more frequent meals or additional burping.

Additional Sources: Ari Brown, M.D., Parents advisor and coauthor of Baby 411; Grzegorz Telega, M.D., pediatric gastroenterologist at Children’s Wisconsin, in Milwaukee.

How Much Spit Up is Normal Newborn

Is your baby spitting up a lot after feedings? There’s usually no need to stress. “Seventy percent of infants under 3 months will spit up three times a day, and it’s even perfectly normal for them to be spitting up as often as 10 or 12 times,” says William Byrne, M.D., chief of pediatric gastroenterology at Doernbecher Children’s Hospital, in Portland, Oregon. Keep reading to learn what causes babies to spit up and how to handle it.

IN THIS ARTICLE

There are some things about newborn care that no amount of parenting classes can prepare you for: cleaning your first diaper blowout, sucking snot from plugged-up infant nostrils and the sheer amount of baby spit up you’ll encounter.

About half of all babies spit up at some point during their early lives. While it might feel concerning to see your little one spitting up — you’re probably wondering whether she’s actually keeping enough breast milk or formula in her stomach — know that spit up is normal and expected.

Keep reading for the full lowdown on baby spit up, plus when to talk to your doctor if you’re concerned about how much your little one is spitting up.

Why do babies spit up?

Baby spit up, or the dribble of stomach contents that can come out after feeding, is messy, frustrating… and perfectly normal.

An infant’s digestive system is still developing, and her lower esophageal sphincter — a ring of muscle that keeps food in the stomach — isn’t fully functional for several months. This makes it very easy for food that she’s just eaten to come back up. If your baby’s stomach is very full after a feeding or you’ve changed her position suddenly after eating, for example, that can force food out of her stomach and up her esophagus in the form of spit up.

Babies also might spit up when they burp, drool, cough or cry. The fact that your infant is on an all-liquid diet (you know, breast milk or formula) also makes it easy for the contents of her stomach to come right back up.

In very rare cases, your baby’s formula might be contributing to excessive spit up. According to the American Academy of Pediatrics (AAP), an estimated 5 percent of babies have milk-soy protein intolerance, meaning that they cannot properly digest the proteins present in milk- or soy-based formulas. (Spit up is one of several signs that could indicate this condition.) If your baby is diagnosed with this condition, her doctor might recommend a hydrolyzed formula.

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Possible causes for baby spit up

Although spit up is normal, there are a few reasons why your little one might be emptying the contents of her stomach.

Spit up 

Normal spit up looks a lot like whatever baby is eating, which is either breast milk or formula before she starts solids (usually sometime around 6 months). Both breastfed and formula-fed babies spit up, and the act of spitting up usually looks effortless. It often comes out through the mouth and/or nose, but doesn’t cause pain and isn’t forcefully done. In fact, most babies typically don’t mind or notice spit up. 

Reflux (infant GERD)

Technically, spit up is reflux. But sometimes, if it’s accompanied by other symptoms or poor weight gain, spit up might indicate that your baby has a condition called gastroesophageal reflux disease in babies, also known as infant GERD.

With infant GERD, the lining of the esophagus becomes irritated and damaged by all of the spit up. It can cause pain and fussiness during and after feeding, and make it harder for baby to feed and gain weight. Other signs of GERD include excessive drooling, uncontrollable crying, poor sleep and erratic feeding patterns. Talk to your child’s pediatrician if you notice these symptoms.

Baby spit up vs. vomit: How can you tell the difference?

Spitting up and vomiting might seem similar. They’re both messy, and both involve your baby’s stomach contents ending up on your clothing.

But unlike spit up, vomit is forceful (and in more serious cases, even projectile). It is also caused by a virus, bacteria, food poisoning or some other kind of specific health issue. Sometimes, vomit can be green (which hints that there might be an infection) or red (which indicates there’s some kind of blockage or gastrointestinal bleeding). Other causes of baby vomit might be motion sickness, certain prescription medications, or disturbing sights or sounds.

In rare cases, true vomiting might indicate that your baby has something called pyloric stenosis, which is when a muscle in the stomach thickens, preventing food from moving to the small intestine. This can cause projectile vomiting and dehydration, and needs to be treated immediately. Symptoms typically start when baby is between 2 weeks and 2 months old.

How much baby spit up is normal?

Yes, spit up means laundry day happens a lot more often during baby’s first few months of life. But it’s usually perfectly normal. And while you might feel like your baby is spitting up all of her breast milk or formula, that is usually not the reality.

Some babies rarely ever spit up; others spit up after nearly every meal. And volumes of spit up can vary. Most often, spit up is a mix of food and stomach acid, and it’s hard to quantify how much is actually being spit up — which is why doctors rarely use volume on its own to tell whether spit up is normal or a sign of something more serious.

Instead, doctors typically consider the following when assessing a baby’s spit up: 

  • Is the spit up forceful? 
  • Is it colored red or green?
  • Does baby appear to be uncomfortable or in pain?
  • Is baby still feeding normally? 
  • Is baby still gaining weight normally? 

Those kinds of questions help practitioners figure out whether a baby is spitting up normally or if something else might be contributing to her spit up. But as long as your baby is still otherwise healthy and gaining weight, spit up is likely normal.

Some parents also wonder if it’s typical for babies to spit up hours after eating. While spitting up typically happens during or shortly after a feeding, if your baby is otherwise healthy, happy, gaining weight and doesn’t have any of the red flags above, this is also probably normal, but ask your child’s pediatrician if you have any concerns.

When do babies stop spitting up?

Spit up happens in most infants, so know that it’s normal — and it gets better as they get older!

Babies typically spit up until they’re around 12 months old. You can expect spit up to get more frequent until about 3 months of age, and then it should gradually start to get better as baby gets stronger and can sit up on her own.

However, if your baby starts spitting up for the first time after 6 months of age or her spit up turns to vomiting, that could be a sign that something more serious is going on.

Tips to minimize spitting up in babies

Again, spit up is normal — but to prevent it from happening as often, there are a few steps experts typically recommend.

  • Don’t overfeed. Babies’ stomachs are small, and it’s easy to overload them. (This tends to be more of an issue with bottle-fed babies, since it’s easier for babies to get milk from a bottle nipple than from the breast.) Try feeding more often at smaller volumes if you notice that your baby often spits up during feedings.
  • Hold baby upright for 30 minutes after feeding. Sitting chest-to-chest on you for at least a half hour after each feed might minimize the amount of spit up your baby experiences.
  • Burp frequently. Burping gently during and after feeds — for bottle-fed babies, at least once halfway through a feeding or after every 2 or 3 ounces, and when you switch from one breast to the other for breastfed babies — can help reduce spit up.
  • Limit post-feeding activity. Going straight from a feeding to playtime might cause milk to come back up, for example.
  • Use a slow-flow nipple. If you bottle-feed, try using a slow-flow nipple. These are designed to slow down feeding and reduce the amount of air baby takes in while eating — which may help reduce spit up risk. 

When to call the doctor about baby spit up

Spit up is usually normal and healthy. But in rare cases, your baby’s spit up habits might indicate a more serious health problem. Be sure to talk to your doctor if you notice any of the following: 

  • Not gaining weight well or losing weight
  • Crying or arching her back while feeding
  • Refusing to feed
  • Spit up that starts after 6 months or continues past 18 months
  • Yellow, green or red spit up
  • Frequent forceful or projectile vomiting 
  • Spit up accompanied by other symptoms such as bloody stools, wheezing or coughing, fewer wet or dirty diapers, lethargy and/or fever 

Like dirty diapers, spit up is a normal part of early parenthood. While you should keep an eye out for any abnormal symptoms, spit up is usually something to ride out. In the meantime, thank goodness for burp cloths and stain removers! 

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