Spitting Up

In the first 6 months of life, most babies spit up 20-30 times per day. Most of the time they swallow it back down, without you seeing it at all. This occurs because the sphincter (think of a rubber band) that keeps food from leaving the stomach back to the mouth is loose in babies and gets tighter and stronger as they approach 6 months. When caregivers do see the spit up, it can be alarming because it happens suddenly and can seem like “they spit up the entire feed.” Additionally, it can begin out the of the blue, when there had not been as much spitting up before. 

Normal Spit Up

Your baby's spit up will change all the time during the first 6 months of life, and just when you're getting used to the pattern, it will change again. Examples of normal spit up include:

  • A lot or a little
  • After every feed or just some of the feeds
  • 2 minutes or several hours after a feed
  • Clear, yellow, or the color of whatever they have been eating
  • Curdled or uncurdled

Spit Up is Not Caused By

  • Eating too much (if you follow the hunger cues, you can’t overfeed a baby!)
  • Eating too fast
  • Not burping long enough, or the baby being a “bad burper”
  • Mom’s diet
  • Putting them down too fast after a feed
  • Indigestion
  • Gas

When To Worry: Three reasons

  • If any of the emergency symptoms are present
  • Painful reflux
    • All babies have reflux, but a very small percentage of babies have painful reflux.
    • Babies with painful reflux are in pain when they eat.
    • They show signs of hunger, and feed for a few sucks when offered food, but then scream in pain while eating, and refuse to eat anymore.
    • Sometimes these babies will lose weight due to painful eating, and may need medicine to reduce the acid in their stomachs so eating isn’t painful.
  • The color is dark green (think "forest green") in color.
    • This is called "bilious vomiting," and is an uncommon, but dangerous, sign of an emergency.
    • Don't confuse this dark green color with yellow, or light green.

What To Do

  • If it ain't broke don't fix it!
    • If none of the three worrisome situations from the last section is present, this reflux is completely normal, 
    • If you try to fix it, you won’t get the results you want, and you may create a new problem, such as feeding your baby less than she needs.

Important

  • Your baby will not suffocate on their own spit up, provided they do not have severe brain abnormalities, which have previously been diagnosed by a neurologist.
  • They will swallow it back down, or it will make a mess, but they will not choke to death if they spit up while lying on their back.