When it comes to newborns and feeding, spit up happens. The sphincter muscle that opens and closes at the top of the stomach is still immature in a young baby, allowing milk and air (burps) to come back up into the esophagus. This results in small amounts of milk — from a dribble up to 2-3 tablespoons — to come back out of the mouth. This type of spit up is normal, common, and usually ends by one year of age. Spit up that occurs in babies who are healthy, appear comfortable most of the time, and who are growing/gaining weight is not a cause for concern.
Common, normal causes of spit up include:
- Swallowing air during feedings
- Rapid milk flow, which can occur if you have a strong let-down reflex when breastfeeding / body feeding. (See some suggestions for dealing with a strong let-down reflex.)
- Excessive movement after feedings
- Crying before a feeding (causes swallowing air)
- Overeating/feeding
To prevent or reduce spitting up, burp your baby in between a feeding and after the feeding is over, ideally in an upright position. Limit active play/movement, including “tummy time,” after feeds to encourage milk to stay in baby’s stomach.
Spit up may be a health concern when:
- It is continuous
- It is forceful and/or projectile, which indicates vomiting
- Baby seems to be in pain when spitting up
- Fluid is green or yellow
- Fluid has blood or looks like it has coffee grounds
- Baby spits up frequently and is excessively fussy after and in between feedings
- Baby is having issues gaining weight, not peeing or pooping frequently, or appears weak or lethargic
- Baby refuses to eat
If you are experiencing any of the above, call your baby’s pediatrician. Some symptoms could indicate reflux, which is often easily treated. Other symptoms may point to something more serious. It’s important to talk to your child’s doctor about your concerns, even if you’re unsure, rather than letting symptoms go unchecked.
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