RD, LDN, CBS
Certified in Maternal and Infant Nutrition from Cornell, Angela’s mission is to help people reach their wellness goals. She also helps run a program that teaches pregnant women about how a healthy lifestyle optimizes prenatal and postnatal care.
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It can certainly be upsetting to see your baby spit up what appears to be a large amount of liquid from their tiny body! However spitting up, sometimes called ‘uncomplicated reflux’, can be totally common in healthy babies.1,2,3,4,5
In fact, 70 – 85% of babies under three months experience some sort of regurgitation of their milk2 and 50% of all babies spit up daily.1
Normally a muscle between the esophagus and stomach, the lower esophageal sphincter, keeps the contents of the stomach where they belong. In babies, this muscle isn’t fully developed yet, allowing breastmilk and/or formula to sometimes make its way back up the esophagus and out of the mouth (and all over your and baby’s clothes!).5,6,7
Since your baby’s stomach is so small, swallowing too much air during a feeding or getting too much milk too fast, can also contribute to your baby spitting up.6,8,10 This might happen if mom’s breasts are overfull; if baby cannot get a good seal or latch on the breast or bottle; or if the bottle nipple hole is too big and baby gets milk faster than they can control.
Spitting up might also happen if baby is crying a lot before or after a feed (which introduces more air into the stomach) or is overstimulated, bounced, or played with too soon after a feed.6
Read more: Top Latching Tips
Learn about: Choosing the Right Bottles and Nipples
Most babies outgrow spitting up by 6 to 7 months, once they learn to sit up on their own and have started eating more solid foods3,5,8
If your baby exhibits any of these signs or symptoms along with spitting up, then be sure to contact your pediatrician.
If you have more questions about your baby’s spit up, reach out to our team of registered dietitians and lactation consultants for free! They’re here to help on our free to live chat from Monday – Friday 8am-8pm (EST), and Saturday – Sunday 8am-4pm (EST). Chat Now!
Reduce stimulation, like bright lights and loud sounds, during feedings to avoid distracted eating. When a distracted baby pops on and off the breast or bottle frequently, it can increase the amount of air being swallowed.
If you are nursing, feed on demand and allow baby to eat at their own pace. If bottle feeding, avoid tipping the bottle and allowing baby to “chug.”10
Pace the feeding by holding the bottle more horizontally, allowing the baby to eat more slowly, take breaks and draw the nipple back in when they are ready.
Read more: What is Paced Bottle Feeding?
Burping your baby more frequently (as opposed to waiting until the end of the feeding) will help eliminate excess air in the stomach. Burp your baby between switching breasts or after every 2 ounces if bottle-feeding.5, 11
Read more: How Do I Relieve Gas in my Formula or Bottle-Fed Baby?
Keeping your baby as upright as possible during feedings will help prevent the food from traveling back up into the esophagus.1,5,11
If you are breastfeeding, this may mean trying a more upright breastfeeding position, such as the koala hold (also known as saddle / straddle breastfeeding position).13 Note that this position requires your little one to have good neck control, so be sure to try this only if your baby is strong enough.
Keep your baby in an upright position for at least 15 minutes after a feeding to help keep the stomach contents where they belong.1,5,11
Try not to move your baby around too vigorously after a feeding, such as in a bouncy seat. A full, tiny belly combined with an underdeveloped digestive system will make it easier for the milk to flow back up the esophagus.6,7
Smaller, more frequent feedings may help reduce spitting up by not allowing the tummy to become overfilled.1,5,11 Try to feed baby before they are overly hungry.
Spitting up can be messy for the both of you. Keep the burp cloths and the bibs handy to help protect your and your baby’s clothes!
We know parenting often means sleepless nights, stressful days, and countless questions and confusion, and we want to support you in your feeding journey and beyond.
Our Happy Baby Experts are a team of lactation consultants and registered dietitian nutritionists certified in infant and maternal nutrition – and they’re all moms, too! They’re here to offer personalized support on our free, one-on-one, live chat platform Monday – Friday 8am-8pm (EST), and Saturday – Sunday 8am-4pm (EST). No appointment needed, no email or sign-up required. Chat Now!
Read more about the experts that help write our content!
For more on this topic, check out the following articles:
Paced Bottle Feeding
Tips for bottle fed baby gas
How do I manage gas in my breastfed baby?
How much formula is enough?
Baby Hunger & Feeding Cues
1. Lightdale, J. R., & Gremse, D. A. (2013). Gastroesophageal reflux: Management guidance for the pediatrician. PEDIATRICS, 131(5). https://pediatrics.aappublications.org/content/131/5/e1684.long
2. Czinn, S. J., & Blanchard, S. (2013). Gastroesophageal reflux disease in Neonates and infants. Pediatric Drugs, 15(1), 19–27. https://link.springer.com/article/10.1007%2Fs40272-012-0004-2
3. Jacobson, J. C., & Pandya, S. R. (2021). A narrative review of gastroesophageal reflux in the pediatric patient. Translational Gastroenterology and Hepatology, 6, 34–34. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8343508/
4. Quitadamo, P., Ummarino, D., & Staiano, A. (2015). GER and GERD in children: to treat or not to treat?. Minerva pediatrica, 67(2), 187–197. https://pubmed.ncbi.nlm.nih.gov/25645256/
5. Porto, A. (n.d.). Gastroesophageal reflux & gastroesophageal reflux disease: Parent faqs. HealthyChildren.org. Accessed 24 September 2021. https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/GERD-Reflux.aspx
6. American Academy of Pediatrics. (2019, April 19). Why babies spit up. HealthyChildren.org. Accessed 24 September 2021. https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Why-Babies-Spit-Up.aspx
7. American Academy of Pediatrics. (2015, November 21). Infant vomiting. HealthyChildren.org. Accessed 24 September 2021. https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/Infant-Vomiting.aspx
8. Rosen, R., Vandenplas, Y., Singendonk, M., Cabana, M., DiLorenzo, C., Gottrand, F., Gupta, S., Langendam, M., Staiano, A., Thapar, N., Tipnis, N., & Tabbers, M. (2018). Pediatric gastroesophageal REFLUX clinical Practice Guidelines: Joint recommendations of the North American society for Pediatric GASTROENTEROLOGY, HEPATOLOGY, and nutrition and the European society for Pediatric GASTROENTEROLOGY, HEPATOLOGY, and nutrition. Journal of Pediatric Gastroenterology & Nutrition, 66(3), 516–554. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958910/
9. Siegel, S. (2016). Aerophagia Induced Reflux in Breastfeeding Infants With Ankyloglossia and Shortened Maxillary Labial Frenula (Tongue and Lip Tie). International Journal Of Clinical Pediatrics, 5(1), 6-8. https://theijcp.org/index.php/ijcp/article/view/246/190
10. Jones A. B. (2001). Gastroesophageal reflux in infants and children. When to reassure and when to go further. Canadian family physician Medecin de famille canadien, 47, 2045–2053. https://pubmed.ncbi.nlm.nih.gov/11723599/
11. Collins, C. K. (2018, May 29). Reflux in babies and toddlers. EatRight. Retrieved October 1, 2021, from https://www.eatright.org/health/wellness/digestive-health/reflux-in-babies-and-toddlers
12. Chen, P.-L., Soto-Ramírez, N., Zhang, H., & Karmaus, W. (2017). Association between infant feeding modes and gastroesophageal reflux: A repeated measurement analysis of the Infant Feeding Practices Study II. Journal of Human Lactation, 33(2), 267–277. https://journals.sagepub.com/doi/abs/10.1177/0890334416664711
13. Wambach K, Riordan J, editors. Breastfeeding and human lactation. Jones & Bartlett Learning; 2014. 966 p