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.
It can certainly be concerning to see your baby expel what
appears to be a large amount of liquid from his tiny body; however, spitting
up, sometimes called uncomplicated reflux, can be totally common in healthy
babies. In fact, about half of babies under three months experience this at
least once per day and, more often, several times a day. Normally a muscle,
(called the lower esophageal sphincter) between the esophagus and the stomach,
keeps the contents of the stomach where they belong. In babies, this muscle
isn’t fully developed yet, allowing the food to quickly make its way back up
the esophagus and out of the mouth (and all over your clothes!) Since your
baby’s stomach is so small, swallowing too much air during a feeding or getting
too much milk too fast, such as when mom’s breasts are overfull, can also
contribute to some milk being brought back up.
Although it appears that your baby may have spit up his
entire feeding, the amount that actually comes back up is usually only a
tablespoon or two, as opposed to the several ounces he just consumed. If your
baby is happy, not in any obvious discomfort or distress, eating and gaining
weight well, having enough wet and dirty diapers daily, then the spitting up is
a “laundry” issue (sorry, mom!) and not a medical concern. Spitting up usually
peaks around 4 months of age but can continue up to the first birthday. Most
babies outgrow or show a significant decrease in the amount they spit up by 7-8
months, once they learn to sit up on their own and have started eating more
If your baby is experiencing any of these symptoms in
conjunction with spitting up, be sure to contact your pediatrician: refusing
feedings, appears to be in pain or discomfort during or after a feeding, isn’t
gaining weight, weight loss, spits up very forcefully, spitting up blood or
green/yellow fluid, breathing issues like wheezing and arching of the back/neck
with apparent pain or distress.
See the What To Do section for tips on how to help manage
spitting up in infants.
“Pregnancy and Birth: Reflux in Babies” Pub Med <https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0084515/> date accessed 31 July 2018
“Why Babies Spit Up” healthychildren.org <https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Why-Babies-Spit-Up.aspx> date accessed 31 July 2018