Spitting up is a rite of passage for many babies. Here's what's behind spitting up — and when it might signal a more serious problem.

By Mayo Clinic Staff

You've just fed your baby breast milk or formula only to watch him or her spit up what seems like all of it. Is this normal? Find out the possible causes of spitting up, and what you can do about it.

Spitting up is common in healthy babies. About half of all babies experience gastroesophageal reflux, also called infant reflux, during their first three months. Normally, a valve (lower esophageal sphincter) between the esophagus and the stomach keeps stomach contents where they belong. Until this valve has time to mature, spitting up might be an issue — especially if your baby eats too much.

Spitting up is the easy flow of a baby's stomach contents through his or her mouth, possibly with a burp. Vomiting occurs when the flow is forceful — shooting out inches rather than dribbling from the mouth.

Normal spitting up doesn't interfere with a baby's well-being. As long as your baby seems comfortable and is eating well and gaining weight, there's little cause for concern. If your baby is gaining weight, then he or she isn't being harmed by the calories lost through spitting up.

Keep in mind that it's easy to overestimate the amount your baby has spit up based on the size of a spit-up stain.

Spitting up tends to peak at age 4 months, and most babies stop spitting up by age 12 months.

Consider these tips:

  • Keep your baby upright. Feed your baby in an upright position. Follow each feeding with 30 minutes in a sitting position. Avoid immediate active play or use of infant swings.
  • Try smaller, more-frequent feedings. If you're breast-feeding, limit the length of each nursing session. If you're bottle-feeding, offer your baby slightly less than usual.
  • Take time to burp your baby. Frequent burps during and after each feeding can keep air from building up in your baby's stomach.
  • Put baby to sleep on his or her back. To reduce the risk of sudden infant death syndrome (SIDS), it's important to place your baby to sleep on his or her back. Placing a baby to sleep on his or her tummy to prevent spitting up isn't recommended.
  • Experiment with your own diet. If you're breast-feeding, your baby's doctor might suggest that you eliminate dairy products or certain other foods from your diet.

Certain signs and symptoms might indicate an underlying condition or something more serious than run-of-the-mill spitting up. Contact your baby's doctor if your baby:

  • Isn't gaining weight
  • Vomits consistently and forcefully
  • Spits up green or yellow fluid
  • Spits up blood or a material that looks like coffee grounds
  • Refuses feedings repeatedly
  • Has blood in his or her stool
  • Has difficulty breathing or other signs of illness

Treatment depends on what's causing the problem. Special feeding techniques might be helpful. In other cases, the doctor might prescribe medication to treat reflux.

Feb. 22, 2014