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Infant Reflux and Spitting Up

Many babies spit up or reflux small volumes of their stomach contents. Most commonly, this happens soon after eating, but may also happen after an hour or more has passed. It is not uncommon for babies to spit up after every feeding, sometimes more than once. Spitting up may also be associated with coughing, crying or straining. Most of the time, spitting up is a completely normal part of infancy which will resolve on its own, and should not be confused with gastroesophageal reflux disease (GERD).

Spitting Up FAQ (click to open)

  • Spitting up is normal and usually is not an indication of Reflux Disease
  • Babies commonly spit up after each feeding and for an hour or more after feeding
  • Most babies stop spitting up between 6 and 12 months

Babies spit up because:

  • Their stomachs are small and haven’t developed the strength to hold food in
  • They are often lying down–so gravity doesn’t help them keep food down
  • Babies swallow air, which needs to come out, sometimes with food

Decrease spitting up by:

  • Feeding baby in an upright position and/or keeping him/her upright for 30 minutes after feeding
  • Feeding smaller volumes
  • Burping baby frequently

There are several reasons why reflux is so common in babies. First, their stomachs are very small (about the size of their fist) and there isn’t much room to hold the fluid they’ve taken in. In addition, because infants eat an exclusively liquid diet, it is easier for their meal to come up. Third, the muscle that holds the top of the stomach closed is weak. Over time, this muscle gets stronger (just as all of the baby’s muscles do) and it will be better able to keep the stomach contents inside. Furthermore, babies spend much of their time lying down and they don’t have the benefit of gravity helping to keep their food down. Finally, with all of the crying and sucking that babies do, they tend to swallow a lot of air. These air bubbles rise out of the baby’s stomach and often bring some stomach contents up with them. The good news is that all of these things will change and improve with time, and most babies will stop spitting up between 6 and 12 months.

In the vast majority of cases, there is no need to worry when your baby spits up. It is normal for babies to fuss a bit when they spit up. It is uncommon for this fussiness to be the result of acid reflux disease.

You should talk to your doctor about your baby’s reflux if your baby is:

  • Not gaining weight
  • Refusing or resisting feeding
  • Spitting up liquid that is green or yellow
  • Spitting up forcefully (stomach contents shoot out)
  • Spitting up blood or something that looks like coffee grounds
  • Having breathing problems associated with spitting up
  • Spitting up for the first time after 6 months of age

Tips to Reduce Spitting Up

While spitting up is a normal part of infancy, if can be frustrating (and messy!). There are some things that you can try at home to minimize spitting up.

  • Feed your baby in an upright position and keep him or her upright for at least 30 minutes after eating.
  • Feed your baby smaller volumes more often. If you are formula feeding, decrease the number of ounces per bottle and if you are breastfeeding, decrease the number of minutes per side. Be sure to increase the frequency of feedings to ensure that your baby continues to receive enough nutrition.
  • Burp your baby frequently during and after feedings.