Reflux Baby Spit-Up: What's Normal and When To Be Concerned

Spit up is incredibly common among healthy babies, but it can be tough to discern what's normal and what might be too much. Find the answers to some of your most common spit-up questions below!

No matter how much newborn experience you may have, spit-up from your sweet, smiling baby can take even the most seasoned parent by surprise.

Spit-up (also called gastroesophageal reflux) is very common among healthy babies, though some may be more susceptible to it than others. With that in mind, how can you know what’s typical and what may indicate “too much”? Can spitting up be a sign of something more serious? What makes a baby spit up? And can you do anything to help your baby stop spitting up?

These questions are common – and we’ve got answers to help:

Why Do Babies Spit Up?

Generally, most babies start spitting up between two to three weeks after they are born and peak at around four to five months old. Most full-term babies stop spitting up by the time they are one-year old.

One cause of spitting up is that your baby could be ingesting air alongside milk when they are nursing. This is especially true when your baby is first learning to latch. Once they get comfortable with an established sucking pattern and know how to latch effectively, they are less likely to take in air as they nurse.

However, your baby may still spit up even if they haven't taken in air while feeding. A baby’s digestive system is still developing as they grow, which can lead to spit-ups.

Also, if your hungry little one eats more than their growing tummy can hold, they are likely to spit up what their digestive system can’t handle.

All of these common causes behind baby spit-ups are totally normal and typically just a part of the (sometimes messy and not always glamorous) magic of having a sweet newborn!

Gastroesophageal Reflux Disease (GERD) in Babies

If a baby’s spit-up has enough acid to irritate or damage the lining of the esophagus, it’s called Gastroesophageal Reflux Disease (GERD).

According to the American Academy of Pediatrics, when babies spit up and have other symptoms, or if they are still spitting up after infancy, it is considered GERD. However, your pediatrician will likely make a final determination and provide guidance around treatment options if deemed necessary.

Signs of Reflux in Babies

It’s important to remember that spitting up is, for the most part, considered normal in infants. A baby may even feel a little more comfortable after releasing spit-up.

Reflux moves from normal to a potential cause for concern if your baby is also showing slow signs of growth.

Warning Signs of Reflux in Babies

If your baby doesn’t seem to be gaining weight consistently or at all, or is not wetting or soiling their diaper as often as they should, these are signs they aren’t getting enough to eat. Be sure to visit your pediatrician immediately and ensure your little one is checked thoroughly.

Other warning signs for GERD in babies include:

  • Refusing to nurse or feed.
  • Crying and/or arching their back while feeding (or anything else that makes it seem like they are in pain).
  • Blood in the spit-up.
  • Green-colored spit-up.
  • An uptick in how often they spit-up.
  • Spitting up more forcefully than usual.
  • A swollen, distended, or hard-feeling belly.
  • Coughing, wheezing, and/or trouble breathing.

Contact your pediatrician or a healthcare professional right away for immediate attention if your baby is showing any of these symptoms. In some cases, such as with trouble breathing, take your little one to the emergency room or call 911.

Breastfeeding Tips to Minimize Reflux and Spitting Up

There are several things you can try to help minimize spitting up:

  • Change nursing positions and instead hold your baby as upright as you can while feeding. 
  • Keep a close eye on your little one’s hunger cues and nurse him or her before they become extremely hungry, as hectic feedings can cause them to swallow more air as they nurse faster and less effectively.
  • Eliminate interruptions during feedings since distractions can lead to more air being swallowed while your baby is eating. 
  • Burp your little one well after every feeding.
  • Try not to overfeed. If baby is spitting up a large amount, they may be getting too much milk. Instead, try shorter and more frequent nursing sessions.

Finally, always keep a burp cloth on your shoulder or lap for quick clean-ups as needed!

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