Most babies spit up. But if you find yourself changing your milk-drenched shirt again or frequently adding to the pile of already soiled burp cloths, you might start to wonder if this is typical. Is there something wrong? Can your baby be getting all the calories they need to grow when so much seems to be coming back up?
These are normal concerns, but rest assured that most spit-up is very common, especially in the early days of breastfeeding (we’ll cover when it’s not normal and when to seek medical attention later in this article).
If your baby is a "Happy Spitter," meaning that they are gaining weight well, showing no signs of discomfort, and are generally content, then there is no reason to worry about your baby's spit-up.
Statistics show that as many as half of all babies 0-3 months old spit up at least once per day. Babies typically outgrow spitting up by 7-8 months, but some continue to spit up until their first birthday.
When babies begin to vomit or show signs of pain while eating or spitting up, it’s time to speak to your baby’s doctor. These could point to GERD or pyloric stenosis, which require medical intervention.
Before we talk about potential medical issues, we will explore why most babies spit up. This might help you understand what’s triggering your baby’s excessive spit-up.
What causes babies to spit up?
Spitting up is very common in healthy babies. While it may seem unnatural to you, trust that your baby's body is doing exactly what it should.
According to the Mayo Clinic, the muscle between the oesophagus and the stomach is very immature in young babies, meaning the muscle cannot hold the stomach's contents down. This is especially true when your baby is full. Spitting up is to be expected until this muscle becomes more mature.
Remember that your little one might still be learning how to breastfeed effectively. If your baby isn't latching correctly or keeps pulling away, he or she could suck in a lot of air. All this excess air can cause them to spit up, which is why burping is important.
A fast letdown can also make your baby spit up, as it causes them to take in extra air as they try to keep up with the flow of your milk.
Certain positions or fast movements too soon after eating can also lead to spitting up. Bouncing or sitting can cause uneasiness or compress the stomach to the point where the contents just come back up thanks to the immature digestive system.
While spitting up usually occurs shortly after a feeding, it can also happen 1-2 hours after eating, so don’t be alarmed if your baby spits up several hours after a meal.
When you see so much food, and nutrients, end up on the floor you might start getting concerned about your baby’s calorie intake.
Is your baby getting enough to eat?
Throughout your breastfeeding journey, you’ll probably wonder more than a few times if your baby is getting enough to eat. And it’s probably alarming to see all that precious milk come back out of your baby's mouth!
While it might seem like they’re spitting up their entire meal, most spit-up is minimal (even though it looks like more when it’s soaked into your burp cloth).
· Your baby gains weight steadily after the first two weeks – it's normal for babies to lose some of their birth weight in the first two weeks.
· They appear healthy and alert when they're awake.
· From the fourth day, they should do at least two soft, yellow poos the size of a £2 coin every day for the first few weeks.
· From day five onwards, wet nappies should become more frequent, with at least six heavy, wet nappies every 24 hours. In the first 48 hours, your baby will likely have only 2 or 3 wet nappies.
As long as your baby seems content and happy, spitting up isn’t a cause for concern. If they continue to gain weight, you can see that they aren't affected by the calories lost through spitting up. However, you’re probably wondering how you can minimize spitting up, for the benefit of their growth and your laundry pile!
Are there ways to reduce spit-up?
The burp cloth might be a wardrobe staple for quite some time, but there are several things you can do to encourage your baby to keep their milk down. After all, you've worked hard to produce this milk for them and want to ensure they get all those beneficial nutrients!
Here are some things you can do to reduce spit-up.
· Offer smaller feeds more often to ensure your baby doesn't get too full. Smaller meals can be easier to digest for your baby.
· Burp your baby regularly during each feeding to work out any air bubbles that settle in the stomach.
· Try different breastfeeding positions that could reduce the air your baby is sucking in as they’re feeding.
· Avoid fast movement, bouncing, or unnecessary jostling right after a feeding.
· Consider your diet. In some cases, cow’s milk and soy in your diet while breastfeeding can worsen spit-up in infants with Cow Milk Protein Intolerance/Allergy (CMPI and CMPA).
Removing dairy from your diet can help.
Keep in mind that these recommendations may or may not work for your baby. Sometimes nothing changes, and your baby continues to spit up a lot. If this is the case, you’ll have to deal with the extra laundry until their digestive system matures.
Another way to help reduce spit-up is to keep breastfeeding!
Research shows that breastfed babies have shorter and fewer incidents of spitting up, and it appears to be less severe at night.
Since breastmilk is easily digested, it leaves the stomach faster, meaning there is less time to back it up into the oesophagus.
So keep offering your breast milk as long as your baby shows hunger cues, and be sure to burp them early and often.
There are times when it's not your average spit-up. Learn when to seek the help of a doctor.
When should you seek medical attention?
While spitting up is very common in babies, there are things to look for that might signal an underlying condition that needs treatment.
According to the Mayo Clinic, spitting up is a sign of a bigger problem when your baby:
· Isn't gaining weight.
· Spits up forcefully, like vomiting.
· Spits up green or yellow fluid.
· Spits up blood or material that looks like coffee grounds.
· Refuses feedings repeatedly.
· Has blood in his or her stool.
· Has difficulty breathing or other signs of illness.
· Begins spitting up at age six months or older.
· Cries for more than three hours a day and is more irritable than normal.
· Has fewer wet diapers than usual.
If you notice these things, call your doctor right away. It could point to GERD (gastro-esophageal reflux disease), pyloric stenosis, an allergy, or something else that will need to be addressed by a medical professional.
The treatments range from taking medication to improve the reflux, changing your diet while breastfeeding, or surgical intervention in the case of pyloric stenosis.
This might sound extreme but remember that most spitting up is completely normal. As long as your baby is gaining weight, seems content overall, and shows no visible signs of discomfort, continue breastfeeding on demand and keep a stack of burp cloths handy.