Parents of newborns quickly learn to cope with lots of different types of messes: mucus from nasal congestion, super full blow-out diapers, and, for many infants, lots of spit up. Spitting up after eating is quite normal for babies. They often swallow excess air as they suckle, causing them to spit up the extra once they have a full belly. You may be worried that your baby is hungry after seeing all that spit up, and though you can continue to feed them, chances are good that they’ve had enough.

While some babies tend to spit up more than others, as long as they have no breathing issues, are normally comfortable, are developing normally, and don’t seem to be experiencing distress, it’s not typically cause for concern. There are certain symptoms, however, that may indicate your baby needs to see a doctor. If you’re wondering what’s normal – “Why does my baby spit up so much?” or “Why does my baby keep spitting up?” – read on to learn what you can do to minimize spit-up, recognize problems, and keep your little one comfortable.

Why do babies spit up after eating?

According to the American Academy of Pediatrics, spit-up (also known as reflux, gastroesophageal reflux, or GER) is the movement of stomach contents into the esophagus, and sometimes through the mouth and nose. When reflux is accompanied by other issues, or if it lasts beyond infancy, it is considered a disease and is known as gastroesophageal reflux disease or GERD.

GER in babies is not regarded as a disease (and does not include a "D"). GER is considered quite normal. Doctors consider these babies "happy spitters" since they don’t appear to be unhappy or uncomfortable when spitting up. Many infants actually feel better after a thorough spit-up. Other symptoms of GER include mild feeding problems, such as occasional prolonged feeds or interrupted feeds.

GER typically starts when a baby is around 2 to 3 weeks old and peaks between 4 to 5 months. For most full-term infants, symptoms resolve by age one as the upper digestive tract matures. Improved head control, the ability to sit up, and the eventual introduction of solid food will all help improve GER symptoms over time.

My baby seems to take in a lot of air when eating. How do I minimize this?

Aerophagia is swallowing more air than usual. A baby who is feeding very quickly may gulp too much air along with the milk. This is particularly true for babies whose nursing parent has a strong let-down reflex or an overabundant milk supply. 

To keep your baby from gulping too much air during feeding, make sure your infant is properly positioned during and after feedings. Burping during and after feeding helps remove excess air as well. If nursing, consider expressing a bit of milk to slow the flow before latching the baby. If bottle-feeding, consider using a different bottle to minimize your infant’s ability to suck in air.

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Why is my baby spitting up so much when I play with them after feeding?

Your infant could be overstimulated. Try to keep feedings relaxed and subdued. Wait at least half an hour after your baby has finished eating to bounce or actively play.

What is the difference between spit-up vs. vomit?

While spitting up and vomiting are both messy and involve regurgitation, vomiting is more serious. Vomiting can be forceful or projectile. If vomiting occurs once in a while it’s probably alright, but repeated episodes, vomiting that lasts more than 24 hours, or vomit that’s green or bloody requires a doctor visit. It could indicate infection, illness, or a more serious condition, like pyloric stenosis. Other symptoms that require a doctor’s intervention include having an infant who:

• seems dehydrated (fewer wet or dirty diapers) or is unable to keep down any food
• is experiencing weight loss or failing to thrive
• seems inconsolable or in pain
• spits up extreme amounts of milk or spits up very often

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6 Tips for Reducing Your Infant’s Spit-up

Regardless of why babies spit up, there are some easy feeding tips that can help caregivers manage the mess.

1. Burp often. 

Gas bubbles escaping from your baby’s body tend to bring the tummy contents along with them. To reduce the odds of this happening, burp your baby frequently during and after a feeding session.

2. Keep baby calm during and after feedings. 

Pressure on the baby’s belly right after eating can easily push out the contents. Limit active play or any tummy time activities following a meal until after your little one has had a chance to digest their food.

3. Try not to overfeed. 

A baby’s tummy has a way of self-regulating; add too much milk, and it will come right back out. Consider feeding your baby smaller meals more frequently to help minimize the possibility of overfeeding.

4. Evaluate the formula. 

Though some infants just seem to manage better with one formula over another, others are physically incapable of digesting the proteins found in milk or soy formula―a condition called Cow Milk Protein Intolerance/Allery (CMPI and CMPA). If you suspect this may be the case, discuss alternative formulas with your pediatrician. If your baby actually has a true intolerance, your doctor may advise a 1- or 2-week trial of hypoallergenic (hydrolyzed) formula.

5. Evaluate your own diet. 

Though extremely rare, nursing infants can also experience Cow Milk Protein Intolerance/Allergy (CMPI and CMPA). Having the nursing parent remove these proteins from their diet can help reduce or eliminate spit-up for the baby.

6. Consider a bit of oatmeal. 

Solid foods in any form aren’t typically advised until a baby is at least six months old – except for babies with extreme reflux. These infants may require thicker food to swallow safely or to minimize reflux symptoms. The American Academy of Pediatrics (AAP) now advises parents to use oatmeal instead of rice cereal in response to growing concerns over arsenic in rice.

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The Takeaway

The best way to minimize spit-up is to feed your baby smaller, more frequent meals before they get very hungry. Carefully burp your infant during and after feedings. It also helps to keep your baby calm, relaxed, and upright for about half an hour after eating. If you’re concerned your baby may be spitting up too much or too often or has other troubling symptoms, consult your pediatrician right away.

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