12 potential formula feeding problems and how to solve them

Feeding your baby is one of your most important tasks as a new parent – but it's not always the easiest.

If your baby is having trouble with formula feeding or you notice symptoms that concern you, check out this list of possible problems. (And be sure to talk to your baby's doctor – this information isn't meant to replace their guidance.)

Common formula feeding problems

Your baby spits up after every feeding

Spitting up is very common in babies, with 50 percent of infants spitting up regularly. Typically spitting up isn't harmful or even bothersome for babies, and it's often unavoidable. Spit up differs from vomit in that it isn't forceful and it doesn't necessarily mean your baby has an upset stomach. Plus, babies typically don't fuss or seem unhappy when spitting up.

Regular spitting up usually isn't problematic for babies. However, if your baby is arching their back or crying in response to spitting up, if they're struggling to gain weight at a healthy rate, or their spit up is bright yellow or appears red or blood-tinged, it could indicate an underlying medical issue. Talk to your baby's pediatrician if you're concerned.

Some reasons your baby might be spitting up:

• Your baby needs to be held upright during and after eating.
• The nipple makes the formula flow too fast or too slowly. Find out about choosing nipples and bottles for formula feeding.
• Your baby needs more frequent burping. Learn how to burp your baby.
• Many babies spit up frequently due to a weakness in the valve between the stomach and the esophagus. This common condition is called gastroesophageal reflux. When reflux is associated with other symptoms, such as your baby being in a lot of pain while eating and falling off the growth curve, it's considered a disease and is known as gastroesophageal reflux disease or GERD. Talk to your baby's doctor if you think your baby has GERD.

Your baby is vomiting after feeding

If your baby is vomiting forcefully on a regular basis, this is different from simply spitting up. Acute vomiting, occurring a few times over a limited amount of time, might be related to illness or a symptom of a condition that needs medical attention. If it's frequent and lasts for more than a few days, there might be an underlying issue that needs to be addressed.

Some possible causes:

• Your baby might be eating too much. Find out how much formula your baby needs.
• You're using formula that's improperly mixed, stored, or handled. Find out about using formula safely.
• Your baby is sensitive or allergic to an ingredient in the formula. Find out about formula allergies and sensitivities and choosing formula.
• Your baby has a stomach bug or the flu. Other signs of the flu include fever, diarrhea, and excessive fussiness or drowsiness. If your baby is younger than 6 months old and you think they might have the flu, call their doctor.
• Your baby has hypertrophic pyloric stenosis, a gastrointestinal condition that prevents breast milk or formula from passing from the stomach to the small intestines. If your baby is vomiting after every feeding, doctors often test for pyloric stenosis first, since it requires surgery.

Note: If your baby's vomiting is severe, persistent, or forceful, call the doctor immediately.

Your baby is gassy

When babies are gassy, it typically doesn't indicate a serious health issue or even illness. However, it can be uncomfortable and even painful for little ones when air becomes trapped in their belly. Even though gas often clears up on its own, parents may want to pinpoint the cause to stop it from happening often.

Some possible causes:

• Your baby is getting too much air from the bottle. Find out about choosing nipples and bottles for formula feeding.
• Your baby needs to be held in a different position during feedings. You could try paced bottle feeding, which is meant to mimic breastfeeding.
• Your baby isn't being burped often enough or for long enough. Find out how to burp your baby.
• Your baby might be constipated.
• Your baby is sensitive to an ingredient in the formula. Find out about formula allergies and sensitivities and choosing formula.

Your baby is still hungry after a formula feeding

At the end of a feeding, your baby might root around for the bottle, push their hands into their face or mouth, or even smack their lips to indicate they're still hungry. Paying attention to how often your baby eats and how they behave after feedings can help you determine if these are hunger cues, or signs of acid reflux or another need causing them to seek out comfort feeding.

• Your baby might not be eating enough. Find out how much formula your baby needs.
• Some babies have a strong urge to suck that can seem like hunger but may be for comfort. You could try giving your baby a pacifier to see if that helps soothe them.

Your baby is fussy or cries during or after feeding

It's normal to expect feeding to be the solution when your baby cries, so it can be confusing and frustrating if they become fussy during or after a feeding. Some possible causes:

• Your baby might be eating too much or not enough. Find out how much formula your baby needs.
• The bottle nipple is too big for your baby's mouth or the flow of formula is too slow or too fast. Find out how to choose the best bottle nipple for your baby.
• Your baby has painful gastroesophageal reflux.
• Your baby is gassy.

If your baby has reflux, their doctor may recommend trying a different kind of formula.

Find out more about how to cope with colic as well as other causes of colicky baby behavior, including excessive gas and constipation.

Your baby isn't gaining weight after 2 weeks

Healthy newborns lose between 5 and 10 percent of their body weight in the first week of their life and regain it by the time they're about 2 weeks old. After 2 weeks, babies keep gaining about an ounce each day during their first three months. If your baby isn't gaining weight after 2 weeks, here are some possible causes:

• Your baby isn't eating enough because of sleepiness, a weak sucking reflex, or feeding on a schedule (instead of on demand). Find out how much formula your baby needs.
• The formula you're using isn't prepared properly. Find out about using formula safely.

Talk to the doctor if your baby isn't wetting their diaper at least every 6 to 8 hours. This is a sign that they're not getting enough to eat.

Also let your doctor know if your baby has diarrhea for more than a day. Profuse diarrhea can be a sign that a baby isn't absorbing nutrients.

Find out more about why a baby may be diagnosed with failure to gain weight.

Your baby has rashes, hives, or eczema

While many newborns get mild acne or dry skin, developing an itchy rash, hives, or oozing bumps on the skin isn't typical. Rashes that keep coming back could be eczema, which occurs in 20 percent of infants. A possible cause:

• Your baby is allergic to an ingredient in the formula. Find out about formula allergies and sensitivities and choosing formula.

Contact with something else, like a skin care product, clothing item, or detergent, for example, could also irritate your baby's skin and cause issues.

Find out about eczema, hives, and other rashes and skin conditions.

Your baby is gagging or gulping formula

Depending on the age of your baby, bottle feeding takes anywhere between 15 and 40 minutes. Gulping might speed up the feeding, but it can also make your baby uncomfortable or cause them to overeat or gag. Some possible causes:

• The formula is flowing too fast. Find out about choosing nipples and bottles for formula feeding.
• Your baby is getting too hungry – maybe they're not drinking enough formula during each feeding, or they aren't being fed often enough. Find out how much formula your baby needs.
• Your baby needs to be held upright during feedings. You could try paced bottle feeding, which is meant to mimic breastfeeding.

Your baby has trouble sucking from the bottle

While it might seem like feeding would be second nature to a newborn, not all babies have an easy time learning to use a bottle. Some infants have trouble sucking from the bottle. Possible causes include:

• The bottle nipple is too big for your baby's mouth or the flow of formula is too slow. Find out how to choose the best bottle nipple for your baby.
• Your baby may have a tongue tie. You, and sometimes even your baby's doctor, may not be able to tell if your baby has a tongue tie just by looking. Let your pediatrician know if you have any concerns. They might diagnose a tongue tie or refer you to an ear, nose, and throat (ENT) physician for a further evaluation.
• Your baby has a cleft lip or palate. This is likely something your provider will diagnose during a prenatal ultrasound or at birth, but in some cases there may be a small cleft that won't be diagnosed until after the baby is born.

Your baby won't take a bottle

If your baby becomes angry or fussy, turning their head away when you offer the bottle, this could be a sign they're not interested in eating. Some possible causes:

• Your baby may not be hungry. Find out how much formula your baby needs and how often to feed them.
• You're introducing the bottle and your baby isn't used to it. (Breastfed babies often reject the bottle at first, and you may have to try to get them to take it multiple times over several days or longer.)

Your baby has a persistent diaper rash

Most babies get a diaper rash from time to time, but a persistent diaper rash that's impossible to heal or keeps coming back is typically a sign of a different problem. Possible causes:

• Your baby is sensitive or allergic to an ingredient in the formula you're using. Find out about formula allergies and sensitivities and choosing formula.
• If your baby has a diaper rash that doesn't get better even after treatment with zinc oxide cream, it may be due to a yeast infection or a bacterial infection.

Your baby has unusual poops

When your baby is formula fed, you can expect the consistency of their poop to be similar to peanut butter. There's a wide range of normal colors for formula poop, with yellow, brown, and greenish-yellow all considered typical. If your baby is constipated or has unusually hard poop, it could be because:

• They need a different formula. Most babies will do well on a cow's milk-based formula, but other babies have softer stools on a more specialized formula, such as one that is partially hydrolyzed. Ask your baby's doctor about how to switch to a different formula.

Note: You may have heard that the iron in formula can cause constipation, but this isn't true.

If your baby has diarrhea, it could be that:

• You're giving them formula that's been improperly stored or handled. Find out about using formula safely.

If your baby has mucus or blood in their poop, it could be that:

• Your baby is sensitive or allergic to an ingredient in the formula you're using. Find out about formula allergies and sensitivities and choosing formula.

Learn other reasons why you may see a little blood in your baby's diaper.