Why babies spit up

Why does my baby spit up so much?

Your baby is probably just getting the hang of feeding. Almost half of young babies spit up regularly. The peak age for spitting up – also known as reflux – is 4 months.

When your baby swallows air along with breast milk or formula, the air gets trapped in with the liquid. The air has to come up, and when it does, some of the liquid comes up too, through your baby's mouth or nose.

Babies take in a lot of nourishment in relation to their size, and some of them really like to eat, so sometimes they become overfilled and, well, overflow.

A newborn's digestive system isn't fully developed, either. The muscles at the bottom of your baby's esophagus, which control whether food is coming or going, may still be getting up to speed. It's no wonder your little one creates so much laundry.

If your baby's spitting up a lot

Try these tips to help your baby keep their food down:

• Hold your baby in a fairly upright position when you feed them. Feeding them while they're slouched (sitting in a car seat, for example) doesn't give the formula or breast milk a straight path to their tummy.
• Keep feedings calm. Minimize noise and other distractions, and try not to let your baby get too hungry before you start a feeding. If your baby's distracted or frantic, they're more likely to swallow air along with breast milk or formula.
• Check the bottle nipple. If your baby's drinking formula or pumped breast milk from a bottle, make sure the hole in the nipple isn't too small, which will frustrate them and make them swallow air. On the other hand, if the hole's too large, your baby will be gagging and gulping because the fluid will come at them too quickly. Read our advice on choosing nipples and bottles.
• Burp your baby often. If your baby takes a natural pause during a feeding, take the opportunity to burp them before giving them more food. That way, if there's any air, it'll come up before even more food is layered on top of it. If you don't get a burp within a few minutes, don't worry. Your baby probably doesn't need to burp just then. Burp them after each feeding, too.
• Keep the pressure off the tummy. Make sure your baby's clothing and diaper aren't too tight, and don't put their tummy over your shoulder when you burp them. Try to avoid car trips right after feedings, because reclining in a car seat can put pressure on your baby's stomach, too.
• Limit activity after feedings. Don't jostle your baby too much after they eat, and try to keep them in an upright position for half an hour or so. This way they'll have gravity on their side.
• Don't overfeed. If your baby seems to spit up quite a bit after every feeding, they may be getting too much to eat. You might try giving them just a bit less formula or breastfeeding them for a slightly shorter time, and see whether they're satisfied. (Your baby may be willing to take less formula or breast milk at a feeding but want to eat more frequently.)
• Check the formula. Ask your pediatrician if your baby might have an intolerance to milk protein or soy protein that's causing them to spit up. The doctor may suggest trying a hydrolyzed (hypoallergenic) formula for a week or two.

When do babies stop spitting up?

Most babies stop spitting up by around 6 or 7 months old, or once they learn to sit up on their own. As their muscles develop and get stronger, babies are able to keep food down more easily.  However, some babies continue to spit up until their first birthday.

How can I tell if my baby's spitting up or vomiting?

Compared to spitting up, vomiting is usually more forceful, and vomit comes out in greater quantity. If your baby seems distressed, they're probably vomiting. Spitting up doesn't faze most babies at all.

Is spitting up ever a sign of something serious?

Spitting up is usually just par for the course, but if your baby isn't gaining weight as they should be, schedule a visit with the doctor. Babies who spit up so much that they don't gain enough weight or have difficulty breathing may have gastroesophageal reflux disease (GERD).

Call your doctor immediately if your baby begins projectile vomiting. Projectile vomiting is when the vomit flies out of a baby's mouth forcefully – shooting across the room, for example. This could be a sign of a condition called pyloric stenosis, in which the muscles at the bottom of the stomach thicken and prevent the flow of food to the small intestine. This typically happens at about 1 month of age.

Also call your doctor right away if you see blood or green bile in your baby's vomit. This could be a sign of a blockage in their intestines, which would require a visit to the emergency room, a scan, and possibly emergency surgery.

Is it normal for spit up to come out of my baby's nose?

Yes, just like your own nose, your baby's nose is connected to the back of their throat. So spit up will sometimes come out of their nose instead of their mouth. This is more likely to happen if your baby's mouth is closed or their head is tilted in a certain way (allowing the spit up to take the path of least resistance).

Spit up can also come out of your baby's nose if their swallowing process gets a little off-kilter when they hiccup, cough, or sneeze. It even happens to older children – picture kids at the dinner table when they start laughing while trying to swallow milk. If milk comes out their nose, it's the same situation – and perfectly normal.

Learn more

• Will certain foods make my baby gassy if I'm breastfeeding?
• Are there foods I should avoid when I'm breastfeeding?