Spitting Up by Infants: Brief Version

What is spitting up?

Spitting up is the effortless loss of one or two mouthfuls of stomach contents. Milk just rolls out of the mouth, often with a burp. It usually happens shortly after feedings. Spitting up usually happens between birth to 1 year of age. More than half of all infants spit up to some degree.

Babies spit up because the valve (ring of muscle) at the top of the stomach does not close very well. Your baby will stop spitting up as he gets older.

How can I help my child?

• Feed smaller amounts.

  Overfeeding always makes spitting up worse. If the stomach is completely full, spitting up is more likely. If your baby is gaining well, give him smaller amounts (at least 1 ounce less than you have been giving). Wait at least 2 and 1/2 hours between feedings. If he is not gaining well, or is less than 1 month old, skip this advice.

• Avoid pressure on your child's stomach.

  Avoid tight diapers. They put added pressure on the stomach. Don't let people play roughly with your baby right after meals.

• Burp your child.

  Burp your baby 2 or 3 times during each feeding. Burp each time for less than 1 minute. Stop even if no burp occurs. Some babies don’t need to burp. Also cut back on pacifier time. Constant sucking can pump the stomach up with air.

• Keep your child in an upright position after meals.

  After meals, try to keep your baby in an upright position using a frontpack, backpack, or swing for 30 minutes.

• Use a proper sleep position.

  Most babies with spitting up problems can still sleep on their backs. This is the recommended position to reduce the risk of SIDS (sudden infant death syndrome). Talk to your doctor if your child is choking or having breathing problems.

• Add rice cereal to formula.

  If your baby still spits up large amounts after you have tried the suggestions above, you can try thickening the formula with rice cereal. Add 1 level teaspoon of rice cereal to each ounce of formula. You may also need to make the nipple opening bigger.

• Acid blockers or liquid antacids if baby develops heartburn.

  Most infants who spit up do not develop heartburn, Children who do develop heartburn may need medicine. Your child's oral medicine is ___________________. Give ________ every _________ hours for _________ days.

Call your child's doctor right away if:

• You see blood in the spit-up material.
• The spitting up causes your child to choke or cough.

Call your child's doctor during office hours if:

• Your baby doesn't seem to improve with this approach.
• Your baby does not gain weight normally.
• You have other concerns or questions.