Spitting up is common and normal in babies. If it becomes more frequent or forceful, you should bring this to our attention. The most frequent cause of spitting up is improper burping. Burp your baby frequently, through out the feeding and after feedings. Babies also spit up because of overfeeding. You should not feed your child over four ounces at a feeding during the first few months of life. At check up visits, we can help you choose the proper amount of milk to give your child at feeding time.

Sometimes formula intolerance or food allergies can contribute to spitting up. This is generally due to cow's milk protein allergy (intolerance). Symptoms of cow's milk allergy may include: diarrhea, constipation, blood in the stools, spitting up blood, irritability and vomiting. It's important to discuss this possibility with us during an office visit so we can evaluate and address it appropriately. This is treated by first switching from a milk-based formula to a hydrolysate formula, such as Nutramigen LGG. Hydrolysate formulas contain predigested cow milk protein (casein), which are broken down into smaller pieces for easier digestion and reduced risk of allergic reactions. For more severe cases of formula allergy, amino acid formulas like Puramino, which are even more hypoallergenic, may be recommended. In breast fed infants, the mother should stop all dairy products. Consult us for advice on this topic.

Projectile vomiting which is vomiting which shoots out of the mouth under force is abnormal. The baby should have an appointment to check this out (see section on vomiting). Pyloric stenosis, a potentially serious condition, needs to be ruled out. 

Another way to help reduce spitting up is to keep your child upright for 30 to 45 minutes during and after feedings. This position will help to decrease the amount of spitting up. As long as your child is growing and developing well, is not having choking episodes or turning blue, and is not excessively irritable, spitting up is more of a nuisance than it is dangerous. We call this child, a happy spitter. No treatment is indicated for a happy spitter.

If you have any questions about your child’s weight gain, the possibility of choking episodes or if your child is excessively irritable with spitting up, you should call the office for an appointment. Cow milk protein allergy or gastroesophageal reflux disease (GERD)  are possible and treatment options are available.