How To Ease Spit-Up for Your Baby

What Can Make Babies Spit Up?

Spit-up is often a natural and typical part of infant development, and there are several common reasons why:

• The valve between the esophagus and stomach that keeps food down is still developing, so some food contents may spurt out.
• Babies sometimes consume more than their tummies can hold. What they can’t fit often comes right back out.
• Babies spend a good chunk of their time lying flat on their backs. In this position, their belly can put pressure on their lower esophagus and make them more prone to reflux.

About 50% of all babies will spit up repeatedly,¹ with the spit-up period typically peaking at four months.² And while it’s not uncommon for babies to spit up the entire first year, reflux usually ends (or is greatly lessened) by a baby’s first birthday as their digestive system develops.³

Learn more about why babies spit up.

Tips to Help Ease Baby Spit-Up

The following tips may help you ease or manage your baby’s spit-up.

Breastfeeding? Check Your Diet

Some moms have found eliminating certain things—like dairy products—may lessen the amount of their baby’s spit-up. Cow’s milk is a common food sensitivity, but talk to your doctor before cutting dairy out of your diet.⁴

Try a Formula Switch

If you’re formula-feeding or supplementing, ask your pediatrician if a change to a rice starch-thickened formula, such as Enfamil A.R., may help. Enfamil A.R. formula is clinically proven to reduce spit-up by more than 50% while still providing the complete nutrition your baby needs.^*

Hold Your Baby Upright

When feeding, hold your baby in an upright position with their head positioned higher than the rest of their body. After feeding, keep your baby upright for 30 minutes. This positioning could help alleviate spit-up-triggering pressure on their belly.⁵

Control Their Feeding Flow

If you’re bottle feeding, check the bottle’s nipple size. Your baby might be drinking too much formula too fast, which could cause spit-up. A nipple that’s too small may contribute to gas, which could also lead to spit-up. Most nipples are marked to match an appropriate age.

Try Smaller, More Frequent Feedings

Since overfeeding can sometimes contribute to spitting up, try giving your baby a smaller amount of food at each feeding but feed them more often. Your little one will still receive the same overall amount of milk or formula but in smaller and potentially more manageable serving sizes.

Make Burping a Priority

Air bubbles—aka gas—could also cause spit-up or "wet burps." Try burping your baby two or three times during feeding. Burp them when they naturally pause feeding, without disrupting their meal. If they don’t burp within a minute, they may not need to burp, and you can try again later.⁶

Loosen Diapers

Avoid tight diapers as they put added pressure on the stomach.

Reduce Pacifier Time

Constant sucking can pump your baby’s stomach with swallowed air, which could provoke spit-up.

Keep Things Calm after Feeding

Too much activity on a full belly may set off splurts of spit-up. Avoid bouncing your baby and postpone tummy time until after their nap or diaper change.

Know when to Contact Your Pediatrician

It’s not unusual for babies to spit up a tablespoon or two, but call your pediatrician if you have any concerns or questions or if your baby is:

• Not gaining weight
• Refusing to feed
• Spitting up all the time or spitting up more than one or two tablespoons
• Crying, fussy, and showing signs of discomfort
• Showing indications of illness
• Spitting up contents that look bloody, yellow, or green
• Vomiting
• Experiencing diarrhea or other digestive issues
• Coughing, wheezing, or having respiratory issues
• Over a year old

Spit-up accompanied by one or more of the above issues could possibly indicate a food allergy or sensitivity, gastroesophageal reflux disease (GERD), or another health condition.⁷

Before You See Your Doctor

While your pediatrician will answer your questions and explore what may be causing your little one’s spit-up issues, there are some things you can do before your visit to help you get the most out of your appointment.

1. Call the office and ask if you should do anything to prepare for your visit.
2. Write down all your baby’s experiences or issues and your concerns, including answers to these questions:
   • When do you notice the spit-up? Is it always after eating? When they cough, burp, or are highly active?
   • Does your baby spit up after every feeding or just occasionally?
   • Have you recently switched from breast to bottle? Have you changed formulas?
   • Is there anything in particular that makes your little one’s experiences worse? Better?
   • Do you feed your baby in an upright position?
   • How much does your baby eat at each feeding? How much overall in one day?
   • Does your baby seem to be in pain when they are spitting up? Do they have clenched fists, an arched back, or a red face? Are they crying or fussy?
3. Having a written outline of your baby’s experiences or issues will help you clearly—and accurately—explain your baby’s experiences to your pediatrician. After all, you’re the one who knows your baby best.
4. Write down all your questions (a good start is the list below) and bring them with you.
5. Make a list of everything your baby is taking, including:
   • Vitamins or other nutritional supplements
   • Medications
   • Type of formula
   • Breast milk
   • Any solids
6. Note any changes in your baby lately:
   • Sleep patterns
   • Eating habits
   • Illness

Many babies’ reflux issues will improve over time. But your doctor can examine your little one for any potential underlying health concerns and help you find a path to relief for their spit-up issues. Ask your pediatrician if Enfamil A.R. may help ease your baby’s spit-up.

Questions to Ask Your Pediatrician

Spit-up is generally not a cause for concern, but if you think your baby is in pain or you’re worried about what you’re feeding them, don’t hesitate to call your pediatrician for advice and assurance. Here are some questions to consider asking:

1. Is spit-up common in babies?
2. What are the typical causes of spit-up?
3. Is my baby losing any nourishment from spitting up?
4. Should I switch formulas for spit-up relief?
5. I’m breastfeeding; could something in my diet be causing my baby to spit up?
6. My baby spits up after each meal; am I overfeeding them?
7. Does burping help minimize spit-up?
8. What’s the best way to burp my baby? How often should my baby be burped?
9. I can’t get my baby to burp; is it OK if I don’t burp them?
10. Is spitting up something babies outgrow? If so, at what age?
11. What are warning signs that spitting up is something more serious?
12. Will spitting up affect my baby’s growth and development in any way?

Ask Your Doctor If Switching to Enfamil A.R.™ Could Help Relieve Spit-Up

Enfamil A.R. formula is specially formulated with added rice starch for a thicker consistency to reduce reflux and spit-up by over 50% in one week.* It provides complete nutrition for your infant up to 12 months of age and meets reflux reduction guidelines as set by the American Academy of Pediatrics. While you’re waiting to talk with your doctor, be sure to join Enfamil Family Beginnings to earn rewards on Enfamil purchases and get discounts, free baby formula samples, and baby freebies! You’ll also get custom baby content and tips delivered to your email.

^*Based on a clinical study of Enfamil A.R. infant formula before the addition of DHA, ARA, and prebiotics with infants who spit up frequently (five or more spit-ups per day), comparing frequency and volume of spit-up after feeding Enfamil A.R. with the same babies at the beginning of the study.

References:

¹ “Spitting Up - Reflux.” Seattle Children’s. https://www.seattlechildrens.org/conditions/a-z/spitting-up-reflux. Accessed September 27, 2022.

² Badriul Hegar, Debora Hindra I. Satari, Damayanti R. Sjarif, and Yvan Vandenplas. “Regurgitation and Gastroesophageal Reflux Disease in Six to Nine Months Old Indonesian Infants.” National Library of Medicine. December 31, 2013.

³ “Reflux in Infants.” MedLine Plus. https://medlineplus.gov/refluxininfants.html. Accessed September 27, 2022.

⁴  “Why is my baby spitting up so much breast milk?” Texas Children’s Hospital. https://www.texaschildrens.org/blog/why-my-baby-spitting-so-much-breast-milk#:~:text=Food%20sensitivities%20can%20cause%20excessive,and%20spit%20up%20more%20often. Accessed September 27, 2022.

⁵ “Why Babies Spit Up.” HealthyChildren.org. https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Why-Babies-Spit-Up.aspx. Accessed September 27, 2022.

⁶  “Spitting Up - Reflux.” Seattle Children’s. https://www.seattlechildrens.org/conditions/a-z/spitting-up-reflux. Accessed September 27, 2022.

⁷  Porto, Anthony, MD, MPH, FAAP. “Gastroesophageal Reflux & Gastroesophageal Reflux Disease: Parent FAQs.” HealthyChildren.org. https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/GERD-Reflux.aspx. Accessed September 27, 2022.