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Why Is My Baby Spitting Up So Much Breast Milk?

Wellness

My baby is frequently spitting up — it seems like it’s all my breast milk! I never thought breastfed babies spit up this much. This can’t be normal, can it? Is there something wrong with my baby? Why is my baby spitting up my breast milk? 

Don’t worry — we get these questions often, and it’s common for babies to spit up breast milk or formula. Caring for a baby who spits up can be stressful for parents, creating worries about baby’s health and proper growth. Spitting up is very common in healthy babies and usually won’t cause any issues for baby’s growth or development. Babies may spit up because their digestive system is so immature, making it easier for their stomach contents to flow back up into the esophagus.

Why do babies spit up?

Several different factors can contribute to babies spitting up, including:

  • Babies regularly spit up when they drink too much milk too quickly. This can happen when the baby feeds very fast or when mom’s breasts are overfull. The amount of spit up can appear to be much more than it really is.
  • Food sensitivities can cause excessive spitting up in babies. Products with cow milk in mom’s or baby’s diet is a common food sensitivity.
  • Some babies can become distracted when breastfeeding, pulling off to look around. This can cause babies to swallow air and spit up more often.
  • Breast milk oversupply or forceful let-down (milk ejection reflex) can cause reflux-like symptoms in babies.

If your baby seems comfortable and is eating well, gaining weight and developing normally, there’s typically little cause for concern. “Happy spitters” will grow and thrive, despite spitting up frequently. As babies grow and get older, they usually spit up less. Most will stop spitting up by 12 months. Babies may spit up breast milk or formula less as they develop their routine.

How much breast milk a newborn or infant should consume may vary so it’s important to monitor how often your baby eats and whether he spits up or has other symptoms while feeding. In the first few days of life, your baby may eat as often as every 1 to 3 hours, which helps increase your milk supply and enables your baby to practice sucking and swallowing.

In the first few weeks and months, the frequency of feedings will lessen. Most exclusively breastfed babies will nurse about 8 to 12 times in a 24-hour period, but of course every baby is different. You might find your baby feeds more or less at certain times of day. That’s normal. They should be content and drowsy after getting enough milk.

Tips for when baby is spitting up

  • Keep your baby upright. Try feeding your baby this way and keep them upright for about 30 minutes after feedings and see if that helps with spitting up.
  • Avoid engaging in active play for at least 30 minutes after feedings. Active play includes use of a bouncy seat, vibrating seat, infant swing or bouncing the baby while walking/holding.
  • Burp baby frequently during and after each feeding. Burping can keep air from building up in your baby’s stomach.
  • Avoid overfeeding. Feeding your baby smaller amounts of breast milk or formula more frequently might help decrease spitting up.
  • Put your baby to sleep on their back. Placing a baby to sleep on their tummy to prevent spitting up isn’t recommended.
  • Monitor your diet closely if you’re breastfeeding. If you feel certain foods might be upsetting your baby’s stomach, try avoiding them for a while and observing if baby spits up less breast milk.
  • Talk with your child’s pediatrician when needed. If you notice weight loss, forceful spit up, fussiness or other symptoms, talk to your child’s pediatrician about your concerns.

Need to see a doctor?

Find a Texas Children’s Pediatrics location near you. Existing patients with MyChart accounts can also schedule an appointment online.

When do babies stop spitting up?

When babies stop spitting up breast milk or formula can vary, and many factors may cause babies to spit up. Babies typically stop spitting up by the time they’re around 6 to 12 months old, as they get older and their digestive systems mature. If your baby continues to spit up, treatment will depend on what’s causing baby to spit up. Sometimes, your child’s pediatrician might prescribe medicine to treat reflux. Here’s what you expect as your baby develops:

  • As babies grow to 3–6 months old, the frequency of spitting up generally decreases. The muscle that keeps food in the stomach (the lower esophageal sphincter) becomes stronger, reducing the chances of spitting up.
  • By the time babies are 6–12 months old, most will have stopped spitting up or will only do so occasionally. At this age, they’re starting solid foods and spending more time upright, which helps keep food down.

Many babies who still spit up occasionally will have completely stopped by their first birthday. If your baby continues to spit up after 1 year old, or spitting up is accompanied by weight loss, discomfort, refusal to eat or other concerning symptoms, it may be a sign of gastroesophageal reflux disease (GERD) or another underlying issue. In that case, consult your pediatrician.

Meet with a lactation consultant

Texas Children’s Baby Bistro is a service to help support mothers who choose to breastfeed. We offer full breastfeeding evaluations with our international board-certified lactation consultants. If you’re having problems breastfeeding or just want to make sure everything is going well, call us at 832-826-8881.

How to tell the difference between spit up and vomiting in babies

It can be hard to tell the difference between spit up and vomiting sometimes. Typically, spit up flows out of baby’s mouth easily, often with a burp. Vomiting is usually more forceful, caused by the abdominal muscles and diaphragm strongly contracting.

Newborn baby vomiting after feeding

Spitting up is very common in newborns and young infants, as their digestive systems are still developing. It usually occurs after feedings due to swallowing air, overfeeding or immature muscles in the esophagus. While it may often look like a lot, babies usually spit up only a couple of mouthfuls of breast milk or formula.

On the other hand, vomiting may indicate an underlying issue. There could be many potential causes of vomiting, from a stomach bug to motion sickness. Contact your child’s pediatrician if baby vomits forcefully after every feeding or if you see blood in baby's vomit.

Frequently asked questions

If you notice your baby is spitting up breast milk or formula more frequently than in the past, try the tips noted above. Be sure baby is staying upright and avoiding active play for at least 30 minutes after feedings. Does baby still seem generally happy and gaining weight as expected? While spit up is usually normal and not a cause for concern, talk to your child’s pediatrician if you notice weight loss, forceful spit up, fussiness or other symptoms.

Baby may be swallowing too much air when feeding or may need more frequent burping during feedings. If you’ve tried the tips above and you’re still concerned, talk with your baby’s pediatrician or a lactation consultant about your concerns.

First, don’t panic. Spitting up is normal. Gently turn your baby’s head to the side if it isn’t already. Studies have shown that healthy babies sleeping on their backs can turn their heads if they spit up while lying on their backs. In fact, babies’ anatomy actually makes choking more likely if they’re lying on their tummies.

If you notice weight loss, forceful spit up, fussiness or other concerning symptoms, talk to your child’s pediatrician about your concerns.