Baby spits out milk during feeding


Breastfeeding FAQs: Spitting Up, Gagging, and Biting (for Parents)

Breastfeeding is natural, but it takes practice to get it right. Here's what you need to know about spitting up, gagging, and other concerns during breastfeeding.

Is it Normal for My Baby to Spit Up After Feedings?

Sometimes, babies spit up when they eat too much, or when they burp or drool. Many infants will spit up a little after some — or even all — feedings or during burping because their digestive systems are immature. That's perfectly normal.

As long as your baby is growing and gaining weight and doesn't seem uncomfortable with the spitting up, it's OK. The amount of spit-up often looks like more than it actually is. But spitting up isn't the same as forcefully vomiting all or most of a feeding.

What’s the Difference Between Spitting Up and Vomiting?

Vomiting is a forceful projection of stomach fluids. Spitting up is a more gentle "flow" of fluids that come up. Babies don’t usually react to spitting up, but a vomiting baby will usually look upset or cry.

If you're concerned that your baby is vomiting, call your doctor. In rare cases, there may be an allergy, digestive problem, or other problem that needs medical care. It helps to keep track of how often and how much your baby is vomiting or spitting up.

How Can I Keep My Baby From Spitting Up?

If the doctor says your baby's spitting up is normal, here are some things you can do to help lessen it:

  • Burp your baby after each feed from each breast. Sometimes giving smaller feeds more often can help, rather than giving larger-volume feeds.
  • Keep your baby upright after feedings for at least 30 minutes. Holding your baby is best, since the way your baby sits in an infant seat may actually make spitting up more likely.
  • Don't jiggle, bounce, or actively play with your baby right after feedings.
  • Keep your baby's head above the feet while feeding. Don't hold your baby in a dipped-down position when feeding.
  • Raise the head of your baby's crib or bassinet. Roll up a few small hand towels or receiving blankets (or you can buy special wedges) to place under — not on top of — the mattress. Never use a pillow under your baby's head. Make sure the mattress doesn’t fold in the middle, and that the incline is gentle enough that your baby doesn’t slide down.

If your baby also gets bottles of breast milk or infant formula supplements:

  • Burp after your baby drinks 1–2 ounces from a bottle.
  • Don't give the bottle while your little one is lying down.
  • Make sure the hole in the nipple is the right size and/or flow for your baby. For example, fast-flow nipples may cause babies to gag or may give them more milk than they can handle at once. Many breastfed babies do well with the slow-flow nipple until they are 3 months old, or even older.

Many babies outgrow spitting up by the time they're sitting up.

How Can I Keep My Baby From Gagging?

Sometimes the force of your milk (especially when it “lets down”) is so strong that it can cause your baby to gag and pull off of the breast. If this happens during feeding:

  • Try nursing your baby in a more upright position (head above the breast). This may ease the force of the milk.
  • Nurse in a side-lying position, which also might help slow the flow of milk. 
  • Make sure your breasts are not engorged or over-full. Nursing every 2–3 hours can help prevent engorgement. If your breasts are too full and you’re concerned about a forceful letdown, express or pump a little bit of milk a few minutes before feeding time to avoid a strong letdown.

If your baby is pulling off and gagging or coughing during feeding, sit your baby up in a seated burp position. Gently pat the back to help your baby calm down before continuing feeding. If you’ve tried the steps above and this continues to happen, talk to your doctor or lactation consultant.  

If your baby sometimes gags or chokes while taking a bottle of breast milk: 

  • Try a different nipple with a slower flow.
  • Practice “paced” bottle feeding. This is where you slow down the milk flow from the bottle by holding it at less of an angle and allowing your baby to pause for breaks.

My Baby Bites During Breastfeeding. What Can I Do?

Babies will often play with their mothers' nipples with their gums, not meaning to cause any harm. But once they start teething, a baby might bite down, not knowing this is hurting mom.

Sometimes you can tell when your baby's about ready to bite down — usually when satisfied and starting to pull away from the breast. When you sense that your baby is finished feeding and may be bored or feeling playful, end the feeding. Break the suction by slipping your finger into the corner of your baby’s mouth.

If your baby is already biting down, pull your baby closer to you to make it more difficult to pull off easily. Then, break the suction. React calmly without raising your voice. 

Here are more ways to make baby less likely to bite:

  • Before a feed, give your baby something to chew on. Make sure it's big enough that it can't be swallowed or choked on and that it can't break into small pieces. A wet washcloth placed in the freezer for 30 minutes makes a handy teething toy. Be sure to take it out of the freezer before it becomes rock hard — you don't want to bruise those already swollen gums. Wash after each use.
  • Say, "Mommy is not for biting. You can bite this." Then, offer your little one a teething toy or ring.
  • Praise your baby — with a hug, kiss, or cuddle — whenever they nurse without biting or trying to bite.

Usually this is enough to stop the biting, but if your baby continues, talk to your doctor or lactation consultant for advice.

Reviewed by: Jamila H. Richardson, BSN, RN, IBCLC

Date reviewed: January 2021

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My baby is frequently spitting up – it seems like it’s all of 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?

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

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 the mom or baby’s diet can be a common food sensitivity.
  • Some babies can become distracted when feeding at the breast, pulling off to look around. This can cause babies to swallow air and spit up more often.
  • Breastmilk oversupply or forceful let-down (milk ejection reflex) can cause reflux-like symptoms in babies.

If your baby seems comfortable, 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 of age.

Consider these tips:

  • Keep your baby upright. Try feeding your baby this way and keep them upright for about 30 minutes after feedings.
  • Avoid engaging in immediate 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.
  • Frequent burps during and after each feeding can keep air from building up in your baby’s stomach.
  • Avoid overfeeding. Feeding your baby smaller amounts more frequently might help decrease spitting up.
  • Put your baby to sleep on his or her back. Placing a baby to sleep on its tummy to prevent spitting up is not recommended.
  • Monitor your diet closely if you’re breastfeeding. If you feel there are certain foods that might be upsetting your baby’s stomach, try avoiding them for a while.
  • If you notice weight loss, forceful spit up, fussiness or other symptoms, talk to your child’s pediatrician about your concerns.

Lactation Support Services at Texas Children’s Hospital offers a variety of services to mothers with questions and concerns regarding breastfeeding, pumping, medications and more. Click here to learn more.

Shelly Nalbone, APRN, CPNP, IBCLC

Why does the baby spit up after breastfeeding?

Every mother has experienced this phenomenon to some extent - this is completely normal, because in the first months the baby's eating habits are just beginning to form. What are the causes of regurgitation? Can this be prevented? What is considered normal, and when should you see a doctor? Let's find out!

Dry initial milk formula adapted by Valio Baby 1 NutriValio for feeding children from birth to 6 months Read more

Follow-up dry milk formula adapted by Valio Baby 2 NutriValio for feeding children from 6 to 12 months More

Dry milk drink "Baby milk" Valio Baby 3 NutriValio for feeding children over 12 months Read more



Main causes

Often the cause of regurgitation depends on the chosen method of feeding: whether the mother is putting the baby to the breast or feeding from a bottle. nine0003 When breastfeeding:

  • Overfeeding the baby. If the baby eats too much, then the excess milk comes out naturally.
  • Incorrect breastfeeding technique, as a result of which a large amount of air enters the baby's stomach along with milk. Try to hold the baby so that he completely grasps the nipple and at the same time can breathe freely through his nose.
  • Features of the digestive system of children at an early age. In infants up to a year old, the muscles of the esophagus are not yet fully formed, so regurgitation is often a natural process. nine0022
  • An abrupt change in the position of the child. After feeding, do not turn the baby over, squeeze, swaddle or swing in the stroller.
  • Intestinal disorders such as bloating, colic and other causes that prevent normal digestion.
  • In rare cases, serious diseases of the digestive system.

Note that regurgitation is more often observed not in newborns, but in children aged about 4 months.

Formula-fed:
  • Abrupt transition from breast milk to formula.
  • Unsuitable size and opening of the nipple, due to which the baby takes in a lot of air.
  • Tendency to overeat. You should follow the rules of nutrition for babies.
  • Inappropriate milk formula. Perhaps the child simply does not tolerate it well, consult a doctor about changing baby food.

Valio Baby's adapted milk formulas are as close as possible in composition to breast milk and contain prebiotics, as well as vitamins and microelements necessary for intestinal health. All components of Valio Baby are natural. A balanced composition allows you to maintain the level of cholesterol in the child's body at an optimal level. The mixtures are designed for three age categories, taking into account the peculiarities of the development of babies in a given period:

  • from the first days of life to six months;
  • for babies from six months to 1 year;
  • and for children over 1 year old.
First aid

If the baby is lying on his back and starts spitting up, immediately turn him over on his stomach, or pick him up - this will prevent food from entering the respiratory tract.

If your baby seems to be uncomfortable while feeding, or if he comes off the breast and starts crying, let him burp. This can be done in two ways:

  • Place a washcloth over your shoulder to keep it clean. Hold the baby on your chest so that his chin rests on your shoulder. Gently stroke or pat your hand on his back.
  • Place the cloth on your lap. Turn the baby over on the tummy and position it perpendicular to your body. Support your chin with one hand and pat or rub your back with the other. Please note that the child's head should be higher than other parts of the body so that blood does not rush to it and food does not reflux into the respiratory tract. nine0022
When you need a doctor

As a rule, spitting up 6-8 times a day (in small portions) does not pose a health risk. Over time, when the baby's muscles get stronger, he will better absorb food. Most children stop spitting up after 6-7 months, but in some situations this problem persists up to one year.

If the spitting up is persistent and strong, prevents weight gain, the child cries after this process, then you should consult a doctor. Such symptoms may indicate that the baby has irritated walls of the esophagus. nine0003

Call a doctor immediately if your child is vomiting violently and profusely. This may indicate either the presence of food poisoning, or a disease associated with deformation of the internal organs.

If an infant vomits with greenish bile, this may be a sign of intestinal blockage, which requires urgent hospitalization and possibly even emergency surgery.

Prevention

If your newborn is spitting up a lot after feeding, follow these guidelines:

  • Do not breastfeed while baby is squatting or in a car seat as milk or formula may not reach the stomach.
  • Create a calm atmosphere. Keep noise and other distractions to a minimum. If the baby is distracted and disturbed by something, there is an increased risk that he will swallow large amounts of air with formula or breast milk. For the same reason, do not let the baby be very hungry.
  • Make sure that nothing is pressing on the baby's tummy. Make sure his clothes and diaper are not too tight. nine0022
  • Avoid driving immediately after feeding.
  • Hold the baby for about 30 minutes. upright after eating.
  • When breastfeeding, make sure that the baby is properly latching onto the breast (his lips should cover not only the nipple, but also the areola, as far as possible).
  • If you are feeding formula or bottled milk, make sure the opening of the nipple is not too small as this can prevent the baby from drinking and cause air to be swallowed. The hole should not be too large, so that the child does not choke. nine0022
  • Do not overfeed your baby. Try feeding him less milk or formula. Watch the reaction. The baby may agree to drink a smaller volume at a time, however, will want to eat more often.

If regurgitation occurs frequently, after each feed, consult your physician.

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