Baby spits up half hour after feeding

Spitting Up - Reflux

Is this your child's symptom?

Spitting up small amounts of breastmilk or formula. Also called reflux.
Spitting up 1 or 2 mouthfuls of milk at a time
No effort or crying
Normal symptom in half of young babies

Symptoms of Normal Spitting Up

Smaller amounts often occur with burping ("wet burps")
Larger amounts can occur after overfeeding
Most often seen during or shortly after feedings
Occurs mainly in children under 1 year of age
Begins in the first weeks of life
Caution: normal reflux does not cause any crying

Complications of Spitting Up (GERD)

Most infants are "happy spitters." Normal spitting up (normal reflux) occurs in half of babies. It does not cause crying or colic.
Normal crying occurs in all babies. Frequent crying (called colic) occurs in 15&percnt; of babies. Crying and colic are not helped by heartburn meds. These meds also have side effects.
If they develop complications, it's called GERD (gastro-esophageal reflux disease). This occurs in less than 1% of babies.

Symptoms of GERD

GERD problems occur in less than 1% of infants:

Choking on spit up milk
Heartburn from acid on lower esophagus. Infants with this problem cry numerous times per day. They also act very unhappy when they are not crying. They are in almost constant discomfort.
Poor Weight Gain

Cause

Poor closure of the valve at the upper end of the stomach (weak valve)
Main trigger: overfeeding of formula or breastmilk
More than half of all infants have occasional spitting up ("happy spitters")

Reflux Versus Vomiting: How to Tell

During the first month of life, newborns with true vomiting need to be seen quickly. The causes of vomiting in this age group can be serious. Therefore, it's important to tell the difference between reflux and true vomiting.

Reflux

The following suggests reflux (normal spitting up):

You've been told by a doctor your baby has reflux
Onset early in life (85% by 7 days of life)
Present for several days or weeks
No pain or crying during reflux
No effort with spitting up
No diarrhea
Your baby acts hungry, looks well and acts happy.

Vomiting

The following suggests vomiting:

Uncomfortable during vomiting
New symptom starting today or yesterday
Forceful vomiting
Contains bile (green color)
Diarrhea is also present or
Your baby looks or acts sick.

Pyloric Stenosis (Serious Cause)

This is the most common cause of true vomiting in young babies.
Onset of vomiting age 2 weeks to 2 months
Vomiting is forceful. It shoots out of the baby's mouth. This is called projectile vomiting.
Right after vomiting, the baby is hungry and wants to feed. ("hungry vomiter")
Cause: the pylorus is the channel between the stomach and the gut. In these babies, it becomes narrow and tight.
Risk: weight loss or dehydration
Treatment: cured by surgery.

When to Call for Spitting Up - Reflux

Call Doctor or Seek Care Now

Blood in the spit up
Choked on milk and turned blue or went limp
Age less than 12 weeks and spitting up changes to vomiting (forceful or projectile)
Age less than 1 month old and looks or acts abnormal in any way
Your child looks or acts very sick
You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

Chokes a lot on milk
Poor weight gain
Frequent crying
Spitting up is getting worse
Age more than 12 months old
Spitting up does not get better with this advice
You have other questions or concerns

Self Care at Home

Normal reflux (spitting up) with no problems

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Bellevue
Everett
Federal Way
Seattle

Care Advice for Spitting Up (Reflux)

What You Should Know About Spitting Up:
- Spitting up occurs in most infants (50&percnt;).
- Almost always doesn't cause any pain or crying.
- Spitting up does not interfere with normal weight gain.
- Infants with normal reflux do not need any tests or medicines.
- Reflux improves with age.
- Here is some care advice that should help.
Feed Smaller Amounts:
- Skip this advice if age less than 1 month or not gaining weight well.
- Bottlefed Babies. Give smaller amounts per feeding (1 ounce or 30 mL less than you have been). Keep the total feeding time to less than 20 minutes. Reason: Overfeeding or completely filling the stomach always makes spitting up worse.
- Breastfed Babies. If you have a good milk supply, try nursing on 1 side per feeding. Pump the other side. Switch sides you start on at each feeding.
Longer Time Between Feedings:
- Formula. Wait at least 2½ hours between feedings.
- Breastmilk. Wait at least 2 hours between feedings.
- Reason: It takes that long for the stomach to empty itself. Don't add more milk to a full stomach.
Loose Diapers:
- Do not put the diaper on too tight. It puts added pressure on the stomach.
- Don't put pressure on the stomach right after meals.
- Also, do not play too hard with your baby during this time.
Upright Position:
- After meals, try to hold your baby in the upright (vertical) position.
- Use a front-pack, backpack, or swing for 30 to 60 minutes after feedings.
- Decrease the time in a sitting position (such as infant seats).
- After 6 months of age, a jumpy seat is helpful. The newer ones are stable.
- During breast or bottle feeds, hold your baby at a slant. Try to keep your baby's head higher than the stomach.
Less Pacifier Time:
- Frequent sucking on a pacifier can pump the stomach up with swallowed air.
- So can sucking on a bottle with too small a nipple hole.
- The formula should drip 1 drop per second when held upside down. If it doesn't, the nipple hole may be clogged. Clean the nipple better. You can also make the nipple hole slightly bigger.
Burping:
- Burping is less important than giving smaller feedings. You can burp your baby 2 or 3 times during each feeding.
- Do it when he pauses and looks around. Don't interrupt his feeding rhythm in order to burp him.
- Burp each time for less than a minute. Stop even if no burp occurs. Some babies don't need to burp.
Add Rice Cereal to Formula:
- If your baby still spits up large amounts, try thickening the formula. Mix it with rice cereal.
- Start with 1 level teaspoon of rice cereal to each ounce of formula.
Acid Blocking Medicines:
- Prescription medicines that block acid production are not helpful for normal reflux.
- These medicines also can have side effects.
- They do not reduce excessive crying from colic.
- They are only useful for symptoms of heartburn.
What to Expect:
- Reflux gets better with age.
- After learning to sit well, many babies are better by 7 months of age.
Call Your Doctor If:
- Spitting up changes to vomiting (forceful or projectile)
- Poor weight gain
- Your baby does not get better with this advice
- You think your child needs to be seen
- Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 01/22/2023

Last Revised: 12/30/2022

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

why baby spit up after feeding

If a child spits up after feeding, this is in most cases due to the anatomical immaturity of the upper digestive system. More often than others, premature babies, babies with congenital pathologies suffer from regurgitation. Sometimes the cause is the wrong breastfeeding technique.

Regurgitation in infants is perhaps the most common occurrence in modern pediatrics. More than half of children spit up at least once a day, which is almost always a physiological reaction. nine0003

As the baby grows older, spitting up less and less and by 6 months it practically stops doing so. However, sometimes the problem remains, and burping continues for up to a year. In such a situation, you need to make sure that the gastrointestinal tract is functioning normally and consult a doctor.

Why does the baby spit up after every feed

There is a very simple explanation for this. The esophagus of newborns is a funnel with a wide part at the top, and the sphincter at the transition to the stomach actually gapes and hardly retains food. nine0003

Normally, after food enters the stomach, the sphincter contracts and prevents it from “returning” into the esophagus. But in this case, when the stomach is full, part of the contents immediately comes out if the baby takes an inclined or horizontal position.

Babies have two more features: increased pressure over the lower esophageal sphincter, as well as a straight and sometimes obtuse angle of His, formed by the side walls of the esophagus and stomach. In adults, this angle is sharp, which also prevents the return of food eaten into the esophagus. nine0003

After feeding, do not put the baby on his stomach, it is better to hold him upright in your arms, trying not to put pressure on his chest. But if he still burps, you should not worry, this is a normal process. If in doubt, please contact our doctors. At a remote consultation, they will explain the causes of regurgitation, talk about pathologies. If necessary, they will tell you which specialists to go through.

A few more reasons why a child often spit up

Physiological belching after feeding is due to two factors: swallowing air (aerophagia) and increased intra-abdominal pressure. The first is usually associated with fast and greedy suckling, improper attachment of the baby to the breast, or the wrong position of the bottle when it comes to artificial feeding. An air bubble forms in the stomach, pushing out a small amount of milk or mixture.

The same results are obtained by a quick change in the position of the baby's body after feeding, which will easily burp if it is immediately started to swaddle, shake, bathe or massage. After all, his stomach resembles an open bottle: tilted / turned over - the contents spilled out. nine0003

As for the increase in intra-abdominal pressure, it increases with a too tight diaper or tight swaddling, as well as against the background of increased gas formation, intestinal colic or stool retention.

Regurgitation in newborns after feeding may be due to the lack of a feeding regimen and overeating.

Baby burps an hour after feeding: what does it mean

The most common cause is constipation, which increases intra-abdominal pressure. Food moves slowly through the gastrointestinal tract, so the child can burp an hour or two after feeding. nine0003

Attention! Delayed regurgitation combined with delayed defecation may be a sign of a lazy stomach. But such a diagnosis should be made by a doctor.

5 causes of regurgitation in newborns after formula feeding

The selection of artificial nutrition is a purely individual process with an unpredictable result. There is no 100% guarantee that the mixture will suit the child, even if the brand is very popular. nine0003

Poor digestion of the mixture may well cause not only frequent spitting up, but also other digestive problems, including colic, constipation and allergic reactions. In addition, store-bought baby food has a denser texture than breast milk and lasts longer in the stomach. Therefore, the likelihood of its reverse promotion to the esophagus after feeding is higher.

Your baby may spit up after every feed because: nine0003

the proportions of dilution of the mixture are violated;
the feeding regime is not observed;
the transition from breastfeeding to artificial feeding was too abrupt;
the wrong bottle is selected;
allergy.

Misproportioning when diluting the mixture

Each manufacturer indicates on the packaging of the mixture how much water is required to dilute it, and what volume is suitable for the baby by weight and age. Sometimes mothers mistakenly or intentionally dilute food in a way that is not recommended, and the child eats more than normal. As a result, the surplus, of course, comes out. nine0003

Case study:

After 3 months, a breastfed child suddenly began to behave restlessly, sleep poorly, spit up after eating, weight gain became slightly below normal. From a conversation with the mother, the doctor learned that the baby was fed too often, the feeding regimen was not observed. After increasing the intervals between breastfeeding, the regurgitation stopped.

Refusal of night feedings is also undesirable: the daily volume of food is distributed during the daytime, which leads to stomach overload and regurgitation. nine0003

Feeding schedule not followed

Unlike natural, artificial feeding involves eating by the hour.

Baby food takes longer to digest, so the recommended interval between feedings is at least 3 hours. If you feed the child more often, he will “give out” the excess back, since the previous portion has not yet been absorbed.

Abrupt transition from breastfeeding to artificial feeding

nine0002 When changing the diet, the child's body must first get used to, adapt to the new food. This applies not only to the transition from breastfeeding to artificial feeding, but also from one type of mixture to another.

Wrong bottle selected

This refers to the too wide neck of the container, because of which the child swallows a lot of air along with food. Its discharge will provoke regurgitation after feedings.

Allergy

nine0002 An allergic reaction to cow's milk protein causes inflammation of the intestinal wall, which in turn leads to malabsorption. Carbohydrate metabolism worsens, since secondary lactase deficiency occurs against the background of an inflammatory reaction - a decrease in the synthesis of the lactase enzyme.

As a result, sugar is broken down incorrectly, increased gas formation occurs, and the baby spits up a fountain. In addition, the baby may feel discomfort at the beginning of feeding and react with an increase in nervous excitability during the period of increased intestinal motility. This also often leads to belching. nine0003

What does curd spitting up mean

Belching with curdled milk after feeding only indicates that the food was in the stomach for some time and managed to curdle - it was fermented. The reason may be in a change in body position or indicate pyloric stenosis with profuse vomiting with a fountain.

Attention! When spouting against the background of pyloric stenosis, the child spits up profusely, the jet scatters to a distance of half a meter. nine0003

What to do

First you need to make sure that you really need to do something. Pediatricians are advised to determine the intensity and frequency of regurgitation on a five-point scale.

nine0120

Points	Regurgitation frequency	Volume nine0111
1	No more than 5 per day	Not more than 3 ml
2	> 5 times a day	> 3 ml
3	> 5 times a day	> 0.5 volume of food eaten
four	After every feeding	Small amount over 30 minutes or more nine0003
five	At least half of the meals are accompanied by regurgitation	> 0.5 volume of food eaten

Now you can determine if there really is a problem. The criteria are:

the baby is not yet a year old; nine0046
he spits up 2 times a day for 3 weeks or longer;
before burping there are no precursors, specific signs;
during regurgitation, the tension of the anterior abdominal wall is not felt;
there are no difficulties with swallowing, sucking, the child does not take any specific forced position;
the baby does not begin to sweat a lot, turn pale after burping, and feels normal; nine0046
he is active, has a good appetite, and is gaining weight appropriately for his age.

The above points indicate that everything is in order.

If the intensity and frequency of spitting up is 3 points or more, this is a reason to consult a doctor. Our doctors are ready to advise on all issues at any time of the day. At a remote consultation, possible causes will be identified, and a plan of further action will be drawn up. nine0003

How parents determine the amount of rejected food

Normal regurgitation after feeding occurs in small volumes, within 1-2 tablespoons. You can determine how much food came out when you burp.

When the child burps into the diaper, you need to pour 1 tbsp nearby. l. water and compare the size of the spots. If they are almost the same, there is no reason to worry.

Alarm symptoms

Medical assistance is necessary if the child spits up a lot after feeding, while crying and acting up. A bad symptom is the requirement of supplementary feeding, that is, the baby remains hungry after he has eaten his portion.

Serious illnesses can present with symptoms such as:

sudden weight loss, weight gain does not meet the standards;
lack of stool;
urination less than 8-10 times a day;
continued spitting up after the child is one year old.

How to deal with regurgitation: a step-by-step guide

If the baby is spitting up after feeding breast milk or formula, you can start with a nutritional correction. When breastfeeding, it is important to ensure that the baby completely captures the nipple along with the areola. His lower lip is usually slightly twisted. nine0003

Step 1

It is better to feed the baby while sitting, holding the baby at an angle of 45-60 ° to the chest. In this position, the air freely leaves the stomach, due to which the likelihood of reflux of food into the esophagus is reduced. After eating, it is preferable to put it on its side in a crib: this way, when returning from the stomach, the masses will not enter the respiratory tract. If the child burped while lying on his back, you should lift him up and turn him face down.

Step 2

After the baby has eaten, it must be held upright (pose of a soldier) for at least 20 minutes. nine0003

Step 3

You can partially remove the air from the stomach before feeding, putting the baby on the stomach for 10-15 minutes. With a tendency to intestinal colic, a light massage of the abdomen, which is done in between meals, will help.

Step 4

Even if the child is constantly spitting up, this is not a reason to transfer him to artificial mixtures. But a clear feeding regimen is desirable after a more or less strict period of time. In addition, mom should follow a hypoallergenic diet and exclude foods that can provoke flatulence - cabbage, legumes, black bread. nine0003

Step 5

For artificial babies, it is preferable to use a special anti-colic bottle and a nipple with a special design. The bottle has a valve that prevents you from swallowing air while eating. It is also necessary to make sure that the milk does not flow like a river, but slowly drips, that is, the hole in the nipple must have the appropriate diameter.

Step 6

When buying a mixture for a spitting up baby, it is better to consult a pediatrician. He may recommend a hypoallergenic formula or a formula that does not contain bovine protein. For some children, the so-called anti-reflux mixture is suitable. nine0003

Step 7

Normally, complementary foods are introduced from the 4th month of a child's life, but in the presence of regurgitation, it is allowed to include food thickeners in the diet after the 1st month. It can be mixtures with rice flour, rice porridge without milk. But they are used in an amount of a maximum of 1 tsp. in one feeding.

Pitch 8

Do not swaddle too tightly, massage, and generally somehow disturb the child after eating. You can only lightly pat him on the back, putting him on his knees, to prevent spitting up. nine0003

Step 9

Is the child overeating? To check this, you just need to weigh it before feeding and after. And it does not matter what he eats - mother's or artificial milk.

FAQ

What symptoms should you call an ambulance for?

If, after spitting up, the child does not breathe or has lost consciousness; lips and face take on a bluish tint; reflux - gastric contents - has a green or brownish color, which may indicate intestinal obstruction, gastric bleeding. nine0003

Why does a baby spit up breast milk, but formula does not?

If everything is in order with the calculation of “doses”, and there is no overfeeding with breast milk, most likely it is lactose intolerance. To clarify the diagnosis, it is necessary to take tests.

Should I supplement my baby if he burps?

No, by no means.

What complications can regurgitation cause? nine0003

Lack of weight gain and even weight loss are the most harmless consequences. With a long-term existence of the problem, 15% of children have a developmental delay, however, only in the physical. Insufficient digestion of food leads to anemia, vitamin deficiency and an increased risk of aspiration pneumonia when inhaled gastric masses.

Expert opinion

If the baby spit up after feeding, this is completely normal in the absence of alarming symptoms. In case of profuse regurgitation, insufficient weight gain, restless behavior, the baby should be shown to the pediatrician. nine0003