Baby spitting up formula after feeding


Formula Feeding FAQs: Some Common Concerns (for Parents)

Whether you plan to formula feed your baby from the start, want to supplement your breast milk with formula, or are switching from breast milk to formula, you probably have questions.

Here are answers to some common questions about formula feeding.

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

Sometimes, babies spit up when they have eaten too much, burp, or drool.

Many infants will spit up a little after some — or even all — feedings or during burping because their digestive tracts are immature. That's 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. Vomiting is a forceful ejection of stomach contents. Spitting up is a more gentle flow out the mouth or nose.

If you're concerned that your baby is vomiting, call your doctor. Keep a record of exactly how often and how much your baby is vomiting or spitting up. In rare cases, there may be an allergy, digestive problem, or other problem that needs medical care. The doctor should be able to tell you if it's normal or something of concern.

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 your little one drinks 1–2 ounces from a bottle.
  • Don't give the bottle while your baby is lying down, and keep your baby’s head above their feet.
  • Keep your baby upright after feedings for at least 30 minutes. Holding your baby is best. The way your baby sits in an infant seat can make spitting up more likely.
  • Don't jiggle, bounce, or actively play with your baby right after feedings.
  • Make sure the hole in the nipple is the right size and/or flow for your baby. For example, fast-flow nipples can make babies gag or may give them more milk than they can handle at once. Many breastfed babies do well with a slow-flow nipple until they are 3 months old, or even older.
  • 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.

Most babies grow out of spitting up by the time they're able to sit up.

How Do I Know If My Baby Has an Allergy?

Some babies are allergic to the protein in cow's milk formula. Symptoms of an allergic reaction may include:

  • vomiting
  • diarrhea
  • belly pain
  • rash
  • blood or mucus in the baby's poop

If your baby has any of these symptoms, tell your doctor. Also talk to the doctor before switching formulas.

If your baby has symptoms of a severe allergic reaction — like sudden drooling, trouble swallowing, wheezing, or breathing problems — see a doctor right away.

Is Soy Formula Safe for My Baby?

Store-bought iron-fortified soy formula is safe and nutritionally complete. Doctors usually recommend soy-based formulas if:

  • Parents don’t want their babies to eat animal protein. 
  • A baby has congenital lactase deficiency, a rare condition where babies are born without the enzyme needed to digest lactose. Lactose is the main sugar found in cow’s milk.
  • A baby is born with galactosemia, a rare condition where babies can’t digest galactose. Lactose is made up of glucose and galactose. 

Many babies who are allergic to cow's milk also are allergic to the protein in soy formulas, so doctors usually recommend hypoallergenic formulas for these infants.

Soy formula is a good alternative to cow's milk formula for full-term babies (those born at 39 weeks or later). Soy formulas are not recommended for premature babies. Talk to your doctor if you are considering a soy-based formula for your baby.

Do not try to make your own formula at home. Online recipes may look healthy and promise to be nutritionally complete, but they can have too little — or too much — of important nutrients and cause serious health problems for your baby.

Is it OK to Switch to a Different Formula?

It’s probably OK to switch brands of the same kind of formula. For example, parents might buy another brand of cow’s milk formula because it’s on sale or to see if it helps with constipation, or switch to an organic formula because they’re concerned about pesticides.

But before switching formulas, talk to your doctor. Some parents may think that formula plays a part in a baby's fussiness, gas, spitting up, or constipation. But that’s not usually the case. Your doctor can help find out what may be causing these symptoms and recommend the right formula for your baby.

Do I Need to Give My Formula-Fed Baby Vitamins?

No. Commercial infant formulas with iron have all the nutrients your baby needs. Babies who are drinking less than about 1 quart (1 liter) of formula will need a vitamin D supplement.

Does My Baby Need Fluoride Supplements?

Babies do not need fluoride supplements during the first 6 months. Your doctor may recommend fluoride supplements when your baby is 6 months to 3 years old, but only if fluoride is not in your drinking water.

Is it OK to Prop a Bottle in My Baby's Mouth?

Never prop your baby’s bottle. Your baby can choke drinking from a propped bottle. Propping a bottle also can lead to ear infections and tooth decay. Always stay with and hold your baby during feedings.

It is OK to Let My Baby Sleep With a Bottle?

Never put your baby to bed with a bottle. Like propping a bottle, sleeping with a bottle can cause choking, ear infections, and tooth decay.

Reviewed by: Mary L. Gavin, MD

Date reviewed: November 2021

Why Babies Spit Up - HealthyChildren.org

By: Alejandro Velez, MD, FAAP & Christine Waasdorp Hurtado, MD, FAAP

All babies spit up. Some babies spit up more than others, or at certain times.

Typically, babies spit up after they gulp down some air with breastmilk or formula. A baby's stomach is small and can't hold a lot, after all. Milk and air can fill it up quickly.

With a full stomach, any change in position such as bouncing or sitting up can force the flap between the esophagus (food pipe) and stomach to open. And when that flap (the esophageal sphincter) opens, that's when some of what your baby just ate can make a return appearance.

So, what can you do―if anything―to reduce the amount of your baby's spit up? How do you know if your baby's symptoms are part of a larger problem? Read on to learn more.

Common concerns parents have about spit up


My baby spits up a little after most feedings.

  • Possible cause: Gastroesophageal reflux (normal if mild)

  • Action to take: None. The spitting up will grow less frequent and stop as your baby's muscles mature—especially that flap we talked about earlier. It often just takes time.

My baby gulps their feedings and seems to have a lot of gas.

  • Possible cause: Aerophagia (swallowing more air than usual)

  • Action to take: Make sure your baby is positioned properly during feeds. Also be sure to burp the baby during and after feeds. Consider trying a different bottle to decrease your baby's ability to suck in air.

My baby spits up when you bounce them or play with them after meals.

My baby's spitting up has changed to vomiting with muscle contractions that occur after every feeding. The vomit shoots out with force.

I found blood in my baby's spit-up or vomit.


  • Possible cause: Swelling of the esophagus or stomach (esophagitis or gastritis), or another health problem that requires diagnosis and treatment.

  • Action to take: Call you pediatrician right away so they can examine your baby.

Remedies for spitty babies

Regardless of whether or not your baby's spit up warrants watchful waiting or medical intervention, there are some simple feeding suggestions that can help you deal with the situation at hand.

5 tips to reduce your baby's spit up

  • Avoid overfeeding. Like a gas tank, fill baby's stomach it too full (or too fast) and it's going to spurt right back out at you. To help reduce the likelihood of overfeeding, feed your baby smaller amounts more frequently.

  • Burp your baby more frequently. Extra gas in your baby's stomach has a way of stirring up trouble. As gas bubbles escape, they have an annoying tendency to bring the rest of the stomach's contents up with them. To minimize the chances of this happening, burp not only after, but also during meals.

  • Limit active play after meals and hold your baby upright. Pressing on a baby's belly right after eating can up the odds that anything in their stomach will be forced into action. While tummy time is important for babies, postponing it for a while after meals can serve as an easy and effective avoidance technique.

  • Consider the formula. If your baby is formula feeding, there's a possibility that their formula could be contributing to their spitting up. While some babies simply seem to fare better with one formula over another without having a true allergy or intolerance, an estimated 5% of babies are genuinely unable to handle the proteins found in milk or soy formula―a condition called Cow Milk Protein Intolerance/Allery (CMPI and CMPA). In either case, spitting up may serve as one of several cues your baby may give you that it's time to discuss alternative formulas with your pediatrician. If your baby does have a true intolerance, a 1- or 2-week trial of hypoallergenic (hydrolyzed) formula designed to be better tolerated might be recommended by your baby's provider.

  • If breastfeeding, consider your diet. Cow's milk and soy in your diet can worsen spit up in infants with Cow Milk Protein Intolerance/Allergy (CMPI and CMPA). Removing these proteins can help to reduce or eliminate spit up.

  • Try a little oatmeal. Giving babies cereal before 6 months is generally not recommended—with one possible exception. Babies and children with dysphagia or reflux, for example, may need their food to be thicker in order to swallow safely or reduce reflux. In response to concerns over arsenic in rice, the American Academy of Pediatrics (AAP) now recommends parents of children with these conditions use of oatmeal instead of rice cereal. See Oatmeal: The Safer Alternative for Infants & Children Who Need Thicker Food for more information.

Vomit vs. spit up: what's the difference?

There is a big difference between vomiting and spitting up:

Vomiting is the forceful throwing up of stomach contents through the mouth. This typically involves using the abdominal muscles and is often uncomfortable, leaving you with a crying child.

Spitting up is the easy flow of stomach contents out of the mouth, frequently with a burp. Spitting up doesn't involve forceful muscle contractions, brings up only small amounts of milk, and doesn't distress your baby or make them uncomfortable.

What causes vomiting?

Vomiting occurs when the abdominal muscles and diaphragm contract vigorously while the stomach is relaxed. This reflex action is triggered by the "vomiting center" in the brain after it has been stimulated by:

  • Nerves from the stomach and intestine when the gastrointestinal tract is either irritated or swollen by an infection or blockage (as in the stomach bug)

  • Chemicals in the blood such as drugs

  • Psychological stimuli from disturbing sights or smells

  • Stimuli from the middle ear (as in vomiting caused by motion sickness)

Always contact your pediatrician if your baby vomits forcefully after every feeding or if there is ever blood in your baby's vomit.

Remember


The best way to reduce spit up is to feed your baby before they get very hungry. Gently burp your baby when they take breaks during feedings. Limit active play after meals and hold your baby in an upright position for at least 20 minutes. Always closely supervise your baby during this time.

More information


  • How to Keep Your Sleeping Baby Safe: AAP Policy Explained
  • Gastroesophageal Reflux & Gastroesophageal Reflux Disease: Parent FAQs
  • How Much and How Often Should Your Baby Eat

About Dr. Velez

Alejandro Velez, MD, FAAP is a second-year gastroenterology fellow at Cincinnati Children’s Hospital who is interested in practicing general gastroenterology with a focus in motility and functional GI disorders, has a love for medical education at all levels, and harbors a passion for supporting and uplifting those that identify as unrepresented minorities in medicine.

About Dr. Waasdorp


Christine Waasdorp Hurtado, MD, MSCS, FAAP is a member of the American Academy of Pediatrics and the North American Society of Pediatric Gastroenterology Hepatology and Nutrition. She is an Associate Professor of Pediatrics at the University of Colorado School of Medicine and practices in Colorado Springs.

Last Updated
10/5/2022
Source
American Academy of Pediatrics Section on Gastroenterology, Hepatology and Nutrition (Copyright © 2022)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Baby spitting up formula | Nutrilak

11/17/2021