Baby throws up after bottle feeding

Baby Vomiting After Feeding Formula: Causes and Treatment

Your little one is happily gulping their formula while cooing at you. They finish off the bottle in no time flat. But shortly after feeding, it seems to all come out as they vomit.

There are several reasons why your baby might be vomiting after a formula feeding, but it’s important to remember that it can be — and often is — very normal.

It’s common for babies to throw up sometimes after feeding on formula or breast milk. Their shiny new digestive systems are still learning what to do with all the yummy milk coming down into their tummy.

However, if your baby often has a hard time keeping their formula down on a regular and frequent basis, let your pediatrician know.

Having a baby around means getting used to soft mushy stuff coming out fairly often. This includes spit-up and vomit.

Spit-up and vomit might seem pretty much the same — and require similar amounts of cleaning to get them off of your sweater and the sofa — but they’re very different. Spitting up is an easy, gentle dribble of milk. Baby may even smile at you as the curd-like spit-up flows from their mouth.

Spit-up is normal in healthy babies, especially if they’re under the age of 1.

On the other hand, vomit takes more effort, as it comes from deeper in your little one’s stomach. It’s a sign that your baby’s stomach is saying nope, not now, please. You might see your baby strain and recoil just before they projectile vomit. This force happens because vomit is squeezed out by the stomach muscles.

Your baby might also look more uncomfortable during and after vomiting. And vomit looks and smells different. This is because it’s usually formula, breast milk, or food (if your baby is eating solids) mixed with stomach juices.

If you’re not sure whether your baby is vomiting or spitting up, look for other vomiting symptoms, like:

crying
gagging
retching
turning red
arching their back

That said, there doesn’t seem to be agreed-upon definitions of these two terms among healthcare providers, caregivers, and others. Plus, their symptoms may overlap. For example, spitting up may sometimes be forceful, and vomiting may sometimes seem painless.

Overfeeding

It’s easier for your baby to overfeed when they’re drinking from a bottle than when they’re breastfeeding. They can also gulp down milk faster from a bottle and rubber nipple. What’s more, because formula is always available, it’s easier for you to give them more milk than they need by accident.

Babies have tiny stomachs. A 4- to 5-week-old infant can only hold about 3 to 4 ounces in their tummy at a time. This is why they need lots of smaller feedings. Drinking too much formula (or breast milk) in one feeding can overfill your baby’s stomach, and it can only come out one way — vomit.

Not burping properly

Some babies need to be burped after every feeding because they swallow lots of air as they gulp down milk. Bottle feeding your baby breast milk or formula may lead to more air-swallowing, as they can gulp even faster.

Too much air in the stomach can make your baby uncomfortable or bloated and trigger vomiting. Burping your baby right after feeding them formula may help prevent this.

To help prevent your baby from swallowing too much air and vomiting after formula feeding, check your baby’s bottle. Make sure you’re using a smaller bottle that’s just big enough to hold a few ounces of milk. Also, check to make sure the nipple hole is not too big, and don’t let your baby continue gulping when the bottle is empty.

Baby or infant reflux

Baby can have acid reflux, indigestion, or occasionally gastroesophageal reflux disease (GERD just like grown-ups! This happens because their stomach and food tubes are still getting used to holding down milk.

Baby reflux happens when milk travels back up toward your baby’s throat and mouth. This usually just causes some painless spitting up, but it can irritate your baby’s throat and trigger gagging and vomiting.

Sometimes, smaller feedings can help prevent baby reflux. If not, don’t worry! Most little ones outgrow baby reflux by the time they’re 1 year old.

Constipation

While simple constipation would be an uncommon cause of vomiting in an otherwise healthy infant, sometimes baby vomiting happens because of what isn’t happening at the other end.

Most babies who are formula-fed need to poop at least once a day. Anything less than your baby’s typical pattern, though, might indicate they’re constipated.

If your baby is vomiting after a formula feeding, they might be constipated if they have other symptoms, including:

gassiness
not pooping for longer than 3–4 days
a swollen or bloated stomach
a firm or hard stomach
crying bouts or irritableness
straining very hard but not pooping or pooping only a little
small, hard pellet-like poop
dry, dark poop

Stomach bug

If your baby doesn’t usually vomit after having formula, they might have a stomach bug. Also known as gastroenteritis or the “stomach flu,” a stomach bug is a very common cause of vomiting in babies. Your little one may vomit several times for up to 24 hours.

Other symptoms of a stomach bug include:

crying
stomach cramps
stomach rumbling
bloating
diarrhea or watery poop
mild fever (or none at all in babies)

Allergy

In rare cases, the cause of your baby’s vomiting might be in the formula. Although it’s uncommon for babies to be allergic to cow’s milk, it may happen to up to 7 percent of babies under the age of 1.

Most children outgrow a milk allergy by the time they’re 5 years old, but it can cause vomiting and other symptoms in babies. A cow’s milk allergy might cause vomiting right after your baby eats. It can also cause vomiting and other symptoms hours or rarely days later.

If your baby has an allergy to milk or something else, they might have other symptoms of an allergic reaction, like:

skin rash (eczema)
diarrhea
cough
hives
difficulty breathing
wheezing

Lactose intolerance

An allergy to milk is different than being lactose intolerant. Lactose intolerance usually causes digestive symptoms like diarrhea. It can also make your baby vomit after drinking formula containing cow’s milk.

Your baby might get temporary lactose intolerance after getting a tummy bug or gastroenteritis, although this is uncommon.

Other symptoms include:

diarrhea or watery poops
constipation
bloating
gassiness
stomach pain
stomach rumbling

Note that lactose intolerance is rare in babies under the age of 1.

Other causes

Some common health conditions can cause vomiting at any time, including after breastfeeding or formula feeding. Some rare genetic conditions can also cause vomiting in babies.

Other causes of vomiting in babies include:

colds and the flu
ear infections
some medications
overheating
motion sickness
galactosemia
pyloric stenosis
intussusception

In most cases, minor tweaks can help stop your baby’s vomiting. Remedies to stop your baby’s vomiting after formula depend on what’s causing it. Try some of these tried and tested methods to see what helps your baby:

feed your baby smaller amounts of formula more often
feed your baby slowly
burp your baby after the feeding
hold your baby’s head and chest up while feeding
hold your baby upright after a feeding
make sure your baby doesn’t move around or play too much right after a feeding
try a smaller bottle and smaller-hole nipple to feed
check the ingredient list on your baby’s formula
ask your baby’s doctor if you should try a different kind of formula
talk to your baby’s doctor about a possible allergic reaction
dress your baby in looser clothing
make sure their diaper isn’t on too tightly

If your baby has the stomach flu, you’ll both usually just have to ride it out for a day or two. Most babies and children with a stomach bug don’t need treatment.

If your baby is vomiting, see your doctor or pediatrician right away if they:

are vomiting often
are vomiting forcefully
aren’t gaining weight
are losing weight
have a skin rash
are unusually sleepy or weak
have blood in their vomit
have green bile in their vomit

Also, see your doctor urgently if your baby has any sign of dehydration from all the vomiting:

dry mouth
crying without shedding tears
a weak or quiet cry
floppiness when picked up
no wet diapers for 8 to 12 hours

It’s pretty common for babies to vomit, especially after feeding. This happens for many reasons, including that these little people are still just getting used to keeping down their milk.

Check with your doctor about what you can do. See your doctor urgently if your baby vomits often for any reason.

Tell the Difference Between Baby Spit-up or Vomit

One’s normal, one’s not—which is which? Get the lowdown on spit-up

Your baby just spit up. Or maybe vomited. You’re not sure which it was or whether you should be worried. Baby spit-up isn’t usually an issue.

Also known as reflux, spit-up is simply the flow of food from your little one’s stomach to their mouth.

It’s common, not painful, and might happen from time to time until your baby is about a year old. Baby spit-up is often just the result of a still-developing digestive system or overfeeding.

The difference between spit-up and vomit is outlined below. If you have further questions or concerns, contact your healthcare provider. 

What is spit-up?

Spitting up is a common occurrence in healthy infants early in life. This is partly because of immaturity of their digestive system. It’s relatively harmless and usually resolves as the digestive system matures, when your baby reaches 12 to 14 months of age.   

Spit-up is sometimes called by other terms like “regurgitation” and “gastroesophageal reflux.” They’re just fancier ways of saying spit-up, with a minor difference. Regurgitation and reflux refer to the backwards movement of the stomach (gastric) contents up into the esophagus—and at times into the mouth. When the contents of your baby’s tummy spill out of their mouth, it’s called spit-up.

 Why do babies spit up? 

At birth, your baby’s tummy is about the size of a small marble. After 3 days, it is about the size of a ping-pong ball, but still can’t hold much.¹ Until they are about 4 months old, most babies’ tummies can hold only small amounts of milk at a time. Too much milk during feedings can cause your baby to spit up or be fussy. 

Babies also have less developed muscles in the upper esophagus, which makes it easier for fluids to flow back up from the stomach. 

Spitting up can also happen when your baby burps (called a wet burp) or swallows too much air. It isn’t painful to your baby, and most babies don’t even realize they have done it.

As long as your baby is healthy and gaining weight, spit-up should be seen as just a normal part of infancy.

How much spit-up is normal? 

It may look like a lot when it’s on your shirt, but the amount of liquid your baby spits up isn’t as much as you think. Usually, it’s just 1 or 2 tablespoons at a time. If your baby spits up more than this—or if their spitting up is the effect of respiratory events like choking, coughing, or wheezing—ask your pediatrician if there is a reason to be concerned. 

How can you lessen spit-up?

To help your baby spit up less often, here are a few things you can try: 

Hold baby in a more upright position while feeding 
Burp baby after every 1 to 2 ounces while feeding 
If you bottle-feed your baby, make sure the hole in the bottle's nipple is not too large. If milk drips out when you turn the bottle upside down, replace the nipple with a smaller one 
Keep your baby upright after eating. Laying them flat on a full stomach can lead to spit-up 
Avoid too much activity for your baby immediately after eating 
Feed your baby less food, but more often

How much and how often to formula feed 

Your newborn will probably be hungry 6 to 10 times in a 24-hour period. As a baby grows, so does their stomach, so your baby should begin to eat more at each feeding and eat less often, as the chart below shows.

Number and volume of feedings during the first year

^2-4

Age	Average number of feedings per day	Average amount per feeding
Birth to 1 week	6–10	2-3 fl oz
1 week to 1 month	7–8	2-4 fl oz
1 to 3 months	5–6	4-5 fl oz
3 to 6 months	4–5	6-7 fl oz
6 to 9 months	3–4	7-8 fl oz
9 to 12 months	3	7-8 fl oz

The best way to feed your baby is to allow them to take as much as they seem to need. If your baby's fussy and has not been fed in more than 2 hours, it is probably time for a feeding. 

How is baby spit-up different than vomit?

When spitting up begins to make your baby uncomfortable, and more liquid than usual comes up with greater force, this is probably vomit. When a baby vomits more than once, it’s usually caused by a virus. Viruses usually aren’t dangerous, but they can cause your little one to get dehydrated. If your baby is less than 1 year of age, they are at more risk for dehydration. Consult your healthcare professional immediately if you think your baby might be dehydrated. 

How can you tell if your baby is dehydrated, and how can you help?

When your baby has a sudden bout of vomiting along with diarrhea, it usually means they have a virus. A virus usually isn’t dangerous, but it can lead to dehydration, which can be a serious problem. It’s important to know these signs of dehydration in your baby: 

Fewer wet diapers than normal 
Seems very tired or weak 
Has tearless, sunken eyes
Has dry skin and little saliva

The younger your baby, the more concerned you should be about dehydration. There are things you can do to help when your baby is ill. Replace the fluids your baby is losing by giving them small, frequent feedings. In some cases, an oral rehydration solution such as Pedialyte^® may be recommended. Check with your healthcare provider for advice. 

When should you be worried about your baby vomiting? 

Although it can be alarming, an occasional vomiting episode is usually nothing to worry about. However, if your baby vomits often, this can be a sign of reflux disease, intestinal obstruction, infection, or a protein allergy. Get in touch with your pediatrician if your baby's usual spit-up: 

Increases in amount or force 
Causes choking or respiratory difficulty like wheezing or coughing 
Leads to other issues including discomfort, fussiness, poor weight gain, or weight loss 
Is accompanied by a fever, diarrhea, bloody mucus, or a bloated tummy 
Is green
Is “projectile,” meaning very sudden and with great force

Repeated vomiting in babies between 2 weeks and 4 months of age can be a sign of a blockage at the stomach. Contact your healthcare professional if your baby vomits repeatedly. 

Would switching baby formulas help with baby’s tummy troubles?

Consult your pediatrician before changing your baby’s formula.

Similac^® offers several easy-to-digest formulas designed to be gentle on your baby’s tummy. For help choosing a formula, check out our Tummy Trouble Tool.

Questions about formula feeding? See our Frequently Asked Questions.

References: 1. Spangler AK, et al. J Hum Lact. 2008;24(2):199-205. 2. Behrman RE, et al. Nelson Textbook of Pediatrics. 16th ed. Philadelphia: WB Saunders Co; 2000:165. 3. Samour PQ, et al. Handbook of Pediatric Nutrition. 3rd ed. Sudbury, MA: Jones and Bartlett Publishers; 2005:90. 4. Fomon SJ. Infant Nutrition. 2nd ed. Philadelphia: WB Saunders Co; 1974:24. 

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Why does the baby spit up after feeding?

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Regurgitation is a common condition in newborns and infants and is most often a normal variant. However, it is not uncommon for parents to worry if their baby is spitting up frequently, believing that it is due to nutritional or health problems in general. Sometimes these fears are not unfounded, and regurgitation really has a pathological origin. What is its cause and when should you really consult a doctor about this?

Regurgitation - Return of a small amount of food (uncurdled or partially curdled milk) from the stomach up the digestive tract: into the esophagus and further into the oral cavity. According to statistics, at least 1 time during the day, at least 50% of babies from 0 to 3 months old can spit up, more than 60% of children 3-4 months old, and in 5% of children spit up continues up to the year ¹.

Regurgitation in newborns is considered a physiological process. It is caused by a number of factors, including:

Features of the structure of the upper digestive tract in babies
In newborns and infants up to a year of life, the stomach has a spherical shape. It holds a small amount of food, besides, the release from it into the duodenum is slower in comparison with children after the year ².
Weakness of the lower esophageal sphincter that separates the esophagus from the stomach
Normally, the lower esophageal sphincter should tightly "close" the esophagus, allowing food to pass into the stomach and not allowing it to enter back into the upper digestive tract. However, in young children (up to a year), the muscles of the esophageal sphincter are poorly developed, and it does not do its job very well ² .
Slow movement of food through the gastrointestinal tract
The neuromuscular system of newborns is immature. It does not ensure the proper movement of food through the esophagus, causing regurgitation.

One of the important risk factors contributing to regurgitation in newborns is aerophagia. This is the swallowing of large amounts of air during feedings. This happens when the baby is not properly attached to the breast, the mother has a lack of breast milk, or the bottle is in the wrong position in the child who receives the mixture. The size of the opening in the nipple also matters - if it is too large, the newborn swallows a lot of air ³ .

With aerophagia, the baby becomes capricious, restless immediately after feeding. Noticeable bloating. If the baby spits up immediately after a feed, the milk (or formula) remains practically fresh, uncurdled ³ .

Promotes regurgitation after feeding and a predominantly horizontal position of the baby during the day, combined with relatively high intra-abdominal pressure ⁴ . Therefore, the correct position of the baby after feeding is so important. To avoid regurgitation of an excessive amount of stomach contents, after feeding, it is necessary to hold the baby in an upright “column” position for some time (10-20 minutes), lightly patting on the back and allowing excess air to “exit”.

Regurgitation in many newborns can be provoked by other situations in which pressure in the abdominal cavity increases and stomach contents are thrown into the esophagus, in particular ³ :

tight swaddling;
stool disorders, in particular constipation;
long, forced cry and some others.

Want to avoid common feeding problems?

Start with a baby bottle with an anti-colic system that helps you avoid common feeding problems such as colic, gas and spitting up*

How can you tell the difference between normal spitting up and vomiting?

Sometimes regurgitation is considered a manifestation of disorders in the digestive tract of children. Due to the constant reflux of acidic stomach contents into the upper sections, inflammation and other complications may develop, including growth retardation, a decrease in hemoglobin levels, and others. Therefore, it is important for parents to understand where the line is between physiological and pathological regurgitation ¹ .

If the mother is worried that her baby is spitting up, keep track of when this happens and count the total number of spit ups per day. Normally, regurgitation usually occurs after eating (the child burps after each feeding), lasts no more than 20 seconds and repeats no more than 20-30 times a day. With pathology, the problem manifests itself at any time of the day, regardless of when the baby was fed. Their number can reach 50 per day, and sometimes more ¹ .

The amount of discharge during regurgitation also matters. With normal, physiological regurgitation, it is approximately 5 - 30 ml. If this volume fluctuates between 50 and 100 ml, it is already defined as profuse vomiting. When the range of the jet of vomit is up to 50 cm, doctors talk about "vomiting a fountain." A variant of atonic vomiting is possible, when the contents of the stomach flow "sluggishly". It occurs with atony of the stomach (decrease in muscle tone of the stomach wall) and disruption of the esophagus ¹ .

Vomiting in babies is a warning sign. Doctors are especially alarmed by repeated vomiting, a fountain, with an admixture of bile, in combination with constipation. Vomiting can lead to the development of dehydration, acid-base imbalance and other consequences, therefore, if it occurs, you should urgently contact a pediatrician to find out the cause and begin treatment. A doctor's consultation is necessary if the child is spitting up a lot (more than 15-30 ml at a time), with a frequency of more than 50 episodes per day ^1.3 .

Physiological regurgitation: symptoms

Regurgitation in newborns, which is considered a normal variant and does not cause concern to pediatricians ³ :

usually continues for a certain period of time;
is characterized by slow, "passive" leakage; if the baby spits up a fountain, it is better to consult a doctor;
has a sour smell of curdled milk;
occurs without the participation of muscles - the baby does not strain during regurgitation;
does not affect the general well-being of the baby.

How to help a newborn who spit up often?

If the baby is healthy, no medication is prescribed for spitting up. To help the child allow simple measures based on lifestyle changes and feeding.

Frequent feeding of the baby
It is known that the baby is more prone to spit up if his stomach is full. To improve the situation, it is recommended to feed the baby more often, avoiding oversaturation, best of all - on demand ⁵ .

Correct feeding technique
Every feeding, the mother must ensure that the baby does not swallow too much air during suckling. When sucking, there should be no loud, smacking, clicking sounds. You also need to control that the baby captures the nipple along with the areola.

Choosing the right bottle and nipple
If the newborn is bottle-fed and receiving formula, it is important to choose the right bottle and nipple. The hole in it should be such that the milk flows out in drops, and not in a stream. The nipple must not be filled with air
New Anti-colic bottle with AirFree valve

The AirFree valve prevents air from entering the baby's stomach.
- Baby standing upright after eating
To allow air that has entered the digestive tract during meals to escape, it is important to keep the newborn upright for 10-20 minutes after feeding ⁴ .
- Ensure the correct position of the baby during sleep
To reduce the negative impact of the acidic contents of the stomach on the esophagus, it is necessary to put the baby to sleep in the supine position. The side or prone position, which many pediatricians used to recommend, is no longer recommended. It was found to be associated with an increased risk of sudden infant death syndrome ⁵ .

If parents notice alarming symptoms, such as spitting up too often or large volume, etc. , it is important to consult a pediatrician without delay. This will allow you to identify the real problem in time and help the baby grow up healthy and happy.

References
¹ Zakharova I. N., Andryukhina E. N. Regurgitation and vomiting syndrome in young children // Pediatric pharmacology, 2010. V. 7. No. 4.

Nagornaya 2900 V., Limarenko M. P., Logvinenko N. G. Experience with the use of domperidone in suspension in young children with regurgitation syndrome // Child Health, 2013. No. 5 (48).

³ Zakharova IN Regurgitation and vomiting in children: what to do? //Pediatrics. Supplement to Consilium Medicum, 2009. No. 3. S. 58-67.

⁴ Zakharova I. N., Sugyan N. G., Pykov M. I. Regurgitation syndrome in young children: diagnosis and correction // Effective pharmacotherapy, 2014. No. 3. P. 18-28.

⁵ Vandenplas Y. et al. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) //Journal of pediatric gastroenterology and nutrition. 2009; 49(4): 498-547.

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Why do newborns spit up? | Philips Avent
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Home ›› Why is my baby spitting up and how can I help him?

Home ›› Why does my baby spit up and how can I help him?

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Whether it's your first or third baby, you're bound to have questions about feeding. Reflux (spitting up) is a common topic among frequently discussed feeding topics, so you are not alone in finding the answer to the question “Why does my baby spit up so often?”.

So why do babies spit up? And is spitting up normal for babies? You have probably thought about this many times. After reading this article, you will receive important information that will explain the causes of infant spitting up, and you will learn how to act to help the child.

If you have any questions or your child has other symptoms, be sure to contact your doctor.

Why do babies spit up and when is it normal?

Let's look at why babies spit up and answer the frequently asked question "Why does my baby spit up so much?". Many newborns spit up after feedings or when burping because their digestive tract is not yet fully developed. However, in some situations, the likelihood of regurgitation in infants increases.

So what causes reflux in babies? The following are some of the main causes of regurgitation in infants: ¹
- The child has moved.
- The child was eating too fast.
- You help your baby spit up air, and with the air, the baby spit up part of the food.
- The child has too much air in the stomach.
- The child has excessive salivation.
So is spitting up normal in infants? In simple words: spitting up after some feeds, or even after each, is absolutely normal for a growing baby. However, there are points that need to be noted in order to distinguish ordinary regurgitation from vomiting. The two processes are very different, so you should check with your doctor if your baby is vomiting heavily after every or most feeds.

Also seek medical attention if your child has the following symptoms, which a doctor can help identify: ²
- The child spit up frequently, does not gain enough height or weight.
- Appears to be in pain, cries a lot, or arches his back.
- Coughing or difficulty breathing, which may be a symptom of gastroesophageal reflux disease.
- Regurgitates even if he hasn't eaten anything.
- There is severe vomiting.
- Fever or diarrhea, which may be a sign of an intestinal infection and lead to dehydration.
If your baby spit up a small amount of milk after a feed and continues to grow and stay healthy, rest assured that this is normal and nothing to worry about. If you have any questions about reflux in infants, check out this article to learn about the symptoms of reflux and how to deal with it!

What to do

Now that you know that spitting up is a normal physiological process and what causes it, you are probably wondering what you can do to help your baby. After you have consulted with your pediatrician and he has determined that spitting up is not a cause for concern, there are a few things you can do to help you when you are confused: ¹

1. Regular belching of air.

In addition to burping after feedings, try helping your baby burp when changing breasts. And when feeding from a bottle, try to have the child spit up air every 30-60 ml of the mixture. Consider using an anti-colic bottle with an AirFree valve. The AirFree valve prevents air from entering the nipple even when the bottle is in a horizontal position and the nipple remains completely filled with milk. The use of such a bottle will allow your baby to drink in an upright position, which will reduce the frequency of reflux, improve the digestion process and make the feeding process more comfortable for both you and the baby. Find out more about Philips Avent anti-colic bottles with AirFree valve here.

3. Avoid vigorous movement after feeding.

To avoid regurgitation after a feed, it is best to refrain from any bouncing, swaying or active play until the milk has been digested better.

4. Keep your baby's head up while feeding.

When you're trying to find the right feeding position that's comfortable for both your baby and you, try to avoid a position where your baby's head is down. In other words, it is necessary to ensure that in the process of feeding the head of the child is above the level of his legs.

5. Raise the mattress at the head of the bed

It is a good idea to roll up some towels or blankets and place them under the mattress (but not on top of the mattress) in the crib. Make sure that only the headboard is raised and that there are no creases in the middle of the mattress. There should be a very slight slope from which the baby will not slip.

It's a natural process

If you ever ask yourself the question "Why is my baby spitting up?" just remember that spitting up is a completely natural, sometimes troublesome process that is part of parenthood. There are various reasons for spitting up in babies, but if your baby looks calm after a feed and is actively developing, you have nothing to worry about. In truth, spitting up is more of a problem for the parents than for the child himself, who may not even notice it.
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