Baby vomiting 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.

Vomiting (0-12 Months)

Is this your child's symptom?

Vomiting (throwing up) stomach contents
Other names for vomiting are puking, barfing and heaving

Causes of Vomiting

Viral Gastritis. Stomach infection from a stomach virus is the most common cause. Also called stomach flu. A common cause is the Rotavirus. The illness starts with vomiting. Watery loose stools may follow within 12-24 hours.
Food Allergy. Vomiting can be the only symptom of a food reaction. The vomiting comes on quickly after eating the food. Uncommon in infants, but main foods are eggs and peanut butter.
Coughing. Hard coughing can also cause your child to throw up. This is more common in children with reflux.
Serious Causes. Vomiting alone should stop within about 24 hours. If it lasts over 24 hours, you must think about more serious causes. An example is a kidney infection. A serious cause in young babies is pyloric stenosis. See below for more on this.

Pyloric Stenosis (Serious Cause)

The most common cause of true vomiting in young babies.
Onset of vomiting is age 2 weeks to 2 months
Vomiting is forceful. It becomes projectile and shoots out.
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.

Vomiting Scale

Mild: 1 - 2 times/day
Moderate: 3 - 7 times/day
Severe: Vomits everything, nearly everything or 8 or more times/day
Severity relates even more to how long the vomiting goes on for. At the start of the illness, it's common for a child to vomit everything. This can last for 3 or 4 hours. Children then often become stable and change to mild vomiting.
The main risk of vomiting is dehydration. Dehydration means the body has lost too much fluid.
The younger the child, the greater the risk for dehydration.

Dehydration: How to Tell

The main risk of vomiting is dehydration. Dehydration means the body has lost too much water.
Vomiting with watery diarrhea is the most common cause of dehydration.
Dehydration is a reason to see a doctor right away.
Your child may have dehydration if not drinking much fluid and:
The urine is dark yellow and has not passed any in over 8 hours.
Inside of the mouth and tongue are very dry.
No tears if your child cries.
Slow blood refill test: Longer than 2 seconds. First, press on the thumbnail and make it pale. Then let go. Count the seconds it takes for the nail to turn pink again. Ask your doctor to teach you how to do this test.

When to Call for Vomiting (0-12 Months)

Call 911 Now

Can't wake up
Not moving
You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

Dehydration suspected. No urine in over 8 hours, dark urine, very dry mouth and no tears.
Stomach pain when not vomiting. Exception: stomach pain or crying just before vomiting is quite common.
Age less than 12 weeks old with vomiting 2 or more times. Exception: normal spitting up.
Vomited 3 or more times and also has diarrhea
Severe vomiting (vomits everything) more than 8 hours while getting Pedialyte (or breastmilk)
Head injury within the last 24 hours
Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
Vomiting a prescription medicine
Fever over 104° F (40° C)
Fever in baby less than 12 weeks old. Caution: Do NOT give your baby any fever medicine before being seen.
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

All other infants (age less than 1 year) with vomiting. See Care Advice while waiting to discuss with doctor.

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 Vomiting

What You Should Know About Vomiting:
- Most vomiting is caused by a viral infection of the stomach.
- Vomiting is the body's way of protecting the lower gut.
- The good news is that stomach illnesses last only a short time.
- The main risk of vomiting is dehydration. Dehydration means the body has lost too much fluid.
- Here is some care advice that should help.
Formula Fed Babies - May Give Oral Rehydration Solution (ORS) for 8 Hours:
- If vomits once, give half the regular amount of formula every 1 to 2 hours.
- If vomits formula more than once, offer ORS for 8 hours. If you don't have ORS, use formula until you can get some.
- ORS is a special fluid that can help your child stay hydrated. You can use Pedialyte or the store brand of ORS. It can be bought in food stores or drug stores.
- Spoon or syringe feed small amounts. Give 1-2 teaspoons (5-10 mL) every 5 minutes.
- After 4 hours without throwing up, double the amount.
- Return to Formula. After 8 hours without throwing up, go back to regular formula.
Breastfed Babies - Reduce the Amount Per Feeding:
- If vomits once, nurse half the regular time every 1 to 2 hours.
- If vomits more than once, nurse for 5 minutes every 30 to 60 minutes. After 4 hours without throwing up, return to regular nursing.
- If continues to vomit, switch to pumped breastmilk. (ORS is rarely needed in breastfed babies. It can be used if vomiting becomes worse).
- Spoon or syringe feed small amounts of pumped milk. Give 1-2 teaspoons (5-10 mL) every 5 minutes.
- After 4 hours without throwing up, return to regular feeding at the breast. Start with small feedings of 5 minutes every 30 minutes. As your baby keeps down the smaller amounts, slowly give more.
Pumped Breastmilk Bottle-Fed Infants - Reduce the Amount per Feeding:
- If vomits once and bottle-feeding breastmilk, give half the regular amount every 1-2 hours.
- If vomits more than once within last 2 hours, give 1 ounce (30 mL) every 30 to 60 minutes.
- If continues to vomit, give 1-2 teaspoons (5-10 mL) every 5 minutes. Only if not tolerating breastmilk, switch to ORS (e. g., Pedialyte) for every 5 minutes for a few hours.
- After 4 hours without vomiting, return to regular feedings. Start with 1 ounce (30 mL) every 30 minutes and slowly increase as tolerated.
Stop All Solid Foods:
- Avoid all solid foods and baby foods in kids who are vomiting.
- After 8 hours without throwing up, gradually add them back.
- If on solid foods, start with starchy foods that are easy to digest. Examples are cereals, crackers and bread.
Do Not Give Medicines:
- Stop using any drug that is over-the-counter for 8 hours. Reason: Some of these can make vomiting worse.
- Fever. Mild fevers don't need to be treated with any drugs. For higher fevers, you can use an acetaminophen suppository (such as FeverAll). This is a form of the drug you put in the rectum (bottom). Ask a pharmacist for help finding this product. Do not use ibuprofen. It can upset the stomach.
- Call your doctor if: Your child vomits a drug ordered by your doctor.
Try to Sleep:
- Help your child go to sleep for a few hours.
- Reason: Sleep often empties the stomach and removes the need to vomit.
- Your child doesn't have to drink anything if his stomach feels upset and he doesn't have any diarrhea.
Return to Child Care:
- Your child can return to child care after the vomiting and fever are gone.
What to Expect:
- For the first 3 or 4 hours, your child may vomit everything. Then the stomach settles down.
- Vomiting from a viral illness often stops in 12 to 24 hours.
- Mild vomiting and nausea may last up to 3 days.
Call Your Doctor If:
- Vomits clear fluids for more than 8 hours
- Vomiting lasts more than 24 hours
- Blood or bile (green color) in the vomit
- Stomach ache present when not vomiting
- Dehydration suspected (no urine in over 8 hours, dark urine, very dry mouth, and no tears)
- 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: 12/09/2022

Last Revised: 09/21/2022

Why do newborns spit up? | Philips Avent

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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 any of the following symptoms that a doctor can help identify: ²

The child vomits frequently, does not gain enough height or weight.
Judging by external signs, he is 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 spitting up after a feed, it is best to refrain from any bouncing, rocking 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 put 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.

Philips Avent Articles & Tips

New Anti-colic Bottle with AirFree Valve

Designed to reduce colic, gas and spitting up ¹

9005 that the baby is not getting enough milk, do not postpone the visit to the doctor. If the doctor confirms that the baby's spitting up is normal, all you have to do is keep a clean bib ready!

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¹ kidshealth.org - Breastfeeding FAQs: Some Common Concerns Any links to third party websites that may be included on this site are provided solely as a convenience to you. Philips makes no warranties regarding any third party websites or the information they contain.

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Breastfeeding is a very special time for a mother and her newborn baby. Together with the feeling of closeness and affection that feeding brings, understanding its nuances cannot but raise many questions, including the question of how to help an infant spit up.

Regurgitation in a newborn is by no means always the result of a simple pat on his back.

In this article, we'll talk about the basics of helping a newborn spit up, as well as other spit-up-related questions you may have.

Why do babies spit up?

Let's get it straight: Why do newborns need to burp in the first place? During feeding, children usually swallow extra air - this is called aerophagy. Spitting up helps prevent this air from entering the intestines, as well as vomiting, gas, and crankiness in the baby. To avoid the return of milk after feeding, you should give the baby the opportunity to burp more often.

How to help a newborn spit up?

During the first six months, the baby should be kept upright in a column for 10-15 minutes after each feed. This will help keep the milk in his stomach, but if the baby occasionally burps anyway, parents need not worry. While carrying your baby in an upright position, you can put a baby diaper or wipes on your shoulder to keep your clothes clean.

We've already seen why spitting up is important, now let's find out how to help your baby spit up. Parents should gently pat the baby on the back with a hand folded in a handful until he burps. Folding your hand into a handful is important because clapping with a flat palm may be too strong for an infant.

Every baby is different and there is no one right position for spitting up. To get started, you can try the following options:

Sitting position with the baby on the chest. In this position, the parent puts the baby's head with his chin on his shoulder and with one hand supports the baby under the back. With the other hand, you can gently pat the baby on the back. This method is most effective in a rocking chair or when the baby is gently rocking.
Holding the child upright on your legs. With one hand, parents can hold the baby by the back and head, supporting his chin and placing his palm on the baby’s chest, with the other hand, you can gently pat him on the back. At the same time, it is important to be careful: do not press the child on the throat, but only gently support his chin.
Holding a baby lying on his tummy in his lap. Make sure his head is above his chest and gently pat your baby on the back until he burps.

Here are some tips on how best to help your newborn spit up:

Let your baby spit up while feeding. If the baby is restless or has swallowed air, it is worth giving him the opportunity to burp during feeding, and not just after.
When bottle feeding, let the newborn burp after every 50-60 ml.
When breastfeeding, let the baby burp at every breast change.

It is important to let your baby spit up after eating, even if he spit up during feeding!

If your baby is gassy, spit up more often. Also, if he vomits frequently or suffers from gastroesophageal reflux disease (GERD), have him spit up after every 30 ml bottle-feeding or every five minutes while breastfeeding.

How long should a baby be held for it to burp? It's different for everyone, but generally keeping a newborn upright for 15 to 20 minutes after a feed helps the milk stay in the baby's stomach.

Minimize the amount of air you swallow. Gas production and regurgitation result from aerophagia during feeding. The baby will inevitably swallow air, but there are ways to prevent it from swallowing too much. Whether you bottle feed your baby or combine breastfeeding with bottle feeding, the Philips Avent anti-colic bottle with AirFree valve is designed so that the nipple is always filled with milk without excess air, even in a horizontal position, thus preventing the baby from swallowing excess air during feeding.

Reducing the amount of air your baby swallows can help reduce your baby's risk of colic, gas, and spitting up.

Breastfeeding is a wonderful time to strengthen the bond between parent and baby. Every mom and every baby is different, so learning to help your newborn burp properly can take time and practice.