Do you keep feeding after baby spits up
How to Know Whether You Should
Your baby just threw up all the milk they’ve chugged down so far, and you’re wondering if it’s OK to continue feeding. How soon should you feed your baby after vomiting?
It’s a good question — just about every parent has likely pondered this. Spit-up is almost a rite of passage for babies (and parents). Baby vomiting is also common and can happen for many reasons. Most of the causes aren’t serious.
The short answer — because you may have a very fussy baby on your hands and want to get back to them ASAP — is yes, you can usually feed your baby after they vomit all over your favorite sweater, sofa throw, and rug.
Here’s just about everything you need to know about feeding your baby after vomiting.
Baby vomit and spit-up are two different things — and they can have different causes. Spitting up is common in babies under the age of 1 year. It typically happens after feeding. Spit-up is usually an easy flow of milk and saliva that dribbles from your baby’s mouth. It often happens with a burp.
Spit-up is normal in healthy babies. It can happen for several reasons. About half of all babies 3 months and under have a type of acid reflux called infant reflux.
Spit-up from infant reflux is especially bound to happen if your baby has a full stomach. Being careful not to overfeed a bottle-fed infant can help. Spitting up typically stops by the time your baby is a year old.
On the other hand, vomiting is typically a more forceful throwing-up of milk (or food, if your baby is old enough to eat solids). It happens when the brain signals the muscles around the stomach to squeeze.
Vomiting (like gagging) is a reflex action that can be triggered by a number of things. These include:
- irritation from a viral or bacterial infection, like the stomach bug
- pain, such as from a fever, earache, or vaccination
- blockage in the stomach or intestines
- chemicals in the blood, like medicine
- allergens, including pollen; very uncommon in babies under 1 year
- motion sickness, such as during a car ride
- dizziness, which might happen after being twirled around too much
- being upset or stressed
- strong smells
- milk intolerance
Vomiting is also common in healthy babies, but it might mean that your baby has caught a bug or is feeling a bit under the weather.
Too much vomiting can cause dehydration and even weight loss in very serious cases. Milk feeding can help prevent both of these. Offer your baby a feeding after they’ve stopped throwing up. If your baby is hungry and takes to the bottle or breast after vomiting, go right ahead and feed them.
Liquid feeding after vomiting can sometimes even help settle your baby’s nausea. Start with small amounts of milk and wait to see if they vomit again. Your baby might vomit the milk right back up, but it’s better to try than not.
If your little one is at least 6 months old and doesn’t want to feed after throwing up several times, offer them water in a bottle or a spoon. This can help prevent dehydration. Wait a short while and try feeding your baby again.
In some cases, it’s better not to feed a baby right after vomiting. If your baby is throwing up because of an earache or fever, they may benefit from medication first.
Most pediatricians recommend pain medications like infant Tylenol for babies in their first year. Ask your doctor about the best medication and dosage for your baby.
If giving pain medication based on your doctor’s advice, wait about 30 to 60 minutes after doing so to feed your little one. Feeding them too soon might cause another bout of vomiting before the meds can work.
Motion sickness isn’t common in babies under the age of 2 years, but some babies may be more sensitive to it. If your baby vomits from motion sickness, it’s better not to offer a feeding afterward.
You’re in luck if your baby likes to nod off in the car. Wait until you’re out of the car to feed your baby milk.
Baby vomiting can be worrying, but it usually goes away by itself — even if your baby has the stomach bug. Most babies with gastroenteritis don’t need medical treatment. This means that most of the time, you’ll have to bravely wait out your baby’s vomiting.
But sometimes, throwing up is a sign that something’s not right. You know your baby best. Trust your gut and call their doctor if you feel your little one is unwell.
In addition, take your baby to a doctor immediately if they’ve been vomiting for 12 hours or longer. Babies and children can dehydrate quickly from too much vomiting.
Also call your baby’s pediatrician if your baby can’t hold anything down and has signs and symptoms of being unwell. These include:
- constant crying
- pain or discomfort
- refusal to feed or drink water
- diaper that hasn’t been wet for 6 hours or longer
- dry lips and mouth
- crying without tears
- extra sleepiness
- vomiting blood or fluid with black flecks (“coffee grounds”)
- lack of smile or response
- vomiting green fluid
- bloated tummy
- blood in bowel movements
You won’t usually have any control over when or how much your baby vomits. When it happens on occasion, repeat this mantra to help you cope: “Healthy babies sometimes vomit.”
However, if your baby often vomits (or spits up) after feeding, you may be able to take some preventative steps. Try these tips:
- avoid overfeeding
- give your baby smaller, more frequent feeds
- burp your baby often between feeds and after feeds
- prop up your baby so they’re upright for at least 30 minutes after feeding (but don’t prop your baby up for sleep or use anything to position them in their crib or elevate their mattress)
If your baby has a tummy bug and is old enough to eat solid foods, avoid feeding solids for about 24 hours. A liquid diet can help the stomach settle after a bout of vomiting.
Vomiting and spit-up are common in healthy babies. In most cases, you can milk feed shortly after your baby vomits. This helps to prevent your baby from getting dehydrated.
In some cases it’s best to wait a little while before trying to feed your baby again. If you’re giving your child medication like pain and fever relievers, wait a bit so the meds don’t come back up.
If your baby is vomiting a lot or seems otherwise unwell, call your pediatrician immediately. If you’re unsure if your baby’s vomiting or spit-up is cause for concern, it’s always best to check with your doctor.
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
Is regurgitation in a child normal?!
Regurgitation is the reflux of small amounts of gastric contents or gastric juice mixed with saliva up the esophagus. Regurgitation often occurs in infants and in the vast majority of cases is a variant of the physiological norm.
The younger the child, the more often regurgitation can be observed. As the child grows, they gradually disappear until they disappear completely. In the first month, regurgitation occurs in 85% of children, this indicator does not depend on the type of feeding (formula or breast milk) and on the method of administration (bottle or natural feeding). After 3 months, regurgitation is much less common, and by one year it disappears completely. nine0003
In the new issue of " Advice of the day from the doctor" , the district pediatrician of DPO No. 3 Shayakhmetova Yazgul Fayzrakhmanovna will give parents practical advice on topical and frequent questions about the features of feeding the baby and due to what factors the involuntary process of regurgitation occurs.
Causes and mechanism of regurgitation
• Filling the stomach with air that the child can swallow while eating. This is the most common cause, which practically does not require special correction. nine0015 • Muscular weakness of the valve between the esophagus and stomach. It develops with the growth of the child and begins to function normally by the first year of life. Therefore, food can pass from the stomach into the esophagus without hindrance, which happens during regurgitation.
• Food allergy (or food intolerance). Most often, it is manifested by skin reactions, but in rare cases, regurgitation can be a symptom.
• Congenital defects of the gastrointestinal tract. The digestive system is quite complex, some violations in its structure can lead to digestive problems that will begin to appear immediately after birth. Thus, narrowing in the area of the gastrointestinal junction can lead to frequent atypical regurgitation. nine0003
Regurgitation and vomiting
Regurgitation is in most cases a physiological phenomenon that does not require special treatment and observation. But it can be similar to vomiting, being a sign of dangerous diseases, in which case a doctor's consultation is necessary. Regurgitation and vomiting are similar in their mechanism of occurrence, namely, the release of gastric contents into the oral cavity.
It is important to distinguish between them, as vomiting in newborns is very dangerous and can lead to aspiration of the contents into the respiratory tract and respiratory arrest. nine0003
There are differences between regurgitation and vomiting:
• Regurgitation most often occurs after eating. Usually this is a single, non-recurring episode. The child spits up the food that he just ate, there are no foreign impurities in it.
• Vomiting usually recurs repeatedly. It may not be related to eating.
• Regurgitation does not affect the well-being and mood of the child - he is active, does not show signs of anxiety, smiles, plays. nine0015 • Vomiting is accompanied by a deterioration in general well-being. The child is lethargic or restless.
• Regurgitation usually occurs suddenly, vomiting is preceded by a decrease in activity and mood.
• Vomiting is rarely the only symptom - there are also other problems with the functioning of the digestive tract or fever. Vomiting in a child is a reason to see a doctor!
Tips for parents!
Let's figure out how to avoid the possible dangers associated with regurgitation. The main thing that responsible parents need to know is that most often children spit up in a prone position. This position is dangerous by aspiration (inhalation) of gastric contents. nine0015 Preventing aspiration is as simple as bringing the baby upright or turning it over on its side or stomach immediately after spitting up. Then the baby himself will be able to push the food out of his mouth.
It is worth remembering that it is unacceptable to leave a child with regurgitation syndrome without adult supervision, especially in the supine position.
Frequent regurgitation can be prevented by following a few feeding rules.
• Keep your baby upright after feeding. Even if the baby is tired or wants to sleep, do not immediately put him down. Babies are very comfortable to hold on the shoulder. After waiting for the belching of air, the child can be given any position. nine0015 • The same should be done before feeding. The thing is that in an upright position, the child can release excess air from the stomach. If this is not done before eating, belching is guaranteed.
• There is a specific position recommended for breastfeeding. One of the main goals of the correct position of a nursing mother and baby is the prevention of regurgitation. The semi-upright position of the baby with the head raised above the level of the body must be maintained during each feeding. nine0015 • Feeding should be frequent but small. Overfeeding is fraught not only with regurgitation, but also with other digestive problems.
• It is important not to feed the baby when he is crying or laughing, otherwise he will swallow extra air.
• When feeding with a teat bottle, make sure that the opening of the teat is not too large and that the position of the bottle is such that the teat is always filled with formula and not with air. nine0015 • From active games you need to refrain from the first half hour after feeding.
Following these simple rules will help reduce the frequency of regurgitation.
If the above recommendations do not bring results, it is worth changing the diet. For a formula-fed baby, you can thicken each serving.
Breastfed babies may require additional treatment formulas.
There are also special mixtures against regurgitation. But they belong to therapeutic mixtures, which means that only a doctor can prescribe them. nine0003
Responsible parents should be aware of danger symptoms requiring medical advice:
• The baby is very restless and often rolls over and arches its back when spitting up or feeding. Such a symptom may indicate chronic irritation of the esophagus.
• Regurgitation is frequent, plentiful, observed after each feeding.
• The child has signs of dehydration.
• Regurgitation, which first appeared after the first half of the year. nine0015 • Prolonged spitting up without improvement (same frequency and same amount of spitting up in a child aged 1 year and older).
• Regurgitation is accompanied by fever.
• The child is not gaining or even losing weight.
• You can't tell for yourself if the baby is spitting up or vomiting.
There are even more dangerous symptoms that require an ambulance call:
• The child stopped breathing after spitting up. nine0015 • A bluish tint appears on the lips and face.
• After spitting up, the child lost consciousness.
• Green or brown reflux (gastric contents) - this may be a sign of intestinal obstruction or stomach bleeding.
Aspiration is extremely dangerous in infants who are unable to get rid of food in the airways on their own. The only thing parents can do is call an ambulance. It is not recommended to try to help the child on your own. nine0003
Should the baby be supplemented after spitting up?
• If the baby has eaten for a long time, the milk/mixture is almost digested, if the position of the body changes, the baby may still burp. This is not a reason for additional feeding.
• If regurgitation occurs after feeding, this is a sign of overeating. It's also not worth feeding.
• If the baby spit up profusely - this is an occasion to discuss this issue with the pediatrician. We also don't feed. nine0015 • If regurgitation is minimal, then you can feed normally.
Why does the baby spit up after feeding?search support icon
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? nine0003
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 can spit up at least 50% of babies from 0 to 3 months, more than 60% of children 3-4 months, and 5% of children spit up until 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 age, 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.
Aerophagia is considered to be one of the important risk factors contributing to regurgitation in newborns. 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 burps immediately after a feed, the milk (or formula) remains practically fresh, uncurdled 3 .
Promotes post-feeding regurgitation and 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”. nine0003
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? nine0163
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 normal and not of concern to pediatricians 3 :
- usually continues for a certain period of time;
- has a slow, "passive" flow; 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
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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 hold 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 stomach acid on the esophagus, put your baby to sleep in a 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. nine0003
1 Zakharova I. N., Andryukhina E. N. Regurgitation and vomiting syndrome in young children // Pediatric pharmacology, 2010. V. 7. No. 4.
Nagornaya 29010 V., Limarenko M. P., Logvinenko N. G. Experience in 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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