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If baby spits up do i feed again


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
  • fever
  • 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
  • diarrhea
  • dry lips and mouth
  • crying without tears
  • extra sleepiness
  • floppiness
  • 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.

Spitting Up - Reflux

Is this your child's symptom?

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

Symptoms of Normal Spitting Up

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

Complications of Spitting Up (GERD)

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

Symptoms of GERD

GERD problems occur in less than 1% of infants:

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

Cause

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

Reflux Versus Vomiting: How to Tell

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

Reflux

The following suggests reflux (normal spitting up):

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

Vomiting

The following suggests vomiting:

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

Pyloric Stenosis (Serious Cause)

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

When to Call for Spitting Up - Reflux

Call Doctor or Seek Care Now

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

Contact Doctor Within 24 Hours

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

Contact Doctor During Office Hours

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

Self Care at Home

  • Normal reflux (spitting up) with no problems

Seattle Children's Urgent Care Locations

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

  • Bellevue
  • Everett
  • Federal Way
  • Seattle
  • Virtual Urgent Care

Care Advice for Spitting Up (Reflux)

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

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

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

Last Reviewed: 03/26/2023

Last Revised: 12/30/2022

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.

Is regurgitation in a child normal?!

31.Mar.2021

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.

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.
• 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.

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.

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.
• 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.
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.

Feeding rules
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.
• 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.
• 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.
• If you are 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.
• 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.

Proper diet
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.

Warning signs
Responsible parents should be aware of danger symptoms that require 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.
• 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.
• 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.

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 spits up profusely - this is an occasion to discuss this issue with the pediatrician. We also don't feed.
• If regurgitation is minimal, then you can feed normally.

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 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”.

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.

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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 meals (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.

. 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.