If baby spits up do you 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.

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

Preventive measures against regurgitation in children

08.03.2017

Regurgitation is the spontaneous reflux of gastric contents into the esophagus and mouth. This condition is not uncommon in infants and is often a cause for concern for parents. The frequency of regurgitation syndrome in children of the first year of life is 18-50%: up to 4 months - 67%, up to 6 months 24%, up to 1 year 5%. In most cases, regurgitation is "benign" and disappears on its own after 12-18 months. At the same time, “benign” or physiological regurgitation characterizes: nine0003

the age of the child is up to 12 months;
spitting up 2 or more times a day for 3 or more weeks;
sufficient weight gain;

The child has no signs of metabolic disorders, diseases of the gastrointestinal tract or the central nervous system. The child does not experience difficulty in swallowing or feeding, there is no forced position of the body. nine0003

Do not confuse regurgitation with vomiting. When a child burps, the abdominal muscles do not tense up. With vomiting, on the contrary, muscle tension occurs and food is ejected by pressure not only through the mouth, but also through the nose. In some cases, there may be general anxiety, pallor, cold extremities. Often with vomiting, the temperature rises, loose stools appear, which is a sign of an infectious disease. Vomit may contain unchanged milk, mucus, blood or bile. nine0003

What explains physiological regurgitation

What is the tendency of babies to spit up? This phenomenon is explained by the peculiarity of the structure of the gastrointestinal tract of young children. At the age of one year, the esophagus is shorter and wider, physiological narrowing is weakly expressed. The stomach is located horizontally, its capacity is small, and the muscles that close the entrance to the stomach and prevent the contents from being thrown back into the esophagus are poorly developed. As the child begins to walk, the axis of the stomach becomes more vertical. The capacity of the stomach increases by the year from 30-35 ml to 250-300 ml. The secretory apparatus matures, the work of the closing muscles (sphincters) improves, which leads to a gradual decrease in the frequency and disappearance of regurgitation. These features explain the predisposition of young children to regurgitation and even the inevitability of this condition. However, there are measures to help reduce the frequency of regurgitation. nine0003

Factors contributing to physiological regurgitation include:

Overfeeding. As a rule, actively sucking babies begin to suffer from overfeeding, with abundant milk secretion, as well as when switching to artificial or mixed feeding with an incorrect calculation of the required amount of milk formula. Regurgitation appears immediately or some time after feeding in the amount of 5-10 ml. Milk can flow out unchanged or curdled. nine0003
Swallowing air during feeding (aerophagia). A similar situation arises if the child suckles greedily at the breast, and the mother's milk is not very plentiful; due to the retracted, flat nipple of the mother's breast, since the child fails to fully capture the nipple and areola; with artificial feeding, if the hole at the nipple of the bottle is large enough or the nipple is not completely filled with milk. Babies with aerophagia often experience anxiety after feeding, bulging of the abdominal wall (belly inflates). After 10-15 minutes, the swallowed milk flows out unchanged, which is accompanied by a loud sound of air eructation. nine0003
Intestinal colic or constipation. These conditions lead to an increase in pressure in the abdominal cavity and a violation of the movement of food through the gastrointestinal tract, causing regurgitation.

Until the child is four months old, spitting up up to two teaspoons of milk after feeding, or one spitting up of more than three spoons during the day, is considered the norm. You can check the amount of spitting up in the following way: take a diaper, pour one teaspoon of water on its surface, and then compare this spot with the spot formed after the next spitting up. nine0003

Pathological regurgitation may be due to:

surgical diseases and malformations of the digestive system;
diaphragmatic hernia;
pathology of the central nervous system, trauma of the cervical spine during childbirth;
food intolerance, lactase deficiency;
nine0010
increased intracranial pressure.

Such regurgitation is characterized by intensity, systematicity, the child spits up a large amount of milk. At the same time, there is a violation of the general condition of the baby - the child is whiny, loses or does not gain weight, cannot eat the amount of food necessary for his age. In such a situation, a pediatrician, gastroenterologist, surgeon, allergist, neurologist should be examined. It also requires examination and exclusion of anomalies in the structure of the upper gastrointestinal tract, the preservation of regurgitation for more than 1 year. nine0003

Scale for assessing the intensity of regurgitation:

Less than 5 regurgitations per day with a volume of not more than 3 ml - 1 point.
More than 5 regurgitations per day with a volume of more than 3 ml - 2 points.
More than 5 regurgitations per day up to half the amount of formula or breast milk, not more often than in half of the feedings - 3 points.
nine0010
Spitting up a small amount of milk for 30 minutes or more after each feeding - 4 points.
Regurgitation from half to full volume of formula or breast milk in at least half of the feedings - 5 points.

Regurgitation with an intensity of 3 or more points requires a visit to a doctor.

Preventive measures against regurgitation in children

If regurgitation is physiological in nature, then it is not worth treating or correcting in this case. It is necessary to deal with the elimination of the cause, if possible, and carry out prevention.

Prevention of regurgitation in children includes the following measures:

Postural therapy: when feeding, it is necessary to hold the baby at an angle of 45 °, make sure that he completely grasps the nipple with the areola; after feeding, hold the baby in an upright position ("column") for 20 minutes - to drain the swallowed air. Due to this, the air that has entered the stomach will be able to go out. If nothing happened, then put the baby down and after a minute or two, lift him upright again. nine0003
Make sure that the opening in the bottle is not too large and that the nipple is filled with milk. Experiment with nipples - perhaps the other will be better. Milk should come out in drops, not a trickle.
Before you start feeding your baby, lay him belly down on a solid base.
After feeding, try to minimize the baby's physical activity, do not disturb him unnecessarily, and change clothes only if there is an emergency. nine0003
Avoid squeezing diapers or clothes on the abdomen of the child.
If the baby's appetite is good, then it is better to feed him often, but in small portions, otherwise, due to the large amount of food, the stomach may overflow, and this, as a result, leads to regurgitation of excess food.
The surface in the bed on which the baby lies should rise 10 cm at the head. nine0003
In addition, it is possible to use special "thickeners" of milk or anti-reflux mixtures, which the doctor will help you choose.

In the event that regurgitation begins to become more frequent or becomes abundant, or first began after six months of the baby's life, or does not subside by one and a half to two years of life, the child should be consulted by a pediatrician. With a high probability, additional help from a gastroenterologist will be needed. nine0003

In our Family Medical Center you can always find highly professional help.

← Back to the list of articles

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. nine0003

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 " Doctor's Advice of the Day" , the district pediatrician of the Children's Professional Education 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. nine0003

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. nine0142 • 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. nine0142 • 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. nine0142 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. nine0142 • 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. nine0142 • 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. nine0142 • 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. nine0003

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. nine0142 • 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. nine0142 • 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.