Why is my baby spitting up?

Shakespeare described infants as, " mewling and puking,"  during the first stage of life. Spitting up, or reflux, was common then and it's common now—affecting almost all babies.  

Common factors that cause spitting up in babies:

• A smaller, less stretchable  stomach
• A baby drinking more than his or her stomach can hold
• The strength (or tone) of the valve (the lower esophageal sphincter) between the esophagus and stomach
• The angle between the stomach and esophagus allows stomach acid and content to come up more easily  

As a result, babies may spit up small amounts of digested or undigested stomach contents right after feedings. Sometimes, it can be an entire bottle or several spit ups that continue until the next meal. Typically, breastmilk or formula is coughed up, but it may also come back up through the nose. Altogether, the presence of these symptoms is completely normal for an infant currently being bottle fed. 

The good news is that almost all babies grow out of this stage entirely, with most beginning to improve by 5-8 months of age. By 13 months of age, 95% of infants are over their reflux .   

 Spitting up improves after: 

• Solids get started (thicker foods stay down better then than breastmilk or formula) 
• Babies learn to sit up and gravity helps keep the food down

If your baby continues to have reflux past infancy or has other symptoms such as poor weight gain, excessive crying or irritability,  he or she may have a more advanced condition called gastroesophageal reflux disease (GERD). Read more about the warning signs of GERD  to determine if your baby needs extra care for their reflux.