Navigating the myriad of normal baby behaviors can be daunting for new parents. Baby spit up ranks high on the list of common concerns. While spitting up is most often a normal behavior for most young babies, there are some times that it may indicate a serious condition. In this article and the video to follow, you will learn about what is normal baby spit up vs when you should be concerned.
Normal Physiological Spit Up
There are many reasons why most babies experience some degree of spitting up. First of all, they consume only a liquid diet for the first 6 months of their life. Additionally, babies lay on their back for the majority of the day. Their bodies can’t make use of gravity to keep the contents of their stomach from coming back up. Last, babies have an immature sphincter or valve between their stomach and esophagus. Each of these reasons contribute to this common symptom during infancy.
Spit Up Due to Overfeeding
Overfeeding or giving a large volume of breast milk or formula all at once will lead to spit up. While it is more difficult to overfeed a breastfeeding baby through direct breastfeeding, babies whose mothers have an overactive letdown or oversupply may spit up due to this large volume as well.
Differentiating Spit Up from Vomiting
It’s important to distinguish spit up from vomiting—vomiting is more forceful and frequent. In infants, vomiting is typically associated with a viral illness or stomach bug. While breastfeeding offers a certain amount of protection from a GI illness, young babies are not completely immune from picking up one of these germs. Generally, stomach bugs include both vomiting and diarrhea. Thankfully, they most often cause short-lived illness.
When to Treat Reflux
In general, reflux or baby spit up is more of a laundry problem than a medical problem. However, as a pediatrician, I will treat infant reflux if your baby is not growing well or is extremely fussy due to the pain of refluxing their stomach contents into the esophagus.
The Rare Case of Pyloric Stenosis
A rare but serious condition that causes vomiting more so than spit up is pyloric stenosis. This occurs when narrowing at the pylorus impedes food from passing from the stomach into the small intestine. This blockage will lead to projectile vomiting and a hungry vomiting baby. Typically this condition presents between three to five weeks of age. Pyloric stenosis always requires urgent medical evaluation and treatment.
Final Thoughts
In most cases, spit up is part of a healthy baby’s growth and isn’t cause for worry. However, be sure to watch for signs like poor weight gain, extreme fussiness, or unusual force or frequency in spit up. Any of these symptoms should be evaluated by your baby’s pediatrician. Thankfully in medicine and in life, common things are common. Most often baby spit up is not the result of a serious medical condition.
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© 127 Pediatrics, May 2024
This article is for information purposes only. Please consult your personal physician for medical advice.
