Spit-up, reflux, and when to worry

Spit-up is usually normal

Most babies spit up milk, sometimes often, in the early months. Their digestive system is still developing and the muscle at the top of the stomach is immature, so milk comes back up easily. A baby who is spitting up but feeding well, gaining weight, and generally content is often called a "happy spitter" — this is normal and improves with time, usually by around 12 months.

Reducing spit-up

• Feed in a more upright position and keep your baby upright for a while afterward
• Offer smaller, more frequent feeds
• Burp gently during and after feeds
• Avoid tight diapers or waistbands that press on the tummy

Reflux vs normal spit-up

Frequent spit-up alone is not a problem if your baby is comfortable and growing. Reflux that causes pain, poor feeding, or poor weight gain is less common and worth discussing with a doctor.

Warning signs to get checked

Contact your pediatrician if your baby has forceful or projectile vomiting, green or bloody vomit, is not gaining weight, refuses feeds or arches in pain during them, has few wet diapers, or is unusually irritable or lethargic.

When to check with a professional

Everyday spit-up rarely needs treatment, but you never need to wait if you are worried. Your pediatrician can reassure you or look into reflux if the pattern seems to be affecting your baby's comfort or growth.