How to Know When Your Baby’s Spit-up is a Concern

How do you know when your baby’s spit-up is a concern? When you’re a new parent, everything is worrisome. Your baby’s eating habits are probably chief among those worries. If you’re nursing, you also feel a personal responsibility and sense of guilt if your baby is not gaining weight quickly enough in those early months. As if the intake of breastmilk or formula is not stressful enough, you also worry about spit-up after she eats – how do you know how much is too much and when to worry?

I came across a question from a new mom that asked, “What should I do if my baby is spitting up a watery liquid after being breastfed?” Here’s a guide to help you know when you should worry about your baby spitting up. This is not medical advice, and you should always raise any concerns to your baby’s doctor.

When Your Baby’s Spit-Up is a Concern

1. Some spit-up is normal. Our pediatrician used to ask if our babies were “happy spitters.” What she meant was, do they seem to be in pain or distress when they spit-up or does it not seem to bother them much? If they are bothered by spitting up, it may be reflux and you should discuss options with your doctor.
2. Use color, texture, and odor as your guide. If your baby is breastfed, spit-up will usually be rather watery and pale white in color. It shouldn’t smell unpleasant; if there is a sour odor, consult with your doctor. If your baby is formula-fed, spit-up will usually be more yellow and a little thicker; while it smells stronger than breastmilk spit-up, the odor still should not be overly sour. You will learn what is “normal” for your baby so you can raise the flag of concern for anything unusual.
3. Is your baby plateauing or losing weight? A baby’s job is to sleep, eat, and poop. If the amount that he is spitting up is preventing him from gaining weight it is definitely a problem. But, if your baby is gaining weight, it’s probably okay. My first child is very small and has always been right in that 0-10% range on the growth chart; when she spit-up, I was terrified that she was losing all the nutrients she’d just taken in. But, she continued to grow. While her growth path was not average, it was normal for her.
4. Are you changing plenty of wet and soiled diapers? A good indicator that your baby is getting the food and nutrients he needs is that he’s also having plenty of wet and soiled diapers. After a few days of life, your baby should be up to 5-6 wet diapers a day and one stool (or more) every couple of days.

Now that you know when to be overly concerned about spit-up, here are some ways to keep more of your baby’s food in her belly.

1. Burp your baby to get out any air bubbles. Burping may cause a little bit of spit-up, but not doing so may cause a lot more. Firmly pat your baby’s back after every feeding to get out those air bubbles.
2. Keep your baby upright for 30 minutes after eating. By giving your baby’s stomach some time to process the milk or formula before laying down, more of the food will stay where it belongs.
3. Plan tummy time for just before feedings. I noticed that even if I waited an hour after eating for tummy time, I still dealt with quite a bit of spit-up. I started doing tummy time right before the next feeding and found it to be much more successful.
4. If you’re nursing, make sure your baby is getting hindmilk. Hindmilk is heavier and fattier than foremilk, so if you have a snacker, if can be hard to get them to nurse long enough for them to get hindmilk. Try alternating breasts at each feeding rather than nursing on both sides each time so your baby takes in more of the dense hindmilk at each feeding.

 

If these tips don’t seem to make much of a difference, you’ve discussed your baby’s spit-up concerns with your doctor, and your baby is a “happy spitter,” know that eventually, the spit-up will stop. Your baby is happy and healthy, and that is what matters!

Have you dealt with any times when your baby’s spit-up was more than just normal baby stuff? Share your experiences in the comments.