What is spitting up?

Your baby spits up when they bring up the contents of their stomach into their oesophagus (the tube that leads from the mouth to the stomach) and sometimes out of their mouth. They may also spit up small amounts of milk along with air when you burp your baby.

Spitting up is also called:

• posseting
• regurgitation
• reflux
• gastro-oesophageal reflux (GOR)

Spitting up is common and normal in babies, especially after a feed. It is equally common in babies who are fed with formula or breastmilk.

Most babies usually stop spitting up by the time they are about 12 to 18 months, unless they have other health conditions, such as cerebral palsy.

What is the difference between spitting up and vomiting?

When your baby spits up, they ‘spill’ out milk from their mouths, without effort, after or between their feeds. Your baby may not even be bothered by their spit up.

If your baby vomits suddenly or forcefully, or if your baby’s vomit is green or yellow or contains blood, this is not spitting up. If this happens, you need to take your baby to the doctor.

Read more about vomiting in babies.

What are the symptoms of spitting up?

If your baby spits up, you will see them bring up some milk out of their mouth, usually during or after a feed. Usually, it does not bother them.

Your baby will be happy, putting on weight and developing well. Your baby may be called a ‘happy chucker’.

What causes babies to spit up?

Your baby may spit up because, when they are young, their sphincter (the muscle at the entrance to the stomach that keeps the stomach closed) is very weak. This means that their stomach is not tightly closed. Food can spill up and out through their mouth.

Your baby is more likely to spit up if:

• they are lying down or are picked up quickly after lying down
• their tummy is very full
• there is pressure on their tummy from a tight nappy, clothes or seat belt
• they are slumped, curled or in a flat position in a capsule, baby carrier or sling
• they are having their nappy changed or in the bath
• they were born premature

Tobacco smoke in the environment can contribute to your baby having reflux. Make sure that you or other people do not smoke around your baby.

Read more on the health effects of passive smoking and vaping.

When should my baby see a doctor?

You should take your child to see their doctor if you notice:

• fever
• gagging, choking or trouble with swallowing
• mucus or blood in their poo, or a green or yellow colour or blood in their vomit
• irritability or difficulty settling them
• they are refusing milk or food
• their tummy is swollen or bloated
• they are losing weight or gaining weight slowly

You should also visit your doctor if your child is receiving treatment for spitting up that is not helping them.

If your child is spitting up and otherwise happy and gaining weight as they should, you do not need to take them to the doctor.

How is spitting up diagnosed?

Your child’s doctor or maternal child and family health nurse can diagnose them with reflux by asking about their medical history, examining them and watching your baby feed.

If your child does not have any other symptoms and is healthy, their doctor will not recommend any tests.

How is spitting up treated?

If your baby does not have any symptoms other than spitting up, they do not need any specific treatment. As your baby grows and develops, they will gradually stop spitting up.

Even though your baby may be a ‘happy chucker’, it can still be an emotionally and physically challenging time for you. Here are some tips to help you out:

• Keep small towels or cloths handy to put over your shoulder when you hold your baby.
• Put large soft bibs over your baby’s clothes.
• When you plan to go out, get everything ready first and then change your clothes right before leaving.
• Carry extra wipes and clothes for you and your baby in your car and nappy bag.

What are the complications of spitting up?

Spitting up does not usually cause any health problems, however it can be tiring and stressful for parents and carers.

If your baby spits up and cries a lot, is difficult to settle, has feeding problems or is not gaining enough weight, they may be diagnosed with gastro-oesophageal reflux disease (GORD). This means that acid from your baby’s stomach burns and damages their oesophagus. This is painful for your baby. You may notice they also arch their back.

Your baby will need medical treatment and your GP may refer them to a paediatrician. They may order need special tests.

Your doctor may recommend you feed your baby thickened feeds. Their doctor may prescribe a medicine called omeprazole to reduce the acidity in their stomach. Do not thicken your baby’s feeds without first getting advice from your doctor or child health nurse.

Can spitting up be prevented?

Spitting up is normal, but there are some things you can do to help your baby spit up less.

During feeds, try these tips:

• Hold your baby in an upright position, not lying down.
• Feed your baby smaller amounts at a time, while ensuring that they still get the daily amount of milk that they need.

After you feed your baby:

• Keep your baby upright for 20 to 30 minutes. You can also hold them on your shoulder.
• If you need to burp your baby, do it gently and keep their back straight.
• Use an upright baby carrier rather than one where your baby is curled up.
• If you need to change your baby’s nappy after a feed, keep their head higher than their body. Roll their bottom sideways rather than lifting it up.

Always follow safe sleeping guidelines and place your baby on their back to sleep, even if they have reflux.

You can also seek support from a lactation consultant or child health nurse. They can observe how your baby feeds and give advice on how to help them spit up less.

Find a lactation consultant in your area.

To find a maternal child and family health service near you, use the Pregnancy Birth and Baby Service Finder tool.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

Resources and support

• Read more about spitting up at the Australian Breastfeeding Association website.
• Visit the Sydney Children’s Hospitals Network for some practical advice about common newborn concerns.
• Reach out to PANDA for mental health and wellbeing support if you feel you are struggling. Call their helpline on 1300 726 306.

Do you prefer to read in languages other than English?

PANDA offers support in more than 40 community languages.

Looking for information for Aboriginal and/or Torres Strait Islander people?

Visit ‘Breastfeeding our Boori’, a resource providing education, support and local knowledge to assist Aboriginal and/or Torres Strait Islander people to breastfeed.

Looking for information for sexually and gender-diverse families?

The Centre of Perinatal Excellence (COPE) has resources and tips for LGBTIQ+ parents and rainbow families.