When Do Babies Stop Spitting Up? (And How Much Spit Up Is Normal?)

Baby spit up is a fact of life for new parents. (It’s so normal, there are even special baby cloths dedicated to cleaning up the stuff!) But when your child seems to be spitting up constantly, it can feel a bit concerning. How much or how frequently a newborn or infant spits up varies from baby to baby, says Jeffrey Bourne, MD, a pediatrician at Providence Saint John’s Health Center in Santa Monica, California. But he adds that it’s “very, very common and generally not worrisome.” So how much spit up is “normal,” and when do babies stop spitting up? Here, pediatricians explain why babies spit up, how you can help them and when to expect this to more or less stop.

Key Takeaways

• The majority of babies will spit up to some degree at some point in the first year of life, particularly during the newborn period. They should start to grow out of it by the time they approach their first birthday.
• If baby is spitting up a lot, it could be due to a variety of reasons, including overfeeding, swallowing air when feeding too quickly, reflux and dietary intolerances.
• To reduce baby spit up, consider giving smaller feedings more frequently, burping baby longer and keeping them upright after a feeding.
• Spit up is different from vomit in that it’s in smaller amounts, can occur when burping, isn’t forceful and doesn’t always smell bad.
• If baby seems to be in pain, has bile in their spit up, a fever, or seems like they’re vomiting rather than spitting up, reach out to your pediatrician.

Baby Spit Up Vs. Vomit

To understand why babies spit up, it’s worth first knowing what spit up is—and what spit up isn’t. Spit up is different from vomit. Vomiting is a forceful elimination of something by the body, whereas spit-up tend to be “gentle regurgitations,” says Ashanti Woods, MD, a pediatrician at Mercy Medical Center in Baltimore. Baby spit up usually occurs in small amounts and may happen during burping, while vomiting has more volume and may smell bad, adds Denise Scott, MD, an Oklahoma-based pediatrician.

Why Do Babies Spit Up?

Babies spit up commonly during the newborn period, Scott notes. “It’s a common event, occurring in about half of babies. It’s less common for a baby to start spitting up after 6 months and could be indicative of a food allergy or other concerns.” So why do babies spit up in the first place? It could be due to a few different things. These include:

• They have reflux. Babies often spit up because of gastroesophageal reflux, a condition in which things that are ingested come back up from the stomach and out the mouth and nose, Woods explains. A valve at the bottom of the esophagus, called the sphincter, typically prevents that—but it’s still developing in newborns and doesn’t always work very well, so the food can climb back up, explains Bourne. Until that mechanism matures, babies are prone to frequent spit up.
• They had too much milk. The size of baby’s stomach in ounces is about half of their weight in pounds, Woods says, so a newborn who weighs 7 pounds has a stomach capacity of about 3.5 ounces. “If a family were to feed baby 4 ounces of milk at one feeding, it’s a good chance the baby may have some spitting up,” he says.
• They swallowed too much air. Similarly, spit up may also happen if baby eats too quickly and swallows too much air, Scott adds. In this case, it’s the air taking up room in their tiny tummy rather than milk.
• Their formula is not agreeing with them. If baby is fed formula, it’s possible they may be intolerant to the type you’re using, Woods says. If you suspect that’s the reason for baby spit up, talk to your pediatrician about switching brands.
• Something in your diet doesn’t sit well with them. If you’re breastfeeding, it’s possible that something you’re having, like too much dairy, is increasing the amount of spit up, Woods says. But talk to baby’s pediatrician before removing things from your diet, especially since there are so many other reasons why baby might be spitting up. “We don’t want moms unnecessarily doing a huge elimination from their diet,” Bourne says.

Additionally, if baby has a cold, they may have swallowed mucus in their stomach, which could lead to increased spit up, Scott adds.

Baby spit up color

Wondering if the color of baby’s spit up can tell you anything about the cause or their health? It’s possible, but not an exact science. According to Scott, if baby’s spit up is clear, it could be saliva or stomach fluid without anything baby ate. If the spit up is curdled (like expired milk), then it could contain food from baby’s stomach that hasn’t been digested. But for the most part, clear or white spit up is usually just baby’s milk or saliva coming back up. If the spit up is yellowish green, in rare cases, it could mean bile is present, which is usually caused by an obstruction in baby’s digestive system, like pyloric stenosis. Red or brown baby spit up could indicate the presence of blood and be caused by internal bleeding, Scott adds.

How Much Spit Up Is Normal?

As noted, spit up is fairly common in newborns and babies. But baby spit up should generally be a couple of tablespoons or less than an ounce, Woods says. “A small amount of spit up after feedings, such as a wet burp, is entirely normal,” Scott adds. If baby’s spitting up more than that or they’re spitting up after every feeding, tell your pediatrician to be safe. Chances are, they’re fine—some babies simply spit up more often than others. “If baby is still gaining weight and doesn’t seem bothered by their spit up, it’s usually not cause for concern,” Bourne says. “We call [these babies] ‘happy spitters.’”

When Do Babies Stop Spitting Up?

Babies don’t spit up forever—something worth remembering if you feel as if all of your clothes have been stained by spit up. While every child is different, Bourne says most babies will stop spitting up by around 6 months. “Usually it just gets better and better with time,” he says. Scott agrees, adding spit up can peak around 4 months and usually stops sometime between 6 and 12 months.

Tips For Reducing Baby Spit Up

If baby spits up a lot, you might need to do a little detective work to track down what’s causing baby to spit up and how to help them. Here are a few methods that might provide clues—as well as some relief for baby:

Hold baby upright during and after a feeding

Keeping baby’s head elevated as they feed and for 30 minutes after—rather than laying them down immediately after—can help with spit up, Scott says. Bourne also recommends holding baby face down at a 30- to 45-degree angle after a feeding. “This is often the position you’d hold a baby to burp them,” he explains. Resting baby on your shoulder in this position for 15 to 20 minutes afterward should make a big difference in reducing baby spit up.

Try feeding baby less at a time

Scott suggests decreasing each feeding by a half ounce to 1 ounce to avoid overfeeding, or limiting how much time they spend on each breast. “Babies will sometimes take as much as you offer rather than stop themselves, while others will turn their heads when they are full,” she explains. If baby still seems hungry, you can make up for it by feeding them more frequently, Woods adds.

Take more breaks to burp

Scott recommends burping baby for 5 to 10 minutes after every couple of ounces they eat. Plus, try a slower nipple flow if bottle-feeding and keep it filled with milk to decrease how much air baby swallows.

Consider changing your formula

It’s possible that another brand will sit better with baby. Of course, always consult your pediatrician before making any big changes to baby’s diet.

Pay attention to your diet

If you’re breastfeeding, and baby’s spit up has suddenly worsened, think back to what you ate one to two meals before nursing, Scott says. While you don’t want to make any severe dietary changes, it can be helpful to track your diet and note how baby responds to it.

If those methods don’t work, or you still have concerns about baby spitting up, talk to your pediatrician about next steps. Usually, though, there’s no need to worry. “Most babies will do fine with no changes,” says Woods—you may just need to wait it out.

When Is Baby Spit Up a Concern?

For the most part, baby spitting up isn’t something to worry about, as it should resolve on its own. But there are a few circumstances that warrant a call to your pediatrician. According to Woods and Scott, these include if baby has:

• Lethargy
• Weight loss or improper weight gain
• Fewer wet diapers
• A disinterest in feeding
• Blood in their spit up
• Trouble breathing
• Spit up with a lot of volume (more akin to vomiting)
• Spit up with a yellow-greenish tinge (may signal an issue in baby’s gastrointestinal system)
• Fever
• Pain when lying down or spitting up

You’ll also want to call the pediatrician if baby seems generally bothered. The stomach acid might be causing discomfort, and certain medications can make it less acidic.

One of the things that’s guaranteed in new parenthood is baby spitting up (most likely on you). But know that this is a normal part of their development, and the issue should improve as they get older. For any questions or concerns, don’t hesitate to talk to baby’s provider. “Your doctor will be following your baby’s growth closely and can discuss any concerns and treatment regarding frequent spit up,” Scott says. “Be sure to bring it to their attention, especially should you notice any worrisome symptoms.”

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.