Why babies spit up?

Why does my baby spit up so much?
He's probably just working on getting the hang of feeding.

When your baby takes in air along with his breast milk or formula, the air gets trapped between the liquid — when the air comes up, so does the liquid. Also, because babies like to eat, and because they take in a lot of nourishment in relation to their overall size, they sometimes become overfilled and, well, overflow.

A newborn's stomach muscles aren't fully developed, either — so the muscles at the bottom of your baby's esophagus (which control whether food is coming or going) may still be getting up to speed. It's no wonder he creates so much laundry.

Is there anything I can do about it?
Yes, try these ways to help out your baby:

• Hold your baby in a fairly upright position when you feed him. Feeding him while he's slouched (curled up in your arms, or in a car seat, for example) doesn't give the formula or breast milk a straight path to his tummy.

• Keep things calm when you feed your baby. Minimize noise and other distractions, and try not to let him get too frantically hungry before you start feeding him. If he's distracted or upset, he's more likely to swallow air along with his breast milk or formula.

• If your baby's bottle fed, make sure the hole in the nipple isn't too small — which will frustrate your baby and make him gulp. On the other hand, make sure it isn't too large, or he'll be gagging and gulping because the formula or expressed breast milk will come at him too quickly.

• Burp your baby after each feeding. In fact, if your baby takes a natural pause during a feeding, take the opportunity to burp him then, too, before giving him more food. That way, if there is any air, it'll come up before even more food is layered on top of it. Don't forget to put a soft cloth on your shoulder first! (By the way, if you don't get a burp up in a few minutes, don't worry. Your baby probably doesn't need to burp right now.)

• Keep the pressure off his tummy. Make sure your baby's pant waist or diaper isn't too tight, and don't put his tummy over your shoulder when you burp him. Try to avoid a car trip right after a feeding, because sitting in the car seat (in a slouched position) can put pressure on your baby's stomach, too.

• After he eats, don't jostle your baby around too much, and try to keep him in an upright position for half an hour or so. This way he'll have gravity on his side. You can carry him, put him in a pack, or prop him against some pillows next to you, if he's big enough.

• Don't overfeed him. If your baby seems to spit up quite a bit after every feeding, he may just be overfilled. You might try to give him just a bit less formula or breastfeed him for just a little less time, and see if he's satisfied. (He may be willing to take less formula or breast milk at a time, but more frequently.)

• If your baby tends to spit up while sleeping, elevate his head. It's unsafe for your baby to sleep with a pillow, but you can place a foam wedge under his mattress or put the head of his crib safely on blocks.

When will my baby outgrow this?
Most babies stop spitting up by around 6 months of age, or once they learn to sit up, but a few will continue until their first birthdays.

Is spitting up ever a sign of something serious?
Call your doctor immediately if your baby begins projectile vomiting. Projectile vomiting is when the spit-up forcefully flies out of a baby's mouth — across the room, for example. This could be a sign of a condition called pyloric stenosis, in which the muscles at the bottom of the stomach thicken and don't allow food to pass into the small intestine. Also phone your doctor right away if your baby is vomiting (which will be more forceful and more quantity than if he's just spitting up some of his latest meal) and there is green bile in his vomit. This can be a sign of a blockage in his intestines, which would require emergency surgery.

And finally, spitting up is usually just par for the parenting course, but if your baby isn't gaining weight as he should be, schedule a visit with your doctor.