As the mother of a newborn or infant, you’ve probably seen your baby spit up more than once. Possibly even seen the milk come through your baby’s nose.
It can be quite frightening watching all that milk or formula make a reappearance, especially when it pours through the nose. It can make your little one upset but rest assured it’s a regular and natural occurrence.
Babies spit up. A lot. To ease your mind, we’re here to discuss why it happens and how you can reduce the chances of it happening again.
Spit up Through the Nose. Is It Normal?
Reflux in infants is when the milk comes back up from the baby’s stomach and out the mouth or nose. It usually isn’t a serious problem, and it can happen in healthy babies several times per day, though it’s less common after 18 months (1).
The natural reflex that pushes the milk back up is something your baby has no control over. The nose and throat are connected (2), and if spit-up happens quickly, it can be projectile and take you by surprise.
Several things may cause your baby to spit up frequently:
- Stomach valve: A sphincter muscle connects your baby’s stomach and esophagus. This muscle, the lower esophageal sphincter, is immature in newborns and sometimes allows food to escape into the esophagus (3).
- Distractions: When your baby gets distracted while feeding, the suck-swallow reflex can be disrupted (4). Large amounts of milk may be swallowed, causing slight choking, sending milk back out the nose.
- Swallowing air: If your baby is really hungry, he or she might feed in a rushed, gulping manner. This can cause them to ingest air as well. The air can then return later, bringing the milk with it.
- Coughing or sneezing: Your baby has little control over their body when newborn (5). The simple act of sneezing or coughing can cause milk to come back up the esophagus.
Spit-up Versus Vomit
Spit-up is normal and happens often, but it is less severe than vomiting. Vomiting is the forceful expulsion of the stomach’s contents (6). Spit-up is an easy flow, like the milk that comes out with a burp.
Many things can trigger the part of the brain that stimulates the reflex action of vomiting. They include:
- The nerves in the stomach or intestine reacting to inflammation or irritation due to an infection or a blockage.
- Chemicals that are present in the blood, likely from drugs or poison.
- Motion sickness that is triggered by the middle ear.
Your baby may occasionally vomit due to rotavirus or a mild stomach infection (7). However, it shouldn’t be a regular occurrence. If it doesn’t pass quickly and your child shows signs of illness, we recommend contacting your healthcare provider.
How Can I Reduce How Often My Baby Spits Up?
Let’s face it, spit-up isn’t a pleasant part of child rearing. It stains clothes, and your blankets will require frequent washes and changes. Plus, if your baby is on formula, it doesn’t exactly smell great.
There’s good news, though. Here are a few things that you can do to reduce the chances of frequent spit up from your little one:
- Try to feed your baby on time as much as possible: If your baby is overly hungry, they may gulp and swallow air, increasing the chance for spit up later on.
- If your baby is bottle fed, make sure that the hole on the nipple isn’t too large: A larger nipple hole may cause your baby to get too much milk too quickly.
- Feed your baby in a room with minimal distractions: A nice quiet spot will keep your baby focused on eating instead of what is going on around them. This may be the most difficult thing to fix if you have other children to care for.
- Finally, don’t overdo the feeding: If your baby is acting full, even if they’ve eaten less than usual, trust their instincts (8). Don’t try to force them to eat more than they want or need.
- Immediately after your baby is done feeding, burp them: You can reduce a lot of spit-up by simply making sure your baby has been properly burped.
- Try to keep your baby upright for a few minutes: This will allow the milk to flow down into the stomach and not be left in the esophagus.
- If your baby falls asleep, put them on their back: Your baby will automatically swallow or cough out any milk in their throat. Sleeping on the back will help them clear the fluids, should they spit up in their sleep (9).
- Refrain from putting tight clothing on your baby after feeding: You’ll want to avoid putting pressure on the stomach. This can include pulling the diaper on too tight.
When to Call Your Doctor
Spitting up is a bit bothersome in general, and spitting up through the nose, in particular, may freak you out. Try to keep in mind that it’s completely natural. However, there are a few symptoms that you may want to discuss with your doctor, should they occur:
- The spit-up doesn’t look like milk, may be yellow or green in color.
- Your baby is spitting up blood.
- Your baby isn’t gaining or is losing weight.
- The stools look different, either watery or bloody.
- Your baby is fussy or not happy while eating.
At the End of the Day
Spitting up, even out of the nose, is a normal part of your baby’s development. So, as long as they’re feeding well, gaining weight, and aren’t overly fussy, things are probably just fine.
Taking precautions like burping, holding your baby upright, and not overfeeding, will minimize as much of the spit up as possible. If concerned, be sure to contact your baby’s pediatrician or doctor.