As the mother of a newborn or infant, you’ve probably seen your baby spit up more than once. You may have even seen the milk come out of your baby’s nose.
It can be pretty 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 in infants is a natural and regular occurrence, when milk comes back up from the baby’s stomach through the mouth or nose.
- Spit-up can happen frequently due to an immature stomach valve, distractions while feeding, swallowing air, or coughing/sneezing.
- Spit-up is less severe than vomiting and can be caused by different factors.
- To reduce the frequency of spit-up, parents can try feeding their baby on time, using smaller hole on the nipple if bottle-fed, creating a quiet and distraction-free environment while feeding, and not overfeeding the baby.
Spit-up Through the Nose — Is It Normal?
Reflux in infants is when milk comes back up from a 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:
- Immature stomach valve: A sphincter muscle connects your baby’s stomach and esophagus. The lower esophageal sphincter muscle is immature in newborns and sometimes allows food to escape into the esophagus (3).
- Distractions: When your baby gets distracted while feeding, their suck-swallow reflex can be disrupted. They may swallow too much milk at once, causing slight choking, sending milk back out the nose.
- Swallowing air: If your baby is really hungry, they might feed in a rushed, gulping manner. This can cause them to ingest air. The air can then return later, bringing the milk with it.
- Coughing or sneezing: Your newborn baby has little control over their body. 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. 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 vomiting reflex. They include the following:
- The nerves in the stomach or intestine reacting to inflammation or irritation due to an infection or blockage.
- Chemicals 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 (4). However, this shouldn’t happen regularly. If it doesn’t pass quickly and your child shows signs of illness, we recommend contacting your health care provider.
How Can I Reduce How Often My Baby Spits Up?
Spit-up isn’t a pleasant part of child rearing. It stains clothes and blankets, and you will have to do more laundry than you ever wished to do. Plus, if your baby is on formula, their spit-up will smell awful.
There’s good news, though. Here are a few things you can do to reduce your little one’s chances of frequently spitting up:
- 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 happening around them. This may be the most difficult thing to fix if you have other children to care for.
- Don’t overfeed: If your baby is acting full, even if they’ve eaten less than usual, trust their instincts (5). Don’t force them to eat more than they want or need.
- Burp your baby immediately: You can reduce a lot of spit-up by simply making sure your baby has been properly burped.
- 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, lay 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 (6).
- Avoid tight clothing: You’ll want to avoid putting pressure on the stomach. This can include fasting the diaper too tight.
When to Call Your Doctor
Spitting up is 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 you may want to discuss with your doctor should they occur:
- The spit-up doesn’t look like milk, or it’s yellow or green.
- Your baby is spitting up blood.
- Your baby isn’t gaining or is losing weight.
- Your baby’s 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, you have no reason for concern.
Taking precautions like burping, holding your baby upright, and not overfeeding will minimize as much of the spit-up as possible. If you’re concerned, contact your baby’s pediatrician or doctor.