Here’s why Spitting Up Is Probably Normal (and Even Helpful)

New parents often find themselves staring at a tiny human covered in a milky mess, wondering, "Is this normal?" When it comes to spit-up, the answer in most cases is a resounding yes. Spitting up is a frequent occurrence for many babies, especially newborns. If it’s not causing your baby discomfort, spitting up is, basically, a laundry problem. That being said, it can be messy and concerning. To put your mind at ease, let’s dig into why this happens and when it might be a sign of something more.    

Why Do Spit-Ups Happen?

The culprit behind most baby spit-ups is an immature digestive system. Unlike adults, a baby's esophagus, the tube that connects their mouth to their stomach, has a weak muscular valve at the bottom. This valve is supposed to keep food going down, but sometimes, especially when a baby's stomach is full, it can allow some milk to flow back up. Here's another factor to consider: babies spend a lot of time lying down, both on their backs for sleep (which is the safest position) and during playtime. However, from an evolutionary standpoint, humans are biologically programmed to be carried for most of the day. This upright position helps with digestion and keeps the milk flowing smoothly down the esophagus. So, when a baby is laid flat on their back for extended periods, it can contribute to the milk coming back up. This is known as positional reflux.  Another cause of spitting up is air babies swallow while feeding. This air can cause discomfort and lead to spit-up. When a baby spits up, it may also expel some of that air, leading to a feeling of relief.  

How Can Spit-Ups Be Beneficial?

While the sight of spit-up might not be ideal, it might be a healthy thing. Believe it or not, some studies show how breast milk spit-up could be beneficial for babies. Breastmilk is a powerhouse of nutrients and antibodies that protect your baby from infections. As any kid who laughed too hard while drinking chocolate milk can tell you, the mouth and nose are connected through a back passage called the nasopharynx. This means that some of the breastmilk that comes up during a spit-up episode can travel to the nose, delivering those precious antibodies directly to the baby's respiratory system. A 2018 study published in the journal Pediatrics supports this idea. In the study, preterm infants who were tube fed and so didn’t naturally have breastmilk in their noses received breastmilk directly instilled into their noses. These babies fared better than those who only received breastmilk through a tube. This suggests that the antibodies in breast milk can indeed reach and benefit the respiratory system through the nose. Researchers also think that Stem cells reach the brain directly when babies spit up. They may be responsible for the study’s babies healing faster from common preterm brain complications.

When Are Spit-Ups a Problem?

While frequent spit-up is usually normal, there are some situations where you should consult your pediatrician. Projectile vomiting, which is forceful vomiting that propels the milk out of the baby's mouth in a large arc, is a cause for concern. If you see blood in your baby's vomit, it's important to seek medical attention immediately. If your baby seems excessively fussy or uncomfortable after spitting up, it could be a sign of an underlying issue, sometimes referred to as reflux. Reflux can be caused by immaturity of the digestion system but also by allergies and other issues. If your baby is not gaining weight as expected despite frequent feedings, your pediatrician may want to investigate the cause of the spit-up.

What Can You Do To Help Minimize Spit-Ups?

Here are some strategies that can help minimize spit-up in most babies. Normally, breastfed babies don’t need to be burped. Some research shows burping them even increases spit-ups. However, if your breastfed baby spits up a lot or seems uncomfortable during a feed, you may consider burping. Burp your baby after breastfeeding from one breast before offering the other breast or putting them down.  If you are bottle feeding, burp your baby every ounce or two and again at the end of the feed. Hold your baby as much as possible, and make sure to keep your baby upright for at least 20-30 minutes after feeding to aid digestion.  A baby carrier can come in handy for this. Try feeding your baby smaller amounts more frequently. You can speak to your lactation consultant about breastfeeding schedules that can help your baby get fattier milk if spit-ups and gas have become a serious issue. 

Spit-ups are usually nothing to worry about and may even offer some unexpected benefits. However, if you have any concerns about your baby's spit-up, especially if it's accompanied by any of the warning signs mentioned earlier, don't hesitate to reach out to your pediatrician. They can help you determine the cause of the spit-up and offer guidance on how to manage it effectively.