Skip Ribbon Commands
Skip to main content
Skip Navigation LinksBoys Town Pediatrics > Knowledge Center > Health Articles > Spit-Up Concerns

Spit-Up Concerns

When to be Concerned About Spit Up

​Spitting up is normal and completely harmless for most infants. When the spitting up or vomiting becomes too frequent, your child may have Gastroesophageal Reflux (GER). This reflux is a result of an immature digestive system and the poor closure of the valve (ring of muscle) at the upper end of the stomach. Most reflux or spitting up occurs during or after a meal, when the stomach, or tube that connects the stomach, is full. GER can begin during the first few weeks of life, peaking around 4 months and ending by 12 months of age. As long as your baby is not experiencing any discomfort and is making the appropriate weight gain, he/she is a healthy and normal infant.

Tips to Reduce Infant GER:

  • Do not over feed your baby. More frequent, smaller feedings may reduce vomiting.
  • Add rice cereal to bottle feedings. (1 Tablespoon of rice cereal per 1 ounce of formula or breast milk)
  • Keep your baby in an upright position for 30 minutes after feeding.
  • Burp your baby during and after feedings.
  • Do not smoke around your baby.
  • Elevate your baby’s head during sleep. (According to the American Academy of Pediatrics, the best sleep position for a baby is on his/her back).
  • Avoid tight diapers or elastic waistbands that put pressure on baby’s abdomen.

Contact your physician right away if your child’s condition is severe, worsens or you notice the following symptoms:

  • Blood or a yellow or green fluid when vomiting
  • Poor weight gain or growth
  • Difficulty eating
  • Inconsolable or severe irritability
  • Difficulty breathing, wheezing, turning blue, chronic cough or breathing stops

Always contact your physician if you have questions or concerns about your baby’s health. If GER symptoms continue, you may choose to see a Pediatric Gastroenterologist—a medical doctor who specializes in the digestive health care of infants, children and adolescents.