Limiting infant spit-up

Q: My infant son constantly spits up after feeding, to the point where he seems to spit up almost his entire bottle. He still has full diapers, so we feel he’s getting enough food, but should we try to limit the amount given? He screams when we stop feeding him midway through a bottle. Are there any tips to limit spit-up?

A: Part of the reason spitting up is so common for babies is because the valve at the top of the stomach is usually not fully developed. 

This valve opens when food passes from the esophagus into the stomach and then should close when food is in the stomach. Immature valves can open at the wrong time or not fully close, resulting in spit-up. This is called gastroesophageal reflux (GERD). In babies, this kind of reflux is usually not a serious problem, just a very messy one that most infants outgrow. So what can you do?

If you’re bottle-feeding, consider offering smaller volumes (perhaps not dramatically smaller volumes at first), but more frequently. And use the slowest-flow nipple available to keep your son from filling up before he realizes he’s full.  

Nursing moms might consider nursing for shorter times or only doing one breast at a time, but, again, more frequently.  

Right after feeding, try to keep your baby in an upright position in a stroller, swing or carrier for 20 minutes or up to an hour. (On a personal note: We found that if we fed our infant son smaller volumes more frequently and kept him upright in the Ergo baby carrier after the feedings for about 20 minutes, the amount he spit up greatly decreased.)

Avoid tummy time after feedings, which is notorious for causing spit-ups.

Don’t be too vigorous with burping after feeding. You can also try, if he’s eating very quickly, to pause during feeding to burp him and possibly let out some extra air.  

Note: In very rare cases, GERD is severe enough to cause a baby to not want to nurse or take a bottle, be irritable during or after a feeding. If you have concerns that your child’s experiencing severe symptoms, please seek medical care.