Spitting up and vomiting

7 May 2020

Babies often vomit during their first few weeks because they have to get used to a new way of feeding, and their bodies are still developing. However, it is important to know the difference between spitting up and vomiting.


What is the difference?


  • Spitting up (also known as gastro-oesophageal reflux) is usually in small amounts and flows easily out of your baby’s mouth – almost like drooling or dribbling. Once milk is swallowed, it passes through the oesophagus, past a ring of muscles (oesophageal sphincter) and then into the stomach. That ring of muscles connects the oesophagus and stomach, and opens to let food in then closes once the food is through. Spitting up happens because the sphincter doesn’t close tight enough and the milk comes back up.


  • Vomiting is more forceful and is also usually larger amounts of food that get brought up.



Most times, your baby will spit up either from eating too much or too little.


Just like you wolf down food when you are really hungry, babies do this too, even while they are nursing. They become over-eager and end up swallowing too much air while feeding, which is spat up when they burp.


On the other hand, if your baby drinks too much, they will spit up because their little stomachs can only hold so much.


What can you do to help?


  • Try feed your baby in the most upright position possible and after 30 minutes of feeding, sit your baby upright – unless they have fallen asleep of course.
  • Avoid going too long without feeding as this will make them likely to overfeed.
  • Avoid overfeeding; a tummy that is too full will spit up the excess.
  • Help get any wind out. Burping your baby after a feed will prevent too much air building up in your baby’s tummy.
  • If you are breastfeeding, keep track of your own diet. Certain foods may trigger spitting up more than others.


When should you worry?


Nine times out of 10, spitting up is completely normal and nothing to worry about, but there are those rare cases that involve a more serious underlying condition. Contact your doctor or midwife if you notice any of the following:


  • Your baby is spitting up green fluid or blood.
  • Your baby is not gaining weight or is losing weight.
  • There is blood in your baby’s stool.
  • Your baby is urinating less frequently.
  • Your baby refuses to feed repeatedly.


Many times spitting up can be helped by adjusting feeding techniques and diet, and most babies stop spitting up by the time they are 12 months old.