All babies spit up or throw up now and then. But some do so more often than usual. This is called reflux. Reflux is short for gastroesophageal reflux or GER.
Reflux is common among premature babies. Most babies outgrow it after a few months. Only 1 percent of babies are still spitting up after their first birthday.
- Food first passes through the mouth and the esophagus into the stomach. The esophagus is the tube that connects the mouth and the stomach.
- Once the food is in the stomach, it comes back up the esophagus and out of the mouth.
- Most babies with reflux are less bothered by it than their parents. They grow and develop normally. But for a few babies, reflux is more serious. The baby needs medication to make sure reflux is not dangerous.
If your baby had reflux in the NICU, the nurses may have shown you how to feed and position your baby to minimize spit up. These tips may help:
- Hold your baby upright during feeding.
- Try smaller, more frequent feedings.
- Burp your baby often, especially if you are feeding him with a bottle.
- Try a different nipple on your baby's bottle so he swallows less air.
- Ask your baby's health care provider if you can thicken the formula or expressed breast milk with a small amount of rice cereal.
- Keep your baby still after feeding.
- Raise the head of your baby's bed 30 degrees or so.
- Keep a stack of cloth diapers or burp cloths handy. Use them to protect your clothes, your baby's clothes and your furniture.
If your formula-fed baby spits up more often than usual, his health provider may suggest adding a small amount of baby cereal to thicken the formula.
These symptoms may mean that your baby has other problems digesting food:
- The spit-up is bright yellow or green.
- There is a large amount of spit-up.
- Your baby arches his back or cries during feeding.
- Your baby vomits with great force (projectile vomiting).
- Your baby refuses to eat or is irritable after feeding.
Last reviewed November 2013
Frequently Asked Questions
Is there any way to prevent RSV?
The season for respiratory syncytial virus (RSV) infection in the United States is usually October to April. It's wise to take precautions to help prevent it. The main thing to do is wash your hands often and thoroughly with soap and water. Make sure everyone who touches your baby has clean hands. Keep your baby away from crowds of people. Do not allow anyone to smoke around your baby. Cover your mouth when you cough or sneeze and don't share cups, spoons and forks with others. RSV is very contagious. Almost all babies get it before the age of 2. Talk to your baby's health care provider about ways to prevent RSV.
What is diphtheria?
Diphtheria is a disease caused by a bacteria. The disease causes a thick coating in the nose, throat and airway. It can lead to breathing problems, heart failure, paralysis or even death.
Diphtheria can be spread by coughing and sneezing. Symptoms may include a slow onset of a sore throat and low-grade fever.
The DTaP (for children) and Tdap (for adults) vaccines can protect against diphtheria, tetanus and pertussis. Your baby gets the DTaP vaccine in four doses: at 2 months, 4 months, 6 months and between 15 and 18 months.
If you’re thinking about getting pregnant, make sure you’re protected against diphtheria. If you need to get vaccinated, get the adult vaccine before pregnancy.
What is Haemophilus influenzae type b?
Hib is a serious disease caused by bacteria. It usually affects young children.
Hib is spread from person to person through coughing or sneezing. Hib can cause meningitis, pneumonia and other serious health problems.
The Hib vaccine protects against this disease. Your baby gets the Hib vaccine in three to four doses: at 2 months, 4 months, 6 months (some brands of the vaccine require a shot at 6 months, but others don’t) and between 12 and 15 months.
What is hepatitis B?
Hepatitis B is caused by the hepatitis B virus. It can lead to serious liver disease. Signs of hepatitis B infection include belly pain, joint pain, dark urine, loss of appetite, nausea, fatigue and jaundice. However, most people who have hepatitis B infection never show any signs.
You can catch hepatitis B if you’re in contact with bodily fluids of someone who has it. For example, you can get the virus from kissing or having sex with an infected person. You also can get it if you share needles with someone who has the virus. During pregnancy, a mom with hepatitis B can pass the infection on to her baby during childbirth. Pregnant women are tested for hepatitis B at a prenatal care visit.
Most people with hepatitis B get better and may not need treatment. However, if you have chronic (long-lasting) hepatitis B infection, you may need treatment with medicines called antivirals that fight the virus. If the liver is badly damaged, you may need a liver transplant. Babies and children are much more likely than adults to get chronic hepatitis B infection.
The hepatitis B vaccine can prevent infection in babies and adults. Your baby gets three doses of hepatitis B vaccine: at birth, 2 months and between 6 and 18 months.
What is measles?
Measles is a disease that is easily spread and causes rash, cough and fever. In some cases, it can lead to diarrhea, ear infection, pneumonia, brain damage or even death. Measles can cause serious health problems in young children. It also can be especially harmful to pregnant women and can cause miscarriage.
The measles, mumps and rubella (MMR) vaccine protects against these three diseases. Your baby gets the MMR vaccine in two doses: the first between 12 and 15 months, the second between 4 and 6 years.
If you’re thinking about getting pregnant, make sure you’re protected against measles. If you need to get vaccinated, get the MMR vaccine before pregnancy. Wait at least 1 month before trying to get pregnant after getting the shot.
What is meningitis?
Meningitis is an infection that causes swelling in the brain and spinal cord. It’s usually caused by a virus or bacteria. The infection can spread from person to person through coughing, sneezing, kissing or sharing drinks.
Most people get meningitis from a virus. If you get this kind of meningitis, you’ll probably get better in a few days without treatment. But the meningitis caused by bacteria can lead to brain damage and even death.
Adults may have symptoms like headache, fever and a stiff neck. These symptoms are sometimes mistaken for the flu. Babies may show different symptoms, like high fever, constant crying or even seizures.
If you think anyone if your family has meningitis, see your health care provider right away.
The Hib vaccine can protect against bacteria that cause meningitis. Your baby gets the Hib vaccine in three to four doses: at 2 months, 4 months, 6 months and between 12 and 15 months. Some brands of the vaccine require a shot at 6 months, but others don’t. Ask your provider if you have questions about when your baby gets the vaccine.
What is mumps?
Mumps is a disease that spreads easily from person to person, usually through coughing or sneezing.
It causes fever, headache and swollen glands around the jaw. It can lead to hearing loss, meningitis and painful, swollen testicles in men.
The measles, mumps and rubella (MMR) vaccine prevents against these diseases. Your baby gets the MMR vaccine in two doses: the first between 12 and 15 months, the second between 4 and 6 years.
If you’re thinking about getting pregnant, make sure you’re protected against mumps. If you need to get vaccinated, get the MMR vaccine before pregnancy. Wait 1 month before trying to get pregnant after getting the shot.
What is pertussis?
Pertussis (whooping cough) is a disease caused by bacteria. Pertussis leads to coughing and choking that can last for several weeks. Babies who catch pertussis can get very sick, and some may die. Most deaths from pertussis happen in babies less than 4 months old.
The number of pertussis cases in this country has more than doubled since 2000. This may be because protection from the childhood vaccine fades over time. In the last few years, there have been several large pertussis outbreaks. Outbreaks are common in places like schools and hospitals. The disease spreads easily from person to person, usually by coughing or sneezing. Most infants who get pertussis catch it from someone in their family, often a parent.
The DTaP vaccine for children and the Tdap vaccine for adults can protect you and your children from pertussis, diphtheria and tetanus. Your baby gets the DTaP vaccine in four doses: at 2 months, 4 months, 6 months and between 15 and 18 months. The pertussis part of the vaccine may weaken as your child gets older. So for the best protection, she gets a fifth shot before she starts school, around 4 to 6 years old.
All new parents need the pertussis vaccine. Until your baby gets her first pertussis shot at 2 months, the best way to protect her is for you to get the adult vaccine before pregnancy or soon after you have your baby. The vaccine prevents you from getting pertussis and passing it along to your baby. Caregivers, close friends and relatives who spend time with your baby should get vaccinated, too.
What is pneumonia?
Pneumonia is an infection in the lungs caused by bacteria or viruses.
Pneumonia can cause coughing, shortness of breath and chest pain. You can catch it from another person, even if he doesn’t look or feel sick.
Several vaccines can protect you from pneumonia by preventing infection from certain bacteria or viruses. One vaccine that protects against pneumonia is pneumococcal conjugate vaccine (PCV). Your baby gets the PCV vaccine in four doses: at 2 months, 4 months, 6 months and between 12 and 15 months.
Other vaccines that help protect against pneumonia include:
- Influenza (flu)
- , mumps, rubella (MMR)
- , and (DTaP for children and Tdap for adults)
- Varicella (chickenpox)
If you’re thinking about getting pregnant and are at risk for pneumonia, your provider may recommend that you get vaccinated before pregnancy. Talk to your provider if you think you may be at risk for pneumonia.
What is tetanus?
Tetanus (also called lockjaw) is a disease caused by bacteria that attacks the nervous system (that includes the brain, spinal cord and nerves).
Stiffness in the neck or stomach muscles may be early symptoms of tetanus. Tetanus also can cause the jaw to “lock,” so that a person can’t open his mouth or swallow. It also can cause serious, painful spasms of all muscles. It sometimes causes death.
Tetanus is not passed from one person to another. Instead, the bacteria that causes tetanus can enter your body through a break in your skin and cause infection. For example, if you step on a nail, cut your skin in an accident, or get a splinter, you may be at risk of tetanus infection.
The DTaP (for children) and Tdap (for adults) vaccines can protect you from tetanus, diphtheria and pertussis. Your baby gets the DTaP vaccine in four doses: at 2 months, 4 months, 6 months and between 15 and 18 months.
If you’re thinking about getting pregnant, make sure you’re protected against tetanus. If you need to get vaccinated, get the adult vaccine before pregnancy.
What’s an umbilical hernia?
This common hernia in infants usually appears as a soft lump or bulge beneath the belly button. You may see it most clearly when your baby is crying, pushing her belly outward. It happens when a portion of the intestine bulges through the abdominal wall. This happens when the muscles in the area fail to close around the belly button after the umbilical cord falls off. It's more common in girls, particularly African Americans, or premature babies.
Umbilical hernias usually aren't serious or painful to the baby and they go away without treatment by the fifth birthday - often much sooner. If you suspect your baby has a hernia, call your child's health care provider. It’ll be important to watch it for changes over time. If it enlarges or swells, or if you baby has severe pain, vomiting or weakness, call your child's health provider right away, as a serious complication could exist. If surgery is required, it’s usually a quick fix.