Spitting Up and Reflux in Infants

What is normal, safe feeding and sleep practices, and when to seek help

MEDICALLY REVIEWED - APPROVED FOR WEBSITE PUBLICATION

This page is for general education only and does not replace individualized medical advice. This resource does not establish a doctor-patient relationship. For questions about your own child, contact your child's current healthcare professional.

Magnolia Pediatrics, Valley Children's Healthcare
2497 E. Herndon Avenue, Suite 101, Clovis, CA 93611 | 559-538-3070

Spitting up is common in infancy. A baby may bring up a small amount of milk during or soon after a feeding and still look comfortable, feed well, have normal wet diapers, and gain weight. This ordinary reflux usually improves as a baby grows, sits more independently, and begins solid foods.

Urgent warning signs - check this first

Call 911 now for trouble breathing, blue or gray lips or face, a baby who is limp or unresponsive, or another life-threatening emergency.

Go to an emergency department now for green or yellow-green vomit, blood or material that looks like coffee grounds in the vomit, or a baby who chokes and turns blue or goes limp.
Seek urgent medical care for forceful or projectile vomiting, especially in a baby 2 weeks to 2 months old; dehydration; severe belly swelling; or a baby who looks very ill.
A baby younger than 3 months (12 weeks) with a rectal temperature of 100.4 F (38 C) or higher needs prompt medical evaluation.

What is commonly normal

Small amounts of milk coming back up without force, discomfort, coughing, choking, or a change in color.
Spitting up that begins in the first weeks of life and occurs mainly during or after feeds.
A baby who remains alert, seems comfortable overall, feeds adequately, makes wet diapers, and gains weight as expected.
Reflux that gradually improves during later infancy. For many babies it peaks around 4 to 5 months and resolves by 9 to 12 months.

Safe ways to reduce spit-up

Feed at a calm pace and pause when your baby needs a break. Avoid forcing a baby to finish a bottle or feeding.
Burp gently during natural pauses and after feeding. Do not repeatedly interrupt an effective feed just to make a baby burp.
Hold your baby upright for about 15 to 20 minutes after feeding if this seems comfortable. Avoid pressure on the abdomen from tight diapers or waistbands.
For sleep, always place your baby on their back on a firm, flat, non-inclined sleep surface. Do not elevate the mattress, use a positioner, or let a baby sleep in a sitting device because of reflux.
Discuss any change in formula, feeding volume, nipple flow, thickened feeds, or feeding schedule with your child's healthcare professional, especially if your baby is young or has poor weight gain.

When reflux may need medical evaluation

Gastroesophageal reflux disease (GERD) is different from ordinary, painless spit-up. A clinician may look for GERD or another cause when reflux is associated with feeding difficulty, poor growth, pain, breathing symptoms, or other complications.

Contact your child's healthcare professional if spitting up is getting worse, starts after 6 months of age, continues beyond 12 months, or becomes forceful.
Call for frequent choking or gagging, trouble swallowing, repeated coughing or wheezing with feeds, refusal to eat, persistent crying that seems related to feeding, poor weight gain, fewer wet diapers, or blood in stool.
Do not start acid-suppressing medicine, herbal remedies, or over-the-counter stomach products without individualized medical guidance. These do not help ordinary spit-up and may cause harm.

Sources and medical review

Sources checked: August 14, 2026 | Medical review completed: August 14, 2026