It’s normal for babies to spit up, but how much spit up is too much? Here we break down the differences between normal vs. abnormal spit up.

It’s your baby’s four-month birthday. You put her in that little white outfit that Grammy made. The one that can’t go in the washing machine. Before you can snap a pic, your precious little one opens her little mouth and vomits all over everything. After you groan and clean it up, you start to wonder: is this normal?

Spit-up is a fact of infant life; a huge percentage of babies give out these smelly gifts throughout the day. They are particularly adept at puking directly into your cleavage so you smell like sour milk all day.

But how do you know if there’s something bigger at work here? Here are some tips that might help you know where to start.

1. If your baby is...

Fussy + 

Spitting up a lot (projectile or otherwise) +

Uncomfortable or crying when spitting up +

Popping off the breast or twisting away from bottle during feeding +

Kicking legs and arching backs

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Consider… Possible reflux. 

Reflux is very common in babies; in fact, more than half of all babies have it. But most of those babies are what doctors call “happy spitters,” which means they spit up but it doesn’t seem to bother them much. But if your baby seems fussy and unhappy, it’s worth talking to the doc about ways you can help.

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2. If your baby has a lot of the symptoms above AND…

Mucusy or bloody stool +

Very frequent spit-up +

Discomfort 45-60 minutes after feeding

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Consider… an allergy. 

To test for an allergy, your doctor will check a dirty diaper for signs of stool (even if you can’t see it, there might be traces of blood in there). The most likely allergy for babies is cow’s milk, but there are others out there, of course. If there are signs of allergies and you are breastfeeding, you may start an elimination diet to determine what’s upsetting your little one’s tum. Discuss it with your pediatrician.

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3. If your baby has a lot of the symptoms above AND...

No blood in their stool

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Consider… a food sensitivity

Sometimes our digestive systems just plain don’t like stuff. Your baby might have a sensitivity, which is less severe than an allergy. You can talk to your doc about a possible elimination diet, anyway. It isn’t as necessary, but it still might help.

Sources:

WebMed: Is it Colic or Something Else? https://www.webmd.com/parenting/baby/features/infant-digestive-conditions#1

Baby Love: Reflux in Your Baby

https://babylovenappies.com.au/blog/premmie/reflux-in-your-baby/

Mayo Clinic: Spitting up in babies: What’s normal, what’s not

https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/healthy-baby/art-20044329