Spitting up is the mild vomiting or regurgitation of food, milk and saliva. It usually occurs right after feeding or burping. The spit up fluid may look exactly like the formula or milk that was just fed or may appear slightly curdled.
A valve between the oesophagus and the stomach helps prevent food from coming back up and out of the stomach. Since the valve is not well developed in the infant, it causes spitting. Because the infant’s stomach is small, over-feeding or swallowing too much air can help push food past the valve. As the infant grows, the valve develops and solid foods are introduced spitting up decreases.
If the spitting up is forceful and shoots out of the mouth, it can be a sign of pyloric stenosis. This condition usually appears in the first several weeks of life and is caused by an abnormal narrowing of the valve leading from the stomach to the intestine.
Normal infant spitting up does not require emergency treatment. The child should be taken to the hospital:
- If the infant stops breathing, or turns blue in colour during a spitting up episode. With normal spitting up, the child may choke or gag briefly but should not stop breathing or turn blue.
- If the spit up appears green or brown it may be a sign of a blockage in the intestine.
Certain feeding techniques may help with spitting up:
- The infant must be fed slowly and made to burp after feeding.
- Small but frequent meals should be given. Stop feeding once the infant seems full.
- Keep the infant upright for some time after feeding.
- Significant activity immediately after feeds should be avoided.