What should I do if my baby keeps spitting up milk?

Mar 17, 2025 Source: Cainiu Health

Dr. Zhou Xiaofeng

Introduction

In general, persistent spitting up in infants may be caused by rapid feeding, incomplete gastric development, indigestion, gastroesophageal reflux, respiratory tract infections, or other reasons. After identifying the specific cause, appropriate measures such as general treatment, medication, or surgical treatment should be taken under the guidance of a professional physician. When dealing with infant spitting up, parents should remain calm.

Generally, persistent spitting up in infants may be caused by rapid feeding, incomplete gastric development, indigestion, gastroesophageal reflux, respiratory tract infections, and other related factors. After identifying the specific cause, general treatments, medications, and other measures can be implemented under the guidance of a qualified physician. Detailed explanations are as follows:

1. Rapid Feeding

When infants eat too quickly, they may swallow excessive air, increasing intra-abdominal pressure and pushing stomach contents back into the esophagus, resulting in spitting up. Symptoms may include irritability, frequent swallowing, and hiccups. It is recommended to regulate feeding pace, reduce the volume per feeding, and increase feeding frequency. Ensure the infant latches correctly during feeding to avoid excessive air intake. Gently burping the baby after feeding helps expel air from the stomach.

2. Incomplete Gastric Development

An infant's stomach is not fully developed; the pyloric sphincter (the stomach's exit) tends to be tighter, while the cardiac sphincter (the stomach's entrance) is relatively weak, making spitting up more likely. This condition typically does not present with other symptoms, and spitting up decreases as the infant grows and the stomach develops. Parents are advised to elevate the baby's head slightly by placing a pillow under the mattress. Additionally, burping the infant after feeding helps release gastric gas and reduces internal stomach pressure.

3. Indigestion

Indigestion causes food to remain in the infant's stomach for an extended period, leading to fermentation and gas production, which increases gastric pressure and results in spitting up. Other symptoms may include bloating, diarrhea, constipation, and reduced appetite. Prompt medical consultation is advised, and medications such as lactobacillus tablets, live combined bifidobacterium and lactobacillus tablets, or herbal remedies like Xingpi Yang'er Granules may be taken as directed to regulate intestinal flora and aid digestion. Dietary adjustments are also necessary to avoid feeding the infant difficult-to-digest foods.

4. Gastroesophageal Reflux

Due to incomplete development of the sphincter between the stomach and esophagus in infants, food may easily flow back from the stomach into the esophagus, causing spitting up. Symptoms may include restlessness and crying after feeding. It is recommended to reduce the amount of milk per feeding and increase feeding frequency. Under medical guidance, acid-reducing medications such as omeprazole sodium for injection, domperidone suspension, or digestive tablets may be used to decrease gastric acid secretion and promote gastrointestinal motility.

5. Respiratory Tract Infection

During respiratory infections, increased secretions in the airways may impair breathing and swallowing function, leading to spitting up during feeding. Other symptoms may include coughing, runny nose, and fever. Symptomatic treatment targeting the respiratory infection should be administered under medical supervision, using medications such as Paracetamol, Chlorpheniramine, and Codeine granules for children, or Chai Gui Antipyretic Granules. Maintaining clear airways and preventing coughing during feeding are also important.

When managing infant spitting up, parents should stay calm and take appropriate actions based on the underlying cause and severity of vomiting. Additionally, adjustments to dietary habits and lifestyle should be made to support recovery.

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