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Why does my daughter spit up?
Q: My 6-month-old daughter seems to spit up her formula more during the day. She does fine in the morning and at night. Is it possible she may get too hot or warm and the formula does not sit well on her tummy, or could there be another reason? She is on solid foods now and is doing well. Could I give her something else to drink during the day and limit the formula to morning and night feedings so she doesn’t spit up so much? When she spits it up it’s usually a great deal of curdled formula. I am unsure what’s best for her.
A: Jennifer, spitting up is common in young infants. It’s usually caused by immaturity of the muscles in the baby’s digestive tract, and is more common in premature babies. If the baby’s stomach is full with food or air bubbles, and the baby is bounced around or laid down immediately after a feeding, the food can come up.

Each baby has her own pattern of feeding—how often she feeds, how fast, how much, etc. It’s good that you’ve gotten to know your baby’s feeding patterns. Since she doesn’t spit up the morning and nighttime feedings, you might want to try to make the mid-day feedings more like them. Maybe she spits up the mid-day feedings because she’s a little too hungry, drinking a little too fast and playing a little too actively afterwards. Here are some ideas on how you might prevent your baby from spitting up her mid-day feedings:
  • During the day, try to feed her before she gets too hungry, so she’s not gulping down food and air.
  • Give her solid foods like cereal, pureed vegetables and fruit first. This will help her fill up with food that she’s less likely to spit up.
  • After the solid food, give her formula. Try a smaller quantity in her bottle, maybe four ounces rather than six to eight. Another option is to give her formula in a sippy cup to reduce how much and how fast she drinks. Some doctors recommend thickening the baby’s milk with a little rice cereal, about one teaspoon per ounce.
  • Try to keep the feedings calm and quiet. Take the time to burp your baby mid-feeding. And follow her cues: when she turns her head away, it means her stomach is full.
  • Feed her in a sitting or semi-sitting position, not lying down. Try to keep her in this position—either in your lap, her stroller, or an infant seat—for about 20 minutes after feedings.
  • If she continues to spit-up formula at her mid-day feeding, try giving her juice instead of formula. Be sure to give her 100% fruit juice and not fruit drink or fruit cocktail, which aren’t as nutritious. And don’t give her any more than four to six ounces of juice a day, since too much could upset her stomach and interfere with her growth.
  • Aim to give your baby 16 to 24 ounces of formula a day.
Talk with your pediatrician about other recommendations for your baby’s spitting up. The doctor will want to check your baby to make sure it isn’t interfering with her growth. Be sure to let the doctor know if your baby vomits forcefully after feedings or there’s blood in the vomit, which could indicate a more serious problem. Most babies have only mild spitting up that doesn’t interfere with their nutrition or growth, and they commonly outgrow it once they’re eating more solid food later in infancy.