A: Jennifer, spitting up is common in young infants. It's usually caused by immaturity of the muscles in baby's digestive tract, and it's more common in premature babies. If the baby's stomach is full with food or air bubbles, and she's bounced around or laid down immediately after a feeding, the food can come up. This is also known as gastroesophageal reflux.

Each baby has her own pattern of feeding—how often she feeds, how fast and how much. It's good that you've gotten to know your baby's patterns. Since she doesn't spit up morning and nighttime feedings, you might want to try to make midday feedings more like them. Maybe she spits up midday 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 midday feeding, try giving her juice instead of formula. Be sure to give her 100 percent fruit juice and not fruit drink or fruit cocktail, which isn'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. The doctor will want to check your baby to make sure the spitting up isn't interfering with her growth. If it is, the doctor might prescribe medicine to help prevent it.

Be sure to let the doctor know if your baby vomits forcefully after feedings or if 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.