🩺 Health · Birth to 1 year
🤮 Acid reflux or just normal spit-up?
Spit-up is common in infancy and often improves as babies grow. A comfortable baby who feeds and grows well usually needs less intervention than a baby with pain, feeding difficulty or poor growth. Your pediatric team can help distinguish normal reflux from illness.
What to notice
- Small amounts of milk coming up effortlessly can be normal when baby otherwise seems well.
- Crying, arching, gulping and poor sleep have many possible causes; they do not diagnose GERD or “silent reflux.”
- A brief record of feeds, vomiting, wet diapers and growth concerns can help a clinician.
Practical feeding habits
1. Review the feed, not just the spit-up
Follow hunger and fullness cues rather than pushing a fixed volume. For bottles, hold baby and use responsive pacing; never prop the bottle. Ask for help with breastfeeding attachment or bottle flow if feeds seem difficult.
2. Try comfortable upright holding
Hold baby upright after a feed if it helps, with head and neck supported. Stay awake and keep the airway clear. You do not need to keep an exhausted adult holding baby for a fixed interval.
3. Pause gently and avoid pressure
Offer a burp break if baby seems uncomfortable; not every baby burps at every feed. Avoid tight waistbands and pressure on the tummy immediately after feeding.
4. Keep sleep flat and on the back
Even with reflux, use a flat, firm, clear crib or bassinet and place baby on their back. Do not raise the mattress or use wedges or positioners. Share your room for at least six months; do not use a carrier, sofa or adult bed as the routine sleep space.
5. Seek help for warning signs
Get urgent assessment for green vomit, blood in vomit, repeated forceful vomiting, a swollen abdomen, dehydration or marked lethargy. Poor growth or repeated feed refusal also needs prompt review. Call 911 for breathing difficulty, blue colour or floppiness.
6. Discuss changes before trying them
Ask your pediatric team before using thickeners, changing formula or starting reflux medicines. Do not add cereal or extra powder to bottles. Formula must be mixed using safe water at least 70°C and the exact product ratio, then cooled before feeding; never microwave and discard feed leftovers.
A local detail, or your own experience with this guide? Write to the team
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When in doubt, contact your doctor or midwife. For a life-threatening emergency, call 911.