Is your baby spitting up curdled milk? Or simply spits up a lot?
Let’s go through why a baby spits up, what the curdled milk means, and when the spitting up or vomiting may be a sign that something isn’t quite right. Learn what to do in each situation.
My baby boy is 5 weeks old. He is eating 4 oz every 3-4 hours. He is spitting up a lot. He was on breast milk, but after he was spitting up what looked like curdled milk his doctor said to try formula. He is doing the same thing, so switching to formula didn’t help at all. I’m not sure what to try now?
Brandi (Sparr, FL)
Baby Spitting Up Curdled Milk, Spits Up A Lot or Vomits: Reasons & Remedies
In this article…
- What Does Normal Baby Spit Up Look Like
- Baby Spit-up Color
- Why Do Most Babies Spit Up Even If They Are Not Ill?
- When Do Babies Stop Spitting up?
- Is My Baby Spitting Up or Vomiting?
- 9 Reasons for Excessive Spitting Up of Curdled Milk in Babies
- Warning Signs of Excessive Spitting Up in Babies
- How to Reduce a Baby’s Spitting Up of Curdled Milk?
What Does Normal Baby Spit Up Look Like
For babies that are fully breastfed or formula-fed, normal baby spit-up will look just like the formula or milk that he or she just had or may appear more or less curdled.
The milk becomes curdled when mixed with the acidic stomach fluid. So, a baby spitting up curdled milk in itself is completely normal. Many babies spit up a bit of curdled milk now and then.
If the baby swallowed the milk, and it is mixed with the stomach fluids, it will come back up curdled. If your baby spat up immediately after swallowing, the milk will come back up just like regular milk.
Baby Spit-up Color
As you have already noticed, baby spit-up is likely to be whitish as long as the baby is on formula or breastmilk. Once solid foods are introduced, the spit-up color will depend on what the baby is eating.
However, there are a few colors to watch out for:
Red or coffee-ground color usually indicates blood. This may need to be addressed immediately by a doctor.
Yellow or green spit-up could mean that your baby either is vomiting phlegm or bile, indicating that your baby is ill.
Babies can also spit up clear liquid, which is usually less of a concern. The spit-up can be saliva or stomach content, and it can indicate acid reflux or possibly pyloric stenosis, which you can read more about below.
But again, a baby spitting up curdled milk is not in itself an issue.
Why do most babies spit up even if they are not ill?
It is normal for infants to spit up, especially after feeding or during burping. This is often due to the immaturity of their lower esophageal sphincter or the LES, gastroesophageal reflux, wherein the abdominal contents flow back up to the esophagus, hence the infant spits up.
Another possible cause is aerophagia or swallowing too much air instead of milk.
And lastly, spitting up can also be caused by overstimulation of the infant during mealtime.
These events may occur in young babies and they are common. Babies usually outgrow reflux as they grow older, while aerophagia can be addressed by positioning the infant properly during feeding, and lastly, but keeping mealtimes more peaceful and not “bouncy”.
When Do Babies Stop Spitting up?
In general, spitting-up peaks at around 4 months and then stops at some point between 6 months and 12 months of age. Most babies more or less stop spitting up when they have become strong enough to sit up without support.
Unless there are specific underlying problems, you can say that generally, when babies can tolerate the amount of milk that they ingested, they don’t spit up anymore. So an infant that turns away from the breast or feeding bottle on his own will not spit up, taking into consideration that they are burped and held in an upright position for 30 minutes or so right after feeding.
Is my Baby spitting up or vomiting?
This is a very relevant question since spitting up is considered normal in many cases, while vomiting is always associated with illness.
Vomiting is more forceful than spitting up, and it involves more than just a couple of tablespoons of stomach contents. Vomiting can be a sign of a viral infection in the stomach, a reaction to something the baby ate, or another gastrointestinal problem.
- While spitting up is an easy backflow of stomach contents to the esophagus and into the mouth, vomiting is the forceful, voluminous backflow of stomach contents, and tends to be projectile. Vomiting is usually associated with illnesses such as infection, allergies, and abdominal obstruction.
- A spit-up is usually just a few milliliters of the stomach contents, while vomitus maybe the whole of what you consumed at a time.
9 Reasons for Excessive Spitting Up of Curdled Milk in Babies
Here are a few possible reasons for excessive spitting up of curdled milk:
1. Lactose Intolerance
Lactose intolerance is a common condition for infants. You can shift your formulas to low lactose content milk or lactose-free formulas. Sometimes, they can outgrow this, others may not.
You will find symptoms of lactose intolerance in this post.
You can try a low lactose formula, which can help your baby if he is lactose intolerant. (Link to Amazon, where you can check it out.)
2. Cow’s Milk Allergy
Cow’s milk allergy is a common childhood allergy. It occurs in 7% of babies less than 1-year-old but often resolves by 5 years old.
It can lead to an immediate-type or a delayed-type of reaction when cow’s milk is consumed. For the immediate type of CMA, the infant experiences symptoms right after the introduction of the cow’s milk, while for the delayed type of reaction, the symptoms can be seen after several hours or days after the introduction of CM. The baby may experience one or more symptoms:
- rashes on face or eyelids
- swelling of the face, lips, or around the eyes
- vomiting, abdominal colic, diarrhea, stomachache
- nasal congestion or runny nose
- more severe symptoms include: wheezing or difficulty in breathing, swelling of the throat (these red flags indicate a trip to the emergency room ASAP!)
For a baby with cow’s milk allergy, a type of formula that may work are hydrolysate formula, which is hypoallergenic.
Remember that it is entirely possible to continue breastfeeding a baby who is allergic to cow’s milk! All you have to do is to eliminate cow’s milk from your own diet.
3. Acid reflux
Another possible cause is acid reflux. This is quite common among newborn babies, where the gastric juices containing acid can travel back from the stomach into the throat. Continuing breastfeeding is still recommended. Give small frequent feedings. Set him in an upright position right after feeding and make sure to burp him.
Switching to formula can sometimes help slightly since the formula is a bit thicker than breast milk. This is probably why the doctor suggested it. But it is a fairly minor difference – or no difference, as in your case!
There is also some medication available for severe acid reflux.
Obviously, no one can tell if your baby does have reflux without examining him and there may be other reasons for his spitting up.
4. Feeding position and swallowing of air
Positioning during feeding is important since the baby’s LES are immature.
Keep your baby’s head elevated when feeding, so the milk flows directly down to the esophagus and the stomach. Keeping his lower extremities higher than his head can cause a backflow of the contents to his esophagus. Also, this can eliminate aerophagia, which can also cause spitting up.
Keeping him in an upright position after feeding is also helpful in keeping the milk down and actively preventing any reflux to happen. Keep him in this position until he burps.
Babies have small stomachs that can only accommodate a few millilitres per feeding. But sometimes, they become overzealous in feeding that they do not release the breast from their latch.
When you notice your baby spitting up after feeding or while burping and grunting while sleeping, this is usually a sign of overfeeding. Hence, it is still advisable to give them small frequent feedings, to feed on demand, and to always keep them upright right after feeding.
6. Immature gastrointestinal system
As already mentioned, infants have less developed gastric organs. The lower esophageal sphincter or LES is still immature and can weakness of this sphincter can cause reflux or spit-up. A baby may spit up to 10 to 12 times in a day and it is still considered normal.
7. Pyloric Stenosis
Pyloric Stenosis is a condition where the outlet of the stomach is too narrow for the foods to travel over into the intestines. It usually presents with projectile vomiting of milk that may or may not is curdled and an olive-shaped mass near the umbilical area. This condition needs treatment and surgery. (You can read more about pyloric stenosis at KidsHealth.org).
This video presents an excellent explanation of pyloric stenosis:
8. Duodenal Atresia
Duodenal Atresia is another anatomical abnormality that can present with vomiting shortly after birth. In this case, there is a closure in the first part of their small intestines.
Duodenal Atresia is rare and the cause is unknown. 1 of 3 cases occur in babies who also have Down’s syndrome.
You can watch the video below to learn more about the condition:
9. Intestinal malrotation and volvulus
Another condition is intestinal malrotation. It is a birth defect and happens when your baby’s intestine doesn’t turn like it should. This can result in the intestine getting twisted (called volvulus) which in turn can cause a blockage.
This usually presents with abdominal distention and bilious vomiting.
There are more anatomical abnormalities that can present with vomiting or spitting up. The best thing to do is still to call your doctor.
A neurological infection or a gastrointestinal infection can present with spitting up or vomiting. Increased intracranial pressure can press on the vomiting center of the brain, causing the baby to spit up more frequently than normal. Acute gastroenteritis can cause vomiting and is usually accompanied by watery stools.
These situations warrant medical consult the earliest possible time. It is important to avoid dehydration since infants are so fragile to infections like these.
This is not a full list, of course, but some examples. It may very well also be that nothing is wrong with your baby and that he simply is a baby who spits up a bit more than the average infant. If your baby is gaining weight and doesn’t appear to be in pain, he is likely to be fine.
Warning Signs of Excessive Spitting Up in Babies
The reason I say that the doctor and you may have misunderstood each other is that it should be the excessive spitting up rather than the curled milk that is the main problem.
Here are some indicators from Mayo Clinic of problematic excessive spitting up in babies:
- Your baby isn’t gaining weight
- The spit ups are forceful, more like real vomiting
- The spit-up contain green or yellow fluid
- Your baby spits up blood or material that looks like coffee grounds (which is likely to be blood, and in this case you need to take your baby to a doctor immediately)
- Your baby refuses to eat repeatedly
- There is blood in his or her poop
- Your baby has difficulty breathing or other signs of illness (again, call the Dr or an ambulance, depending on the situation)
- Spitting starts late – at age 6 months or older (this could, for example, be due to a food intolerance)
- If your baby cries a lot – for more than three hours a day and is more irritable than normal
- Shows signs of dehydration and has fewer wet diapers than usual
It is always imperative to consult your doctors when there are sudden changes in your babies’ diet, activities, milestones, and habits. Babies are prone to infection and are very vulnerable when they get sick. Breastfeeding is still the best source of antibodies for babies up to six months of age.
How to reduce a baby’s spitting up of curdled milk?
First of all, make sure there are no medical reasons for his spitting up and again remember that it is not the curdled milk that may be a problem, but how much your baby is spitting up/vomiting and his or her health in general.
If you believe any of the reasons explained above may be relevant to your baby, consult a doctor.
If the spitting up is caused by less concerning reasons, such as how your baby is fed, his age, mild acid reflux, etc, then here are some tips to prevent him from spitting up:
- Feed your baby before she is starving. A very hungry baby will feed more aggressively and risk swallowing air or overfeed.
- Burp frequently.
- Feed in smaller portions (but more frequently).
- Feed in a more upright position.
- Consider low lactose milk formula or lactose-free milk formula (if your baby is formula-fed).
- Limit active playing, like bouncing or tummy time for 30 minutes after feeding. Keep his meal times peaceful.
- Duodenal Atresia
- Approach to Pediatric Vomiting
- Vomiting in Children
- Intestinal Malrotation and Volvulus in Children
Hey, parents, is your baby spitting up curdled milk too? Please help this mom by commenting below! Or share your own thoughts and worries!