Liquid regurgitation in babies

When parents carry their baby, the spit-up cloth over the shoulder is a staple: it catches liquid "burps". If a baby regurgitates some milk or food more often, it is usually not a reason to worry.

Babies gain weight very quickly in their first year of life and need a lot of food to do so. It is sometimes difficult for their digestive system to cope with this without problems. Infants therefore spit up more often in the first months of their lives. It is normal for a small amount of milk to come back up, about a spoonful.

Only rarely does liquid regurgitation indicate illness. But then it is usually accompanied by other problems – for example, if the child does not grow properly.

How does liquid regurgitation occur? Information on $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

From the mouth to the stomach, food passes through the esophagus ("food pipe"). At the lower end of the esophagus sits a ring of muscle also called the lower esophageal sphincter. This muscle ring ensures that the food pulp remains in the stomach. In infants, this "sphincter" often does not yet function properly; moreover, their stomachs are still relatively small.

Liquid burping is not vomiting. When vomiting, among other things, a contraction of the diaphragm and the muscles of the esophagus causes the stomach contents to be actively regurgitated out. Most of the time you also feel nauseous. In liquid regurgitation, the food simply rises back up and a little flows all the way back into the mouth. The technical term for this is "regurgitation".

Esophageal sphincter in babies

When is liquid regurgitation normal? Information on $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

Half to two-thirds of all babies regurgitate liquid at least once a day by the time they are six months old. So if your baby is spitting up more often, there’s no need to worry: it may be a nuisance sometimes, but it’s normal as long as the baby has no symptoms. It also does not spit up because it has been fed too much or because it does not tolerate the milk well.

By ten to twelve months, only 5 out of 100 babies are still spitting up. For the others, the problem has simply grown without any treatment. When liquid burping stops varies from child to child: some babies still spit up regularly when they are older than one year.

When medical advice is needed? Information about $CMS_IF( ! tt_headline.isEmpty)$$CMS_VALUE(tt_headline.toText(false).convert2)$$CMS_END_IF$

If your baby is well-fed and thriving, a medical problem is unlikely. Babies who simply burp and have no other complaints also do not need to be examined. A visit to the doctor is necessary, however, if your baby..

  • Spits up very often, is strikingly pale, is not growing, and is not gaining weight as would be normal for his or her age.
  • Has pain – then cries a lot, cries or often arches his back.
  • Coughs, gasps, and clears his throat frequently. This can be a sign that the baby’s esophagus is irritated by stomach acid.
  • spits not only after a meal, but also when fasting.
  • vomits like a gush: This causes the gastrointestinal muscles to cramp and food to be regurgitated in larger quantities and with some pressure.
  • has diarrhea and fever at the same time: When babies lose too much fluid, they can quickly become dehydrated, and that can be dangerous for them.

In a few babies, liquid regurgitation may indicate a serious problem, for example in premature babies and babies with conditions that delay their development. Frequent spitting up can then be a sign of intestinal malformations, for example. In this case, the baby is also likely to vomit more often and have gastrointestinal spasms that can be felt or seen. In case of such signs, fast medical help is important.

Reflux disease can also be behind the complaints. The refluxing food can cause damage to the esophagus or respiratory diseases if food gets into the lungs.

Gortner L, Meyer S, Sitzmann FC. Dual series in pediatrics. Stuttgart: Thieme; 2012.

Mazur LJ, Smith HD. Gastroesophageal reflux in the infant. In: Moyer V, Elliott E (Ed). Evidence-based pediatrics and child health. London: Wiley; 2004.

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Whether one of the options we have described is actually useful in a particular case can be clarified in consultation with a physician. Health can support, but not replace, discussions with doctors and other specialists. We do not provide individual consulting.

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