Feeding a baby can be messy business, especially if your baby is one of half of all infants who spit up. While the phenomenon may cause you extra laundry, it's not usually cause for concern. "As long as babies are gaining weight and are happy and comfortable, even those who spit up 10 to 20 times a day shouldn't require a visit to a gastrointestinal specialist," says Judith Sondheimer, M.D., professor of pediatrics at the University of Colorado Health Sciences Center in Denver.
Babies spit up because the muscles in their digestive tracts aren't fully mature—a condition called reflux that corrects itself in almost all babies by the time they can walk. But spitting up rarely interferes with your baby getting the nutrition he needs. Though it may seem like a lot of curdled breast milk or formula ends upon your shoulder, looks can be deceiving. "What is actually a tablespoon of spit-up formula can look like several ounces when mixed with stomach juices," says Michael Hart, M.D., director of pediatric gastroenterology and nutrition at the Carilion Children's Medical Center in Roanoke, VA.
To keep spitting up in check, offer smaller amounts of breast milk or formula more frequently, and keep your baby upright for about 20 minutes after each meal. Leave snap-bottom clothing unfastened, and make sure that diapers aren't too tight. If your baby spits up during the night, ask your doctor about using a wedge, like the Tucker Sling, to keep your baby partially upright while sleeping. (www.tuckerdesigns.com; $99; 800/780-7479)
Talk to your pediatrician if your baby is overly fussy following feedings, suffers uncomfortable diarrhea or bloating, or is slow to gain weight. In these cases, the spitting up could be caused by a milk allergy or more severe reflux that requires medication. And seek immediate medical attention for forceful spitting up that seems more like vomiting than a wet burp, or if your baby spits up blood or yellowish-green bile—either may signal a more serious condition.