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Spit-Up vs. GERD

If you're wondering whether your baby's little upchucks are normal or caused by something more serious, like gastro-esophageal reflux disease (GERD), here's how to tell:

Normal spitup

Most babies experience some kind of regular reflux—mild to moderate spitting up—from the mouth or nose without pain or discomfort. It's most common during or right after feedings (okay, you knew that!).

What's the harm? You'll worry about choking, but it's rarely caused by spitup.

What to do: Always burp your baby mid-feeding, and keep her upright immediately after she eats—she still may spit up, but maybe not so much. Leading experts no longer recommend thickening bottles with rice cereal, especially for regular spitup. One reason: A new study in Pediatrics found that this can lead to overfeeding, which only makes spitup worse (the last thing you want).


Babies might have this disorder if they spit up or vomit often, scream or cry for hours, refuse feedings, or don't gain weight.

What's the harm? If a baby associates eating with pain, this can lead to low weight. There's also the potential for esophageal damage.

What to do: Call the doctor, who may suggest you change your diet to make breast milk more palatable; bottle-fed babies may need an easier-to-digest hydrolysate formula. It can also help to feed your baby smaller amounts more often and burp her midway through, as well as keep her upright for a half hour after. Your doctor might also prescribe an antacid. By age 1, the vast majority of babies outgrow GERD.