HELP! My Baby Spits up Clear Liquid : Could it be Reflux?

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Spit-ups are common among newborns. Read on to learn why your baby spits up clear liquid and what you can do.

Worries come naturally to you when you are a first-time parent. Every little thing that newborns do differently like banging their head against your chest, chewing their hands aggressively, or keeping their mouth always open makes you question their actions. From their every whine to sleeping longer than usual seems like a ‘red alert’.

And when it comes to newborns spitting up after breastfeeding or bottle-feeding, it is definitely a cause of concern for new parents.

But take solace in knowing that spitting up is common in newborns and usually, it is nothing to worry about. But frequent and persistent spitting up, along with poor weight gain can be a sign of acid reflux in babies.

Let’s look at why the baby spits up clear liquid and what you can do to help your baby.  

Related Read

Why Baby Squirms, Cries, or fuss while Bottle Feeding? (Bottle-feeding Problems and Solutions)

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My Baby Spits up Clear Liquid..should I worry about it?

Nearly 40% of normal, healthy babies spit up after feeding. Spitting up clear liquid is often due to saliva, formula, breastmilk, or a combination of all three.

Spit-up, also called gastroesophageal reflux (GER) or physiological reflux, is common in babies, occurs throughout the day in infants.

My son was a big spitter. He was exclusively breastfed, and he would spit up clear liquid after every feed. I was worried and convinced that he was starving since he was spiting after every single feed.

Despite all the spit-up, he was never fussy and was gaining weight. My pediatrician reassured me that he is healthy and spitting up due to GER.

Babies often spit up when they are overfed or get too much milk too fast. This may happen when the mom’s breasts are too full or the baby feeds aggressively.

If the baby is pulling off the breast or fussy at the breast, she may swallow air and spit up more often. Some babies spit up more when they are teething or starting solid foods.

If you are worried about the quantity of spit up then you shouldn’t. It may look like a lot and makes you wonder if the baby getting enough milk or tempts you to feed again.

You might be surprised to know that, most spit up is only a teaspoon of liquid, according to our pediatrician.

To put my mind to ease, our pediatrician also suggested trying a simple experiment: Pour a tablespoon of liquid on the floor and compare the spit ups. You will notice that the liquid on the floor is larger.

Baby spit up usually drools or spurt out of their mouth. Occasionally, the baby spits up forcefully or projectile. Frequent spitting up or vomiting without any other condition – is called acid reflux or gastroesophageal reflux disease (GERD). This is mostly due to the anatomy of the digestive tract in infants.

If the baby is a ‘Happy Spitter’ (without discomfort, content, and gaining weight), then spitting up is a laundry and social problem rather than a medical issue.

Why is baby Spitting up Clear Liquid?

Wondering, why some baby spits up clear liquid and do it frequently? Most babies have some level of reflux during the first year of their life.

The most common causes for baby to spit up clear liquids are,

Immature Digestive System

Babies spit up because…they are just being a baby. The lower esophageal sphincter muscle that separates the esophagus and stomach is underdeveloped in babies, which allows the content of the stomach to wash back into the baby’s food pipe – esophagus and sometimes throat- causing spit-up.

Breastmilk oversupply or fast letdown

Sometimes, mama’s breasts are too full and it’s hard for the baby to keep it up with milk flow. It can cause the baby to take in excess air while swallowing all that milk.

Overactive letdown can also cause the baby to take in air while feeding. It can be easily remedied by pumping out some milk before feeding or trying different breastfeeding positions.

If you are bottle-feeding, make sure you have a slow flow nipple and try paced bottle feeding.

Improper Latch

Improper latch while breastfeeding or bottle-feeding can also cause the baby to take in an excessive amount of air. Ensuring proper latch while feeding may help with spit-up and also save you from clogged milk ducts and other discomforts while breastfeeding.

Food sensitivities

Sensitivities to food or milk can also lead to excessive spitting in babies. Look out for allergies to cow’s milk or something in mom’s diet (if you are breastfeeding).

Burping

You may also notice clear liquid coming out of the baby’s mouth when they burp. It is called a wet burp. This is again due to an immature digestive system backing up liquids from the stomach.

Tight Diaper

The wrong size of diapers could cause spit-up in babies. Too tight diapers around the abdomen can put pressure and cause the baby to spit up clear fluid.

GERD

Gastroesophageal Reflux Disease can also cause the baby to spit up clear liquid. This is more serious than physiological reflux.

As mentioned earlier, reflux in babies is due to a poorly coordinated digestive system. Anything that causes the lower esophageal sphincter to relax, can cause GERD. Reflux (spit-up) becomes GERD or Acid reflux when acid in the reflux irritates or injures the esophagus.

Remember that GERD is not as common as reflux. Approximately one in 300 infants show abnormal signs and symptoms of GERD.

Many infants with GERD are healthy. However, some infants can have problems affecting their nerves, brain, or muscles. Most infants grow out of the condition by their first birthday. Read on to learn the difference between spit-up and GERD below.

Pyloric Stenosis

Pyloric stenosis is a condition where a baby’s thickened and narrow pyloric sphincter muscle restricts food in the stomach from entering the small intestine.

To empty stomach, it contracts and causes the liquid to come back up as a clear liquid or curdled milk. This stomach contraction causes the liquid to come out forcefully, often referred to as projectile vomiting.

Pyloric Stenosis is a serious condition, and it requires immediate medical attention.

How do you know if your Baby has Reflux (Spit-up) or GERD/Acid reflux?

Symptoms may vary, here are some common ones to look out for. Diagnosis of GERD may require a doctor’s intervention.

Reflux (Spit-up)	GERD or Acid reflux
Frequent spit-up	Frequent vomiting, projectile vomiting
Normal after eating	• Frequent crying after eating • Irritability after eating • Back arching after eating • Resistant to lying on the back • Gassy and/or foamy bowel movement • Colicky, unhappy
Prolonged or refused to feed	• Feeding refusal or lengthy feedings • difficulty swallowing • pain when swallowing • Hiccups, burps, or sour breath
Normal weight gain	Poor weight gain, weight loss, and failure to thrive
No significant respiratory symptoms	Coughing or choking regularly, wheezing, or hoarseness, apnea, recurrent pneumonia
No neurobehavioral symptoms	Neck tilting in infants

Natural Remedies for Baby Spitting up Clear Liquid

Natural remedies for spit-up are not aimed at curing the condition but to help the baby feel better until she outgrows it.

Breastfeeding Frequently

Aim for frequent breastfeeding, rather than larger, less frequent feedings. These smaller, less frequent feeding can be easier to digest. If you are formula feeding or baby on solid, feed smaller quantities more often.

Try feeding the baby in an upright position – called the koala or upright football hold while feeding. This position ensures that milk goes into the stomach rather than staying up in the esophagus reducing spit-up.

A Boppy pillow can help position the baby upright after meals.

Try lots of skin-to-skin contacts or breastfeed in motion if the baby is fussy and refuses to feed.

Don’t switch breasts often when the baby is actively sucking. Switching sides too often can cause excessive spitting up.

Allow baby comfort sucking at the breast or offer a pacifier after feeding since it reduces irritation and speeds gastric emptying.

Hold baby upright after feeding

Hold baby upright for a minimum of 30 min after feeding. You can babywear in an infant wrap or sling to make things easy. You can walk around the house or have the dad walk around the house with the baby after feeding.

After feeding, if the baby needs to go to sleep make sure they sleep elevated to reduce acid reflux in the baby.

Our favorite woven wrap to maintain the baby in an upright position is Moby Wrap. The material is breathable, soft and it does not contain any buckle or straps that could pinch a baby.

This wrap supports the entire back and shoulders to distribute the baby’s weight, making it comfortable for both of you. Check out the Moby Wrap here.

Don’t forget to Burp!!

Make sure to burp the baby frequently after each feeding. My grandmother suggested burping the baby at least 2 times after feeding. I know that sounds crazy (I thought so too!!) but worked for my son. He was less gassy and reduced spit-ups.

If your baby seems fussy at feeding, stop and burp your baby and then begin feeding again. Try burping baby every 5 min if you are breastfeeding or early ounce if you are bottle feeding.

Avoid compressing the baby’s stomach while burping as it can increase reflux. Try another position of burping such as—support the baby’s chest and head with one hand by gently holding your baby’s chin in your palm (not throat). Use your other hand to pat your baby’s back.

Check out this video to learn about the burping method.

Sleeping position

If the baby is uncomfortable laying on his back, swaddle her and put her in a rocker/sleeper. Several research studies have compared various positions to determine which works best for babies with reflux.

Studies have shown that lying baby on the left and baby on his tummy helped reduce reflux significantly. These should ONLY be done when the baby is awake under continuous monitoring and should be avoided during sleep due to the increased SIDS risk.

Loose clothing

Dress baby in loose clothing with loose diaper waistbands. While changing a diaper, roll baby on his side rather than lifting legs toward tummy..

Probiotics

Probiotics can boost the health of the gut thereby improving digestion. Including me, some mothers have seen improvement in acid reflux symptoms after feeding probiotic supplements (L.reuteri) to their babies.

Research study has shown that giving infants a probiotic during the first three months of their lives can improve colic, acid reflux symptoms, and constipation (source).

Switch Formula

Spit up may cause your baby to refuse a bottle. Don’t panic if your baby suddenly refuses a bottle. Try cow-milk-free formula as many babies are sensitive to cow milk protein. Or ask your pediatrician for a better formula option.

Homeopathic remedy

Aethusa cynapium is an herb used in homeopathy to treat digestive issues. Aethusa is especially beneficial for infants who have a problem digesting milk resulting in spit ups or vomiting.

I have used Aethusa 200x for acid reflux in my 2 months old son. I was a little hesitant to give my 2-month-old baby anything that is not breastmilk, but I am glad that I chose with the doctor’s permission.

He was much better in the 4th month, stopped spitting up or showing any other symptoms of acid reflux. I gave him five globules dissolved in 1 tsp of breastmilk three times a day for 5 days.

Some moms have also benefited from the use of Nat Phos a natural cell salt for acid reflux in their babies. Nat Phos 6X is a natural cell salt that aids with digestion. Some babies don’t make enough of it.

Consult your doctor before administering homeopathic remedies to your infant. Dissolve ½ tablet in breastmilk (1 tsp) or formula and give it to a baby with a syringe.

Some moms also tried Gripe water or Colic calm successfully for baby reflux. Although it did not work for my son’s reflux.

Is there any Medication for Baby Spitting up clear Liquid?

There are no medications if your baby is normal other than spitting up clear liquid. However, the pediatrician may prescribe medication to help reduce stomach acids in case the baby is diagnosed with GERD.

Doctor may recommend

• Proton pump inhibitor such as Prilosec
• Histamine-2 blocker such as Zantac, Pepcid
• Antacids such as Mylanta

Keep in mind that they can occasionally cause side effects such as an increased risk of intestinal and respiratory infections. These medications should only be used under the doctor’s supervision in babies with GERD.

Does Thickening Formula help Spitting-up clear Liquid?

Baby cereal mixed with breastmilk or formula has been used to treat reflux in babies. Thickening feeds may help food to stay down in the stomach but it is not a good idea for several reasons.

Thickened formula or breast milk may reduce spitting up, but silent reflux is still present in babies. It may cause increased coughing after feeding and decreased gastric emptying time as the baby’s digestive system is not ready for solids.

Your baby may take in less milk overall decrease in nutrient intake– if you are thickening feeds. Early introduction of solids before 3 months increases the baby’s risk for allergies, respiratory infections, type 1 diabetes.

The early introduction of solids also affects the breastfeeding relationship and is associated with early weaning.

How long does Spit-up in babies last?

Babies usually start spitting up clear liquid between weeks 2 and 4. They peak around 2-4 months of age and begin to subside around 6-7 months when the baby begins to sit upright. And usually resolves by 12 months of age.

What does it mean when a Baby Spits Up Curdled Milk?

Baby spits up curdled milk when milk from breastfeeding or formula sits in the stomach for a little bit and mixes with stomach juices.

Immediate baby spits up after feeding is usually a clear liquid but as time passes, spits up look like curdled milk.  

Baby Spits-up Clear Liquid – Conclusion

It may be exhausting to deal with a baby spitting up clear liquid but remember that they do outgrow it at some point. As always, watch your baby, take a note of what bothers your baby and what works best to ease the reflux in babies.

Did your baby spit up clear liquid? What remedy worked for you? Leave your comment below.

References
Behrman RE, Kliegman R, Jenso HB, eds. Nelson Textbook of pediatrics. 16th ed. Philadelphia: W.B. Saunders, 2000:1125–6.

Carroll AE, Garrison MM, Christakis DA. A systematic review of non pharmacological and nonsurgical therapies for gastroesophageal reflux in infants. Arch Pediatr Adolesc Med 2002;156:109-13

Corvaglia L, Rotatori R, Ferlini M, et al. The effect of body positioning on gastroesophageal reflux in premature infants: evaluation by combined impedance and pH monitoring. J Pediatr 2007;151:591-6
Image Credit – Photo by Hollie Santos on Unsplash

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