
If you're a new parent, you may be alarmed to see your newborn spitting up yellow fluid. However, rest assured that spitting up is a normal occurrence for newborns and older babies, usually caused by an immature digestive system. In fact, mild reflux occurs in at least 50% of infants and tends to improve with age. While most spit-up is clear and consists of partially digested formula, breast milk, or saliva, gastroesophageal reflux can cause yellow spit-up when stomach acid mixes with formula or breast milk. Although reflux is typically harmless, if you notice any red flags, such as forceful vomiting, choking, coughing, or irritability during feeding, it's important to consult your pediatrician.
Characteristics | Values |
---|---|
Spit-up colour | Yellow |
Spit-up frequency | More than once a day |
Spit-up amount | More than 1-2 tablespoons |
Baby's behaviour | Happy, hungry, and growing well |
Baby's age | Newborn to 1 year old |
Possible causes | Gastroesophageal reflux, pyloric stenosis, food allergy, overfeeding, swallowing air |
When to be concerned | Blood in spit-up, bile (bright yellow or green), choking, frequent crying, failure to gain weight |
What You'll Learn
Gastroesophageal reflux disease (GERD)
While it is normal for a newborn to spit up, if the spit-up is yellow, it could be a cause for concern. Yellow spit-up can be mucous, bile, or colostrum. If your baby is spitting up yellow, it is always a good idea to check for other symptoms and contact your pediatrician.
Yellow spit-up can be a sign of gastroesophageal reflux disease (GERD). GERD is a more severe and long-lasting form of gastroesophageal reflux (GER). GER occurs when the contents of the stomach come back up into the oesophagus, which is the tube that goes from the throat to the stomach. GER is common in infants because they have a liquid diet and spend a lot of time lying down. They may outgrow GER as they get older.
GERD can cause the following symptoms in infants:
- Not gaining weight
- Difficulty eating or swallowing
- Blood, or green or yellow fluid in their vomit
- Breathing problems such as wheezing, coughing, or trouble breathing
- Coughing or wheezing so much that it wakes them up
If left untreated, GERD can lead to serious complications. However, it can be treated with medicine and lifestyle changes. Lifestyle changes that may help include:
- Not smoking around the baby
- Burping the baby more often
- Holding the baby upright for 20 to 30 minutes after they eat
- Placing the baby on their back to sleep
- Feeding the baby smaller amounts and avoiding overfeeding
- Extending the time between feedings
- Thickening the formula to help reduce reflux
If lifestyle changes are not effective, your baby's doctor may prescribe medication to help block and lower the amount of stomach acid. Surgery is rarely suggested for babies, as they will most likely outgrow GERD by the time they are 18 months old.
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Food allergies or intolerance
It is normal for newborns to spit up, and this usually occurs during or shortly after feedings. This happens because the "gatekeeper" muscle—the lower esophageal sphincter, which acts as a valve between the esophagus and the stomach—isn't fully developed. When a newborn's stomach is too full or they change positions suddenly after a feeding, their stomach contents may flow back into the esophagus and out of their mouth. This is known as gastroesophageal reflux or reflux.
Now, onto the question of food allergies or intolerance.
If you are concerned that your baby may have a food allergy or intolerance, it is important to consult your healthcare provider for guidance and advice. They may recommend thickening formula or expressed milk with small amounts of baby cereal or starting a medication. In some cases, a referral to a gastroenterologist may be necessary.
It is worth noting that spitting up is generally not a cause for concern and usually improves with age. Most babies outgrow spitting up by around 12 months of age. However, if you are worried or if your baby is not gaining weight, frequently upset, or showing other signs of discomfort, be sure to consult your healthcare provider.
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Feeding position
It is normal for a newborn to spit up, and this may be yellow in colour due to stomach acid mixing with formula or breast milk. This is known as gastroesophageal reflux (GER) or infant acid reflux and occurs in around 50% of babies. It is usually not harmful and babies tend to grow out of it.
- Keep your baby upright during feeding and for at least 30 minutes afterward. Holding your baby is best, as the way they sit in an infant seat can make spitting up more likely.
- Ensure your baby's head is above their feet while feeding. Do not hold your baby in a dipped-down position.
- Burp your baby during feeding and afterward. If bottle-feeding, burp your baby after they drink 1-2 ounces. If breastfeeding, burp your baby after feeding from each breast.
- Try feeding your baby smaller amounts more frequently, rather than larger amounts less often.
- If your baby is bottle-feeding, do not give the bottle while they are lying down.
- If your baby is breastfeeding, try nursing in a more upright position (head above the breast) or in a side-lying position to slow the flow of milk.
- If your baby is pulling off and gagging or coughing during feeding, sit them up in a seated burp position and gently pat their back to help them calm down before continuing feeding.
- If your baby is bottle-feeding and gags or chokes, try a different nipple with a slower flow and practice "paced" bottle-feeding by slowing down the milk flow and allowing your baby to pause for breaks.
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Overfeeding
It is normal for newborns to spit up, and this usually occurs during or shortly after feedings. In fact, mild reflux occurs in at least 50% of infants and usually doesn't cause any discomfort or complications. However, if your baby is spitting up yellow fluid, this could be due to several reasons, one of which is overfeeding.
Additionally, it is important to hold your baby in an upright or vertical position for 15 to 30 minutes after feeding. If you are unable to hold your baby upright for that long, you can use a front pack, infant seat, swing, or jump seat, depending on your baby's age and ability. Reducing your baby's sucking time and avoiding tight diapers can also help decrease spit-up.
It is important to note that if your baby is frequently spitting up, has forceful or projectile vomiting, appears uncomfortable, or shows other signs of discomfort or illness, you should consult your doctor.
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Dehydration
It is quite common for babies to spit up, and in most cases, it is not a cause for concern. Mild reflux occurs in at least 50% of infants and usually doesn't cause any discomfort or complications. However, if your baby is spitting up yellow liquid, it could be a sign of gastroesophageal reflux (GER) or infant acid reflux. This happens when the contents of the baby's stomach move back up through their oesophagus.
- A sunken soft spot on the top of the head
- Sleeping too much
- Crying with little or no tears
- Cold or discoloured hands and feet
If your baby is spitting up or vomiting frequently and showing signs of dehydration, it is important to call your doctor. They may recommend meeting with a breastfeeding or lactation specialist to help your baby latch on and drink properly. In some cases, your baby may need to be hospitalised and given fluids through a bottle, a tube from their nose to their stomach, or intravenously.
To prevent dehydration, it is important to ensure your baby is feeding regularly and getting enough fluids. Breastfeed or bottle-feed your baby frequently, and if they are older, offer them water in addition to milk. Keep track of their feeding schedule and the number of wet diapers, as this can be an indication of their fluid intake.
If you are concerned about your baby's spitting up or vomiting, and especially if you notice any signs of dehydration, it is always best to consult your doctor for personalised advice and guidance.
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Frequently asked questions
Yellow spit-up in newborns can be due to gastroesophageal reflux (GER) or infant acid reflux, which occurs when the contents of the baby's stomach move back up through their oesophagus. This happens because the lower oesophageal sphincter, the "gatekeeper" muscle, is not yet fully developed. This is a typical occurrence in newborns and usually improves with age.
While spitting up is common and usually not a cause for concern, you can try the following to reduce it:
- Feed your baby in an upright position.
- Keep your baby upright for at least 20-30 minutes after feeding.
- Take frequent burp breaks during feedings.
- Avoid overfeeding and offer smaller, more frequent meals.
- Avoid active play after feedings.
Consult your doctor if you notice any of the following:
- Your baby is choking, coughing, or wheezing.
- Your baby refuses to eat or is irritable while eating.
- Your baby arches their body during or after feeds.
- The spit-up is forceful or projectile.
- The spit-up contains blood or looks like coffee grounds.