Regurgitation (Reflux) in Babies: Causes, Symptoms, and Management
Last updated: January 2026
Quick Answer
Yes, spitting up (ulti/regurgitation) is completely normal in babies - up to 70% of infants experience it! In most cases, your baby is a "happy spitter" who brings up milk but continues to feed well, gain weight, and is otherwise healthy. Reflux usually improves significantly by 6-7 months and resolves by 12-18 months as your baby's digestive system matures.
Understanding Reflux in Babies
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What is Regurgitation (Reflux)?
Reflux happens when milk from the stomach flows back up into the esophagus (food pipe) and sometimes out of the mouth. It occurs because the valve between the stomach and esophagus isn't fully developed yet.
Simple analogy: Think of your baby's stomach like a bottle without a proper cap - when full or squeezed, contents can easily come back up.
Normal vs. Concerning Reflux
Normal (Simple Reflux):
Baby spits up but is content
Good weight gain
Feeds well
No breathing problems
Happy between feeds
Wet and dirty diapers normal
Concerning (May be GERD):
Poor weight gain
Refuses to feed
Cries during/after feeds
Arches back in pain
Breathing difficulties
Blood in spit-up
What Causes Reflux?
Main Causes
1. Immature Digestive System
The valve (lower esophageal sphincter) is still developing
Most common cause
Naturally improves with age
2. Overfeeding
Baby's stomach is small (newborn stomach = walnut size!)
Too much milk at once comes back up
3. Swallowing Air
Poor latch during breastfeeding
Fast flow bottle nipple
Air causes pressure, pushing milk up
4. Lying Flat
Gravity doesn't help keep milk down
Common after feeds
5. Other Factors
Premature birth (more common)
Formula sensitivity (some babies)
Cow's milk protein allergy (rare)
Symptoms to Watch For
Normal Reflux Symptoms
Spitting up during or after feeds
Occasional hiccups
Mild fussiness after feeds
Wet burps
Warning Signs (May Need Medical Attention)
Projectile vomiting (shoots out forcefully)
Vomit is green or yellow
Blood in vomit or stool
Poor weight gain or weight loss
Refusing feeds repeatedly
Choking or breathing problems
Excessive crying during feeds
Arching back in pain
Fever with vomiting
Age-Wise What to Expect
0-3 Months:
Reflux most common during this time
May spit up with most feeds
Usually increases before getting better
4-6 Months:
Often starts improving
Sitting up helps
Introduction of solids may help some babies
6-12 Months:
Significant improvement for most
Walking and being upright helps
Solid foods help keep things down
Beyond 12 Months:
Reflux usually resolves
If continuing, consult pediatrician
Home Remedies for Managing Reflux
Feeding Adjustments
For Breastfed Babies:
Feed in upright position
Ensure good latch (prevents air swallowing)
Feed more frequently, smaller amounts
If you have fast letdown, express before latching
Feed from one breast per session (if milk flow is heavy)
For Bottle-Fed Babies:
Use slow-flow nipple
Keep bottle tilted so nipple is always full
Pace the feeding (take breaks)
Don't force baby to finish
Check formula preparation (not too dilute/concentrated)
Position Changes
During Feeding:
Keep baby at 45-60 degree angle
Never feed lying flat
Support baby's head and neck
After Feeding:
Hold upright for 20-30 minutes
Burp gently after every 2-3 minutes of feeding
Avoid bouncing or active play right after feeds
Don't put in car seat immediately (curves the tummy)
For Sleep:
Place baby on back (always - even with reflux)
Elevate head of crib slightly (ask doctor how)
Don't use pillows or wedges (suffocation risk)
Other Helpful Tips
Loose clothing: Avoid tight diapers or waistbands
Smaller, frequent feeds: Less volume = less spit-up
Burp often: Every few minutes during feed
Keep baby calm: Crying causes air swallowing
Avoid pressure on tummy: After feeds, don't press on belly
When to See a Doctor
Seek Immediate Care If:
Baby is choking or turning blue
Projectile vomiting
Vomit is green, yellow, or has blood
Baby appears in severe pain
Signs of dehydration (dry mouth, few wet diapers, sunken fontanelle)
Fever with vomiting
Baby is lethargic or unresponsive
Schedule Appointment If:
Poor weight gain
Baby refuses most feeds
Excessive crying during feeding
Symptoms getting worse, not better
Reflux continues beyond 12-18 months
You're concerned about baby's feeding
Treatment Options
For Most Babies (Simple Reflux)
No medication needed! Lifestyle changes are usually enough:
Positioning changes
Smaller, frequent feeds
Keep upright after feeds
Time - it gets better with age
When Doctor May Prescribe Treatment
1. Thickened Feeds
Adding rice cereal to bottle (doctor's guidance)
Special anti-reflux formula
Only if recommended by pediatrician
2. Medication (For Severe Cases)
Antacids to reduce acid (rare in babies)
Proton pump inhibitors (PPIs) - only for diagnosed GERD
Not given routinely for normal reflux
3. Formula Changes
Hydrolyzed formula if cow's milk protein allergy suspected
Specialized anti-reflux formula
What About Elimination Diets for Breastfeeding Mothers?
If cow's milk protein allergy is suspected:
Mother may try eliminating dairy for 2-4 weeks
Only under doctor's guidance
Not needed for simple reflux
Prevention
You can't completely prevent reflux (it's developmental), but you can reduce it:
Feed smaller amounts more often
Burp frequently during feeds
Keep baby upright during and after feeding
Ensure good latch or appropriate nipple flow
Avoid overfeeding
Keep baby's environment calm during feeds
Time feeds before, not after, car travel
Frequently Asked Questions
Q: Mera baby har baar doodh ulti kar deta hai - kya ye normal hai?
A: Some spit-up with most feeds is normal in babies under 6 months. As long as baby is gaining weight well, feeding normally, and seems comfortable, it's usually just "happy spitting." It looks like a lot because it spreads, but usually it's only 1-2 teaspoons. If baby is in pain, refusing feeds, or losing weight, consult your doctor.
Q: Kya reflux ki wajah se doodh kam ho jayega?
A: No, your milk supply is not affected by baby's reflux. Continue breastfeeding on demand. If you're concerned about overfeeding, try offering one breast per feed. Breast milk is actually easier to digest than formula and may cause less reflux.
Q: Baby ki ulti green ya yellow hai - kya karun?
A: Green or yellow vomit is not normal and needs immediate medical attention. It could indicate a bowel obstruction or other serious condition. Take your baby to the doctor or emergency room right away.
Q: Spit-up aur vomit mein kya difference hai?
A: Spit-up: Milk flows out gently, often during or right after feeds, baby is comfortable. Vomit: Forceful, may happen anytime, baby may seem uncomfortable. Occasional vomiting can be normal, but frequent forceful vomiting needs medical evaluation.
Q: Reflux kab tak rahega?
A: Most babies improve significantly by 6-7 months when they start sitting up and eating solids. By 12-18 months, reflux usually resolves completely. If it continues beyond this, or if baby has GERD symptoms, longer management may be needed.
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This article was reviewed by a pediatrician. Most reflux is normal and temporary, but trust your instincts - if something seems wrong, consult your doctor.
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