Breastfeeding provides your baby with natural nutrition in the most convenient way. Your milk is easy to digest and has antibodies to help keep your baby's digestive system healthy. Breastfeeding also minimizes air swallowing and too-rapid feedings that can make spitting up worse in bottle-fed babies. However, even breastfed babies often spit up after a feeding. The appearance of the spit-up varies, but, most of the time, white chunks in the milk are normal.
Appearance and Smell
The appearance of your baby's spit-up varies depending on when he spits up. If he spits up immediately after breastfeeding, the spit-up looks like fresh milk. If the milk has had time to mix with stomach acids, it typically has white chunks and a curdled appearance, similar to the sour milk you get by adding vinegar to milk. Curdled and lumpy spit-up also may have a sour smell, similar to vomit. This chunky appearance and bad smell are normal, according to Pediatrician Jennifer Shu on HealthyChildren.org.
Causes of Spitting Up
Some babies are greedy feeders and take in more than their stomachs can handle. Even a breastfed baby spits up when she's had more to eat than she can hold in her stomach. Burping or drooling can also trigger spitting up, as can jostling the baby or putting her down quickly. The immaturity of an infant's digestive tract makes spitting up more common in the early months, but some illnesses can cause spitting up or vomiting.
Approximately half of all babies experience spitting up due to infant reflux, a type of gastroesophageal reflux disease, or GERD, according to the Mayo Clinic website. Reflux occurs during the early months until the valve between the stomach and the esophagus develops fully, but it usually resolves as the baby matures. Although the amount of spit-up is often small, overfeeding can increase it. Infant reflux usually doesn't cause the baby to feel distress or cry.
Vomiting and Illnesss
Vomiting is different from reflux or simple spitting up because it typically produces a large volume and can be a sign of illness. For example, a baby may lose most or all of the feeding by vomiting. If your baby vomits several times in a day or every day, or if he vomits bright green matter, the American Academy of Pediatrics recommends consulting a pediatrician. Vomiting during the first month of life, looking or acting sick, forceful vomiting, diarrhea with vomiting, failure to gain weight and refusing feedings are other signs you should consult a physician immediately.
If your breastfed baby spits up a lot and your doctor has ruled out medical issues, you can reduce the problem by taking a relaxed and unhurried approach. If your physician recommends it, try feeding the baby smaller amounts more often. Burp him after he takes each breast rather than at the end of the entire feeding. Keep him upright or sitting for 30 minutes after the feeding, Mayo Clinic recommends. When you lay him down, put him gently on his back to avoid bringing up milk.