Knowing the difference between baby spit up and vomit is essential when caring for babies. One needs to be guided when to seek medical help and when to regard the incident as simply a rite of passage most babies normally go through.

Definitions

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Baby spit up is common to many healthy babies under one year of age. It is the easy flow of the baby’s stomach contents coming back out of his or her mouth, possibly with burping. All babies spit up at least every now and then, while some do it regularly, some as frequently as with each feeding. This condition is known as gastroesophageal reflux, infant reflux or infant acid reflux. After a baby swallows milk, it glides past the back of the baby’s throat, down a muscular tube called the esophagus, to the stomach. A ring of muscles called the lower esophageal sphincter opens to let the milk into the stomach. When that ring does not tighten again, the milk can come back up. That is reflux.

Young babies are particularly prone to get reflux because of their tiny stomach, just about the size of their fist, and so they tend to fill up easily. In addition, their lower esophageal sphincter is still too immature to work as it should. During the first few months, most babies will spit up small amounts of formula or breast milk, usually within the first hour after feeding. As a baby’s digestive system becomes more mature, they will be able to keep more food in their stomach. By around 6 to 7 months of age, or once they learn to sit up on their own, most babies stop spitting up, but a few will still do until their first birthday.

Normal baby spit up is not a cause for concern because it does not interfere with a baby’s well-being. Most babies who spit up are happy, comfortable, feeding well, gaining weight, and have no health problems caused by spitting up. However, if a baby spits up so much that he or she is not gaining enough weight or if spitting up is associated with respiratory symptoms such as choking, coughing, or wheezing, it is best to ask medical advice as there may be a reason to be concerned.

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If spitting up is making a baby uncomfortable, and gets more forceful with more volume than usual, it might be vomit. If a baby seems to be straining, or in pain, and if the milk is being forcefully expelled, it is vomit. Vomiting occurs when the abdominal muscles and diaphragm contract vigorously while the stomach is relaxed.

Occasional vomiting may occur during a child’s first month of life. It may be just a mild feeding difficulty, but could also be a sign of something more serious, particularly when vomiting happens repeatedly or is unusually forceful. Persistent and forceful vomiting between two weeks to four months of age may be caused by a thickening of the muscle at the stomach exit, known as hypertrophic pyloric stenosis. This condition prevents food from passing into the intestines, and requires immediate medical attention. An important sign of this condition is forceful vomiting occurring within fifteen to thirty minutes after every feeding.

After the first few months of life, the most common cause of vomiting is a stomach or intestinal infection. By far the most frequent infecting agents are viruses, but sometimes bacteria or even parasites may be the cause. The infection may also produce diarrhea, fever, and sometimes nausea and abdominal pain. At times, infections outside of the gastrointestinal tract will cause vomiting. These include infections of the urinary tract, infections of the respiratory system, otitis media in the ear, meningitis, and appendicitis. Some of these infections require immediate treatment particularly if one of the following trouble signs occur:

• Blood or bile (a green-colored material in the vomit)
• Strenuous, repeated vomiting
• Lethargy or severe irritability
• Severe abdominal pain
• Swollen or enlarged abdomen
• Convulsions
• Inability to drink adequate amounts of fluid
• Continued vomiting beyond twenty-four hours

On the other hand, prolonged crying or coughing can trigger the gag reflex and cause babies to vomit. Although it may be troubling, vomiting during a bout of crying does not physically harm babies. If a baby appears otherwise healthy, there is no reason to be concerned.

Baby Spit Up vs Vomit

What is the difference between baby spit up and vomit, then? The main differences would be the amount of food coming back up and whether it is expelled forcefully or not. Baby spit up is the easy flow of stomach contents out of the mouth and in small amounts, while vomiting comes out forcefully, and is often accompanied with discomfort.

Both spitting up and vomiting are common in babies. However, spitting up is more common as every baby does it at least every now and then, while some do it more frequently. Baby spit up is seldom a cause for alarm unless it happens so frequently so that a baby does not gain enough weight. Meanwhile, vomiting is usually a sign of an infection which needs to be treated accordingly. It may be caused by minor infections, but at times it may be a sign of a more serious condition needing immediate medical attention.

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