Between 70 and 85% of babies spit up milk daily starting around 2 months old — it's one of those things that causes more worry than it needs to, because it's almost always normal reflux, not an illness. But since it can look similar to other things, it's hard to know when it's just an extra bib and when it's worth real attention.
Why it happens
The lower esophageal sphincter — the muscle separating the esophagus from the stomach — is still immature in the first months. It opens more easily than it should, and some milk comes back up after a feed. It's not painful in most cases: think of it as new plumbing that doesn't seal all the way yet.
When it's normal
Reflux doesn't need treatment if, besides spitting up, your baby:
- Is gaining weight as expected at pediatrician checkups.
- Seems happy and active between feeds.
- Doesn't seem to be in pain or irritable while eating or lying down.
- The spit-up is gentle milk, not a forceful stream.
When to worry
Check with the pediatrician if you notice:
- Weight plateaus or doesn't go up at routine checkups.
- The baby refuses to eat or gets very fussy during or after feeds.
- Projectile vomiting — forceful, not simple spit-up — especially under 1 month old.
- Signs of dehydration: fewer wet diapers than usual, dry mouth, lethargy.
- Persistent cough, arching the back while feeding, or crying that always seems tied to eating.
What helps at home
- Shorter, more frequent feeds — instead of a few large ones that overload the stomach.
- Keep them upright for 20-30 minutes after each feed, avoiding lying them down right away.
- Burp thoroughly midway through and at the end of the feed, not just at the end.
- Avoid overfeeding — offer breast or bottle on demand, without forcing them to finish it.
- Skip tight clothing around the belly area.
Feeding history — a real screen from the Alfonso app.
Log every feed and see if it improves
Create your baby's profile in 30 seconds, no account or password needed, and note the time and amount of every feed — to see if reflux actually improves with changes, not just guess. Syncs automatically with your partner.
Frequently asked questions
Is reflux the same as vomiting?
No. Reflux is milk that comes back up effortlessly; vomiting is more forceful and in larger amounts — if it's projectile, check with the pediatrician.
How long does it last?
Most babies outgrow it by their first birthday. It usually peaks between 2 and 4 months.
Does switching formula help?
Sometimes, but it's not the first step — try it only on the pediatrician's advice.
Keep reading
ℹ️ This article is informational and doesn't replace a pediatrician's judgment. If you're unsure about your baby's reflux or feeding, always check with a healthcare professional.