Baby lying on cloth. Look at that tiny spit up monster.

How to Handle a Baby Who Spits Up – A Lot

Having a baby who spits up excessively can be a serious drag. You’ve tried everything, you’ve talked to the doctor several times and they’ve concluded “it’s not a medical problem, it’s a laundry problem,” which is a little funny but also downplays the seriousness of just how much laundry you’re doing. When my second kid spit up excessively (great weight gain, didn’t bother her a bit, doctor was not at all medically concerned) it began to really get me down – I smelled like spit up all the time, my clothes were all stained. I was getting rid of rugs, I couldn’t sit with her on the couch for fear that she’d destroy it, I was washing all 30+ of our receiving blankets and burp clothes every day. Not to mention my outfit changes – it’s hard when you know you won’t need nursing clothes in a certain size for too long, but you have to get enough to handle all the spit up. And pants: the number of times the spit up soaked all my clothes down to my underwear …

Anyway, if you’re here and reading this, you probably know all of this already. We had the additional complication of needing to give our baby iron once a day, and the iron supplement dyed her spit up red for 3-6 hours after taking it. In addition to it being distressing to watch your baby spit up in a color that doesn’t exactly look like blood but is far too close for comfort, the iron takes spit up stains to the next level. I’ll have a separate section of the specific things we did to manage the spit ups with iron.

And, as is hopefully obvious from the above, none of this is medical advice! These are just things that helped me once the doctor had told me that there was no medical issue and nothing to be done other than wait out the spit up phase. Hopefully it will help others in the same situation — I asked a group I was in for ideas when my baby was four months old and I was crying one evening after having to change my full outfit for the fourth time that day, and I got a lot of good suggestions. Below are some techniques that I developed and also the suggestions from other folks that worked for me.

Before getting into tactics, a couple notes

First off: deep breath. This is difficult, and it’s the sort of thing that I definitely felt like people downplayed, but it affected my quality of life and the things I could do with my baby significantly (it’s hard to take your baby out if you know when you get her out of the car seat to feed her both of you will be immediately covered in spit up). So, I want to acknowledge that even if you’ve been told it’s not something to worry about, that doesn’t make it not hard. It’s hard. I didn’t believe people when they said it would get better around six months, but it really did. It took another six weeks for it to stop being an issue, but it started diminishing around six months even though our baby was born a month early. It’s hard waiting, but it will happen. 

Secondly, people will say all sorts of things that worked for them, and they may or may not work for you. Some people swear by keeping the baby upright for 45 minutes after a feeding, but I found mine spit up continuously during that time and after. Some nursing parents said cutting dairy out of their diet really helped after a few weeks; I tried that and it didn’t make a difference. It’s worth trying the things you think you can reasonably do (cutting out dairy isn’t a big deal for me), but it’s also important to make sure you’re not going to make yourself more miserable trying something that may or may not fix something that’s main impact is making you unhappy. If cutting out dairy sounds worse than your baby being a happy spitter, then I’m of the opinion it’s not worth trying. 


Spit Up Management: The Tactics

  • Get on top of stains: Buy spit up-specific stain remover, such as Dreft, and keep a small spray bottle anywhere you change your clothes or the baby’s clothes. That way, as you take them off, you can spray them, and the spit up will wash out much better. 

  • Get enough clothes for you: For me, I didn’t want to buy lots of nursing clothes and pants that I would only use for a little while (both because I wouldn’t be nursing forever and also as I lost weight the clothes became too big so I had to buy a new size, etc). But, you do need to have enough clothes that you don’t feel like you need to spend all day in one outfit even if it’s wet and smelly. I got a bunch of cheap nursing shirts, which wasn’t ideal, but allowed me to change when I needed. Pants were trickier, but I ended up getting a few pairs I could rotate between and I usually had one that was clean enough to wear.

  • The big t-shirt method: If your baby spits up a lot right after eating, you can put on an oversized t-shirt before feeding them. This way, if they spit up it’s not on the clothes you’re wearing for the day. 

  • Get bigger burp cloths: Probably the single best piece of advice I got was to use full size bath towels as burp cloths. It was annoying to wash so many, but they were so much more effective than the receiving blankets and ‘normal size’ burp cloths we had around. 

  • Towel it up: Put towels on the chair that you feed the baby on. Put them fully covering the space between you and baby when you’re feeding the baby. If you put baby on the floor, put them on a towel. Again, we are talking full sized bath towels.

  • Change the environment to support you: We got rid of a rug because there was a room I didn’t feel like I could take the baby into. We got a second bouncy chair so that I didn’t have to carry one up and down stairs multiple times a day to put her in after each feeding. We got enough swaddles that we could switch them out as needed. 

  • Patterns can help: Get clothes that don’t show stains as much. Some nursing shirts I found really showed spit up (why!!!) — if you can get patterned shirts (e.g. plaid button ups), the spit up won’t be as visible. 


Tactics for a baby who spits up a ton but has to take iron supplements

Our doctor had us start iron supplementation at around eight weeks, which was unfortunately right as her spit up was ramping up considerably. After a discussion with our doctor, she allowed us to get a blood test to check iron levels; if the iron levels were low, clearly we needed to supplement and just deal with it, but if it wasn’t low we figured we could push it off a bit. Iron levels ended up being at a point where she gave us 4-6 weeks before we needed to start doing iron daily. That bought us just a bit of time, and it’s something I recommend discussing with your doctor if that seems like something you’d want to do. Even with that, we still had about three months of intense spit up with iron supplementation. 

Okay, so you're supplementing. Here's what worked for us:

  • Giving the iron supplement right before the last feed before bedtime ended up working best for us. A lot of our kid’s spit up was triggered by movement, such as bringing her knees up during a diaper change, so to the extent we could give it to her right before a time of less movement, that worked better for us. It also meant that the number of items that could get stained by the iron spit up was more limited — sheet, swaddle, and PJs, rather than “everything in the house.”

  • Not to downplay that the sheet, swaddle, and PJs will get stained. Despite not moving, our baby occasionally woke herself up by “fountaining” (IYKYK). If your baby is still in a bassinet, you can see if you can put a burp cloth behind their head — see if you can tuck it beneath the mattress-pad on either side tightly enough that you feel comfortable leaving it in in the bassinet with your baby. That way, when they spit up, you can easily switch out a burp cloth and not have to do a full sheet change. 

  • Get at least three swaddles of the type you like — that way they can wear one, you can be washing one, and still have a spare if there’s an accident on the one they’re wearing. We ended up finding that having four worked best for us.

  • Some strong stain remover can help here. My typical “put some oxy cleaner in water and let it soak” method didn’t work on these stains, but the Shout or Oxy spray bottle stain remover did: spray, agitate, let it sit, then wash.

  • Our baby, when her spit up was diminishing, had a small resurgence because she would spit up whenever she rolled onto her stomach. This meant that there would be sticky spots in her crib of spit up that were dyed red and sometimes hard to see in the night. Not much to do here other than wipe as much of it away as possible if you are aware of it, and just use that spot remover on those sheets. 

  • We gave the iron right before the last feed so that it wouldn’t be at the “top” of her stomach when she spit up (I’m aware that this isn’t exactly how stomachs work, but having that time to start digesting it did seem to help a bit). The downside of this is that it meant that after that pre-bedtime feeding she sometimes spit up on me, staining my shirt. I ended up using the “big t-shirt” method described above for a while. When I got tired of that, I began just taking off my shirt before feeding her and putting it on once I left her room for the night.


And good luck! You’re not alone, it doesn’t last forever, that doesn’t mean it’s not hard. I hope this helps you manage it.