1) The appearance of spit-up
The spit-up may look like regular milk or curdled milk. Curdled milk looks like a clear liquid with small, cheesy flecks or lumps. The curdled appearance is caused by digestion in the stomach, where acid separates the milk into curds and whey.
2) Typical spitting behaviour
Babies may spit frequently, occasionally, or never. When a baby spits, you may notice:
- No change in the baby’s behaviour after spitting.
- The spit-up is only a small part of the feed.
- The spit-up does not travel far.
- The baby is happy before, during, and after spitting.
- There is generally no sound.
- Spitting can happen at the same time as a burp.
- Spitting often happens with the second hiccup.
In normal spitting, the baby stays happy and the milk just flows out of the mouth. Occasionally, there may be more milk, the baby may choke a little, or the milk may come out of the nose. This may bother the baby a bit.
3) Milk coming out of the baby's nose
In some babies, milk drips out of the lower nostril when they are breastfed on their side as in in the cradle, cross-cradle, or side-lying position. They usually aren’t bothered by this and happily keep breastfeeding. This dripping is not common but nothing to worry about if the baby is otherwise well.
A very small number of breastfed babies who leak milk out of their noses have abnormalities in the roof of their mouth (submucosal cleft palate) or of their feeding and swallowing processes (Rai 2015; van den Engel-Hoek 2015). They may not grow well or may show other signs of illness.