Key Points
- The safest position for babies to sleep in is on their backs
- Babies have a reflex that makes them automatically cough or swallow to prevent them from choking on their own vomit
- There are three different types of spit-ups that babies can experience: projectile, posseting, and gastroesophageal reflux disease
- Babies will usually experience more spit-ups between 0 and 6 months of age
All babies throw up or spit up at some point after feeding, but what happens if they do it while asleep? New parents, you might be worried that this is a choking risk, but it really depends on the position your baby sleeps in.
This article tells you all about the best sleep position for your vomiting baby to prevent them from choking.
In This Article
- Can Babies Choke On Vomit In Their Sleep?
- How Should My Baby Sleep If They Vomit?
- What Are The Most Dangerous Positions For Babies To Sleep If They Vomit?
- How To Monitor The Safety Of Your Baby When They Are Vomiting?
- How Can I Reduce The Chances Of My Baby Vomiting In Their Sleep?
- What Are The Different Types Of Vomiting In Babies?
- How Can I Help A Baby With Reflux?
- Can Solids Cause Vomiting?
- Could Vomiting Be a Sign of Allergies?
- When Should I Seek Medical Advice For A Vomiting Baby?
Can Babies Choke On Vomit In Their Sleep?
Healthy babies naturally spit up or vomit after eating, including sleeping. According to the Mayo Clinic, this is because the muscle at the top of the stomach is immature at birth and can take up to a year to become strong enough to keep milk inside of the stomach. Babies have a reflex that causes them to swallow or cough to prevent choking. Babies that sleep on their backs are less likely to choke due to the position of the oesophagus (food pipe) and trachea (air pipe).
How Should My Baby Sleep If They Vomit?
Unfortunately, many myths terrorise new and older parents and caretakers alike, specifically around babies choking in their sleep. Yes, babies can vomit or spit up in their sleep, but it does not cause choking or increase the risk of Sudden Infant Death Syndrome (SIDS).
Many parents have different opinions on which sleeping position is the best for babies susceptible to vomiting. According to Healthy Children, the best position for a sleeping baby to avoid choking is on their back (the Supine position). The windpipe is located above the oesophagus when babies sleep on their backs. Therefore, any fluid that is spit up, coughed up, or vomited is more likely to go back toward the oesophagus instead of the windpipe.
As long as parents stick to placing babies on their backs when they put them to sleep, they can rest easy knowing their baby is in the safest sleep position, including choking.
Your baby can protect their trachea (windpipe) with an automatic reflex that causes them to swallow. So when your baby regurgitates milk, it lies in the back of the throat, and babies swallow it easily. Also, gravity makes it extremely difficult to go into the windpipe when your baby sleeps on their back, so there’s a minimal chance of choking.
What Are The Most Dangerous Positions For Babies To Sleep If They Vomit?
We’ve spoken about why it’s safer for babies to sleep on their backs. But what happens if babies sleep in other positions?
Babies Who Sleep On Their Tummy
When babies sleep on their stomachs, their trachea is positioned at the bottom of the throat. This means that gravity will shift fluids toward the windpipe instead of the oesophagus. Babies also sleep more deeply and swallow less frequently when they’re positioned on their stomachs, which would increase the chances of your baby inhaling the liquids.
Babies Who Sleep On Their Side
When babies sleep on their sides, there is also a bigger chance of inhaling any fluids they may bring up. Again, this is because, on their side, the spit up or other fluids come up through the oesophagus, and because they’re on their side, both pipes are next to each other, so when your baby swallows, there’s a good chance it could go down their windpipe.
How To Monitor The Safety Of Your Baby When They Are Vomiting?
It can be stressful for parents when their baby is vomiting, but you can monitor your baby’s safety during this time through regular checks and supervision. You should keep your baby’s schedule as normal as possible, so don’t keep them awake or prevent them from sleeping long enough. Sick babies might even need more sleep than usual.
Instead, you should supervise your child through a baby monitor or by regularly checking them through the night. Try not to wake them up unless they’ve vomited, as you’ll need to change their bedding if so.
Don’t use incline sleepers or extra helpers within the bed, as these can increase the risk of SIDS. Offer them more fluids and check the number of wet nappies to monitor if they’re hydrated enough, and keep an eye on their temperature to make sure they’re not running a fever.
How Can I Reduce The Chances Of My Baby Vomiting In Their Sleep?
Below we have detailed how you can reduce the likelihood of your baby vomiting in their sleep:
- Change your baby’s feeding time to earlier: Prevent your baby from being laid down straight away after a feed
- Keep your baby upright after a feed: Some parents find that keeping their baby upright for 10 minutes after a feed prevents them from vomiting
- Burp your baby: Before you lay them to sleep, burping your baby can prevent air bubbles from forcing the milk back up
- Try a sensitive baby formula: Sensitive baby formulas tend to cause less gas due to their lower lactose quantities, which can prevent babies from vomiting in their sleep
What Are The Different Types Of Vomiting In Babies?
Babies have many different types of regurgitation, often caused by different things. Below we have detailed the types of vomiting in babies and what they’re caused by:
- Projectile vomit: This is when babies vomit with force and is generally a symptom of blockage in your baby’s stomach. Contact your doctor to check for underlying issues if this happens frequently after feeds. It could indicate a condition known as pyloric stenosis, where the outflow muscle of the stomach into the intestines is too thick
- Posseting: When your baby spits up small chunks of milk after they feed, it’s called posseting. There is little to no force behind this type of spit-up, and the baby is unbothered by it. This is the normal type of spit-up seen in most young infants
- Acid Reflux: When a baby’s spit-ups cause pain, feeding difficulties, or poor sleep, it is called gastroesophageal reflux disease. As the muscle at the top of their stomach isn’t tight or strong enough, some infants experience irritation of the oesophagus as milk and stomach acids come back up. These babies often find it difficult to be consoled
How Can I Help A Baby With Reflux?
For babies experiencing gastroesophageal reflux, it’s crucial that they sleep on their backs. For adults, you would take medication and elevate your head, but unfortunately, most of these options are not on the table with babies. So, instead, keep your baby sleeping on their back and on a flat surface with no pillows.
We’ve detailed a few things you can do to minimise how often they throw up below, depending on how your baby is responding to the reflux:
Your Baby Is Healthy And Continues To Gain Weight
In the case where you can’t see any problems other than your baby spitting up, it can be helpful to adjust how often and how much your baby feeds. Babies who overeat are more likely to spit up because their bellies are too full. Taking a break during feedings to burp the baby helps to reduce air bubbles in the stomach, which can result in more milk coming up.
Your Baby Is In Pain
The best thing you can do for babies who are frequently uncomfortable, in pain, or not gaining weight when they experience reflux is to take them to the doctor. Your doctor can determine if medication would be helpful and look for other reasons for your baby’s symptoms.
Can Solids Cause Vomiting?
It takes a while for a baby’s digestive system to adapt to processing solid foods because they are growing and their bodies are still developing. This is why it is important not to offer first foods until four to six months old. So when you introduce solid foods, some babies spit up less, but others vomit more.
This happens mainly because of overfeeding; their stomachs are still so small, and it takes a while to adapt to the extra volume of food. That said, bottle feedings thickened with oat cereal may be recommended for severe cases of gastroesophageal reflux.
Could Vomiting Be A Sign Of Allergies?
Allergies are tricky to predict because of the different levels of severity. However, there is a chance it could be an allergy if your baby is vomiting after you’ve introduced them to a new food. Cow’s milk protein allergy is typically the first type of allergy seen in infants. It can be associated with vomiting, poor weight gain, and blood in stools.
When your baby is old enough to begin pureed foods, consult your doctor for professional advice and guidance on what your baby should and shouldn’t eat. Unless there are known risk factors, it is recommended to introduce potentially allergenic foods early to prevent sensitivities from developing. These include nut butter, eggs, and fish.
When Should I Seek Medical Advice For A Vomiting Baby?
Parents should seek medical advice for a vomiting baby when they are projectile vomiting, if the vomit contains blood or greenish material, and if they are running a high fever.
Some parents prefer to treat their babies at home and monitor the symptoms, while others prefer to seek medical advice as soon as possible. When in doubt or worried, always err on the side of caution and seek medical advice from a professional.
Final Thoughts For Best Sleep Position For Vomiting Baby To Prevent Choking
The safest sleeping position for your baby to be in all situations is on their back, especially when your baby vomits. Consider changing their feeding schedule and how much they eat if you’re concerned about how much your baby is spitting up when they sleep. It’s also best to consult your doctor to check for allergies or other underlying medical issues if they show signs of pain or discomfort or aren’t gaining weight.