Why is my baby spitting out food?

Spitting out food is part of learning

Eating is a whole new skill. The NHS says that at the start, the most important thing is getting your baby used to new tastes and textures, and learning how to move food around their mouth and swallow it. How much they actually eat matters much less.

So expect a lot of food to come back out. The AAP says babies may look confused, wrinkle their nose, roll the food around their mouth or reject it altogether, and that most of the first few meals end up on their face, hands and bib. Breast milk or formula still gives them most of their nutrition while they practice (AAP, NHS).

The tongue-thrust reflex

Young babies have a reflex that pushes food forward and out of the mouth with the tongue. The AAP lists losing this tongue-thrusting reflex as one of the signs a baby is ready for solids, and the NHS lists swallowing food, rather than spitting it back out, as one of the three readiness signs.

If you offer a spoonful of purée and it dribbles straight back out onto your baby’s chin, the AAP says they may not yet be able to move it to the back of their mouth to swallow. That’s normal: they’ve never had anything thicker than milk. The AAP suggests thinning the food for the first few tries and thickening it gradually, or waiting a week or two and trying again. If your baby is younger than about 6 months and pushes everything out, check the readiness signs.

Learning new textures

Some babies take to lumps and finger foods quickly. Others need longer and prefer smooth food at first. The NHS says to keep offering lumpy textures, and they’ll get used to them. It also suggests moving on from purées to mashed, lumpy and finger foods as soon as your baby can manage, because that’s how they learn to chew and move food around their mouth.

NHS speech and language therapists at Sheffield Children’s Hospital describe three common reasons a child struggles with lumps:

• Development. They’re not quite ready. Babies who took longer to sit up or roll may take longer with textures, too.
• Sensory. They don’t like how lumps feel. Babies born early, or who had reflux, can be more sensitive around the mouth.
• Chewing. They try to swallow lumps without chewing, and need more practice with the chewing movement.

Mixed textures, like a smooth purée with lumps in it, or a thin soup with chunks, are harder to manage than a single texture (Sheffield Children’s).

Spitting out is often mixed with gagging while babies learn. The NHS says a gagging baby may push their tongue forward and retch to bring food forward. That’s a normal safety reflex: see gagging vs. choking.

Funny faces are not a “no”

A grimace or a shudder often just means “this is new”. The NHS says funny faces don’t mean your baby doesn’t like the food: they’re getting used to new flavors and textures. It may take 10 tries or more before a baby accepts a new food or texture.

Watch what comes next, though. If your baby also closes their mouth, turns their head away or pushes the food away, the CDC says those are signs they may be full. Spitting out at the end of a meal is often just “I’m done”. See hunger and fullness cues.

What helps

• Stay relaxed. The NHS warns that rushing or forcing a baby can lead to feeding problems. A calm “all done?” works better than one more spoonful.
• Wait for the open mouth. If you’re spoon-feeding, wait for your baby to open their mouth before offering the food (NHS).
• Let them feed themselves. Finger foods let your baby control what goes in and how much (NHS). Pieces about the size of your own finger work well at first. See safe food sizes and shapes.
• Thin it, then thicken. For spoon-fed babies, start with thinner purées and thicken them gradually (AAP).
• Keep offering refused foods another day, in a small amount (NHS).
• Don’t hide foods inside other foods. Sheffield Children’s says it’s important for children to be aware of, and in control of, what’s happening while they eat.
• Let them explore. Touching, squashing and smearing food is part of learning (NHS). It’s messy, and it helps.
• Eat together. Babies copy their parents and other children (NHS).
• Sit them upright in a high chair, and stay with them for the whole meal (NHS).

Soft first foods like mashed banana, avocado or sweet potato give your baby an easy texture to practice with.

Normal spitting out, or a swallowing problem?

Spitting out food is usually normal if your baby is otherwise happy, keeps drinking milk well and is growing. Some signs suggest a problem with chewing or swallowing (sometimes called dysphagia). NHS speech and language therapists at Dorset HealthCare list signs including:

• coughing or choking when eating or drinking, often
• a gurgly, bubbly or wet-sounding voice or breathing after eating or drinking
• food or drink coming out of the nose
• difficulty chewing or controlling food in the mouth
• holding food in the cheeks, or food left in the mouth after swallowing (see pocketing food)
• repeated chest infections
• unexplained weight loss

When to talk to your doctor

Talk to your pediatrician, GP or health visitor if:

• your baby has any of the signs above
• your baby is over 9 months and still refuses most solid food, or is losing weight (AAP)
• feeding problems happen often, or don’t improve with these tips (AAP)
• your baby gags and gets upset with every new texture, or you’re worried about their chewing (Sheffield Children’s says a referral to a speech and language therapist may help)
• you’re concerned about how much or how little your baby is eating (CDC)

If your baby isn’t eating much at all, see is my baby eating enough?

If your baby can’t cough, cry or breathe, or is turning blue, start choking first aid and have someone call 911.If your baby can’t cough, cry or breathe, or is turning blue, start choking first aid straight away and call 999 if the blockage doesn’t clear.If your baby can’t cough, cry or breathe, or is turning blue, start choking first aid and have someone call your local emergency number (such as 112 in Europe or 000 in Australia). The steps are in gagging vs. choking.

Where US and UK advice differs

• First textures. The AAP suggests thin purées at first, thickened gradually. The NHS says babies who start at around 6 months can often move quickly to mashed, lumpy and finger foods, and may not need smooth, blended food at all.
• After a refusal. The AAP’s solid foods symptom guide says that if your baby spits out a new food, stop and wait a few weeks before offering it again. The NHS says to keep offering foods your baby has rejected, as it can take 10 tries or more. Either way, never force it.

Most babies who spit food out are simply learning. With time, calm meals and plenty of chances to practice, more of it ends up where it’s meant to go.