Milk is coming out of baby's nose. Should I be worried?

What to do when your baby is choking on milk and it’s coming out of his nose? Find out here.

The first few months with a baby are hard. There is so much to learn when it comes to taking care of an infant – from breastfeeding, the proper way to burp their child, and even deciphering their baby’s poop.

First-time parents can get really intense when it comes to their baby’s health and safety, and rightfully so. Paying attention to the little things is how you learn and sometimes, it can even save your baby’s life.

Taking care of an infant in his first few weeks will make you realize that spit-ups are part of this early phase. Babies spit up very often, most of the time, after a feeding session. Here in the Philippines, it is commonly known as “lungad.”

But what do you do if milk suddenly comes out of your baby’s nose?

I’ve had that experience for two of my kids when they were newborns. Every time I breastfed them, it was followed by a look that seemed like they couldn’t breathe properly, and then as if on cue, milk would come out of their nose.

While seeing your baby choking on milk and it’s coming out of his nose seems kind of alarming, most of the time, it’s really not a reason to panic.

Milk coming out of baby’s nose – should you be worried?

According to Dr. Gellina Suderio-Maala or Doc Gel, TAP’s resident pediatrician and also a TAP mom, spit-ups, even those coming out of the baby’s nose, are normal for babies until 6 months.

“Yes, it’s really common especially on the first 6 months of life. Babies experience reflux because the sphincters inside baby’s body are still immature. From the esophagus to the stomach, there’s a sort of lock that keeps milk particles down. But it is not yet mature at this stage, which is why the baby’s tendency is to have a reflux.” she explained in Filipino.

Doc Gel added that babies usually outgrow spit-ups as their bodies and digestive system starts to mature and become fully developed.

“Few spit-ups are acceptable, and the baby will eventually outgrow that around 12 to 18 months. Parents may notice that these episodes of choking on milk and spit-ups will decrease once the baby starts eating solids. It’s because it’s more common for babies 6 months old and below, but it will improve,” she said.

Possible reasons why a baby is choking on milk and it’s coming out of his nose

The pediatrician pointed out that the major reason for spit-ups is when the baby has too much milk or is too full.

“This will happen if the baby is too full. If he drank a lot of milk, spit-ups can happen because if his stomach is full, the excess will go out,” she explained.

Take note that our nose is connected to our throats, and babies don’t have full control of their reflexes. It is for this reason that the baby spits up through the nose sometimes.

Here are other possible reasons why your child chokes on milk and ends up with milk coming out of his mouth:

• Air gets into their mouth when they breastfeed

When a baby is really hungry, he tends to take big gulps of milk in a hurry, which means air sometimes gets into his mouth and through his stomach. Again, the excess milk might go up the esophagus and out through your baby’s nose or mouth.

• The fast let-down of breastmilk

When a baby starts to suck, a reflex involving nerves and hormones (a neurohormonal reflex) releases milk from the breast, commonly known as a let-down. If milk is released very forcefully (for example in hand express or when you press your breasts or sometimes depending on your position while breastfeeding), milk might squirt from the breast very quickly.

For some babies, this is okay, especially if they’ve gotten better at sucking. However, for some babies, a fast letdown might cause them to be overwhelmed, which is why they cough or choke on their milk. And when this happens, some of the milk comes out from the baby’s nose.

• Immature stomach valve

As Doc Gel mentioned earlier, the esophagus and the stomach are connected with a valve present in between. This valve serves as the gate to put the food down to the stomach.

However, this valve is still developing in babies, which is why it lacks the strength to hold back any excess food. This is why when a baby drinks milk in large quantities, the excess milk could easily rise back up and come out of the nose.

What to do when baby spits up through his nose?

According to Doc Gel, the first thing to do is to observe to see if your child’s condition is normal or severe. Most cases of spit-ups are normal, but when you notice that your baby is already projectile vomiting, it’s time to call your pediatrician about it.

“Some babies they can be happy spitters. They spit-up (through their nose) but they are still happy and playing. They have reflux but they’ll eventually outgrow that. But if you notice that it’s more than just a spit-up but a vomiting episode in big volumes, that’s another thing. Maybe there’s something wrong with your baby’s health and you need to have him assessed personally,” said the pediatrician.

So when your baby suddenly spits up through his nose, don’t panic. Instead, observe your child and try to find the reason why he is spitting up.

How to reduce your baby’s spit-up

While spitting up is usually common in children, there are still ways to avoid or lessen these episodes.

• Put baby in an upright position after breastfeeding

According to Doc Gel, resist the urge to put the baby down right away after a breastfeeding session to avoid acid reflux. She suggests putting the baby in an upright or semi-upright position (about 30 degrees) for at least 20 minutes to make sure the milk made its way to the infant’s stomach.

“Let’s wait for a few minutes until we’re sure that the milk has reached baby’s stomach to prevent it from regurgitating,” she said.

• Burp baby after breastfeeding.

The pediatrician also stresses the importance of burping the baby after every feed. In fact, she mentioned that it’s okay to burp the baby when sleeping (just a few gentle taps on the back), so there’s really no reason not to do it.

“If you don’t burp your baby properly, it’s highly likely that a spit-up will occur. There are so many positions you can try to make your baby burp,” she added.

To make sure that the baby has burped before putting her down, wait for the burping sound that she makes.

And for how long should you burp baby? According to Doc Gel, as long as the baby is still spitting up, you should continue to burp her after feeding.

• Avoid overfeeding

Our babies’ stomachs are so tiny at birth, so it gets full easily. And like a tank, if it’s full, it will surely overflow and spurt right back at you.

Another thing to remember here is to feed your baby on time. Because a very hungry baby will most likely suck forcefully, causing him to choke, with milk coming out of his nose.

If you’re feeding on demand, know your baby’s hunger and fullness cues to avoid overeating or starving your little one.

• Check your breastfeeding position and bottle nipple

If you’re likely to have a fast let-down, try a position where the milk won’t squirt too fast, and the baby can control the flow. I’ve found that the laidback position helped lessen choking and vomiting with my hyperactive suckers.

On the other hand, for bottle-fed babies, choose a bottle nipple with the right flow according to your baby’s age.

• Avoid dressing your baby in tight clothes

For this reason, putting a binder or bigkis on your child’s tummy should be avoided. Putting on tight clothes might put pressure on his stomach and his immature valve which would cause him to spit up his milk.

When to call the doctor

As mentioned earlier, most cases of spit-ups are normal for babies, and they can outgrow them in a few months. However, if you think your child is projectile vomiting and feeding is being affected by this, don’t hesitate to contact his pediatrician.

Here are the other signs to watch out for that warrant a visit to the doctor:

• He keeps spitting up even as he’s approaching the one-year mark
• He tends to choke or cough when he spits up
• Milk coming out of his nose happens regularly
• The spit-up contains weird colors or even blood
• He spits up a lot and is not gaining enough weight
• He starts crying each time after spitting up.

For other tips about newborn baby care, check out the newborn safety video in the media section of theAsianparent app. You may download it for free on Google Play and the Apple Store.

Here at theAsianparent Philippines, it’s important for us to give information that is correct, significant, and timely. But this doesn’t serve as an alternative for medical advise or medical treatment. TheAsianparent Philippines is not responsible to those that would choose to drink medicines based on information from our website. If you have any doubts, we recommend to consult your doctor for clearer information.