I need to ask few more questions before answering your query. Early consultations can prevent complications. Kindly contact me on whatsapp chat (84960595 six five) Dr Faisal Zoheb MBBS , MD PAEDIATRICS , PGPN (BOSTON), FELLOWSHIP IN NEONATOLOGY ( Newborn and vaccination specialist )

This is normal as the sphincter is still immature and is called gaate oesophageal reflux . Babies usually outgrow this. Until baby is active, gaining weight, feeding well despite spit ups, not irritable, spit ups are not yellowish greenish in colour , abdomen is soft, no abnormal postures you need not worry. Feed in small quantities frequently, positioning and latching should be proper.keep the baby upright and burp after feeds for about 20-30 min.

In preterm babies (34 weeks), spitting 3-4 times/day is often due to immature lower esophageal sphincter and small stomach capacity. Curdled milk is partially digested reflux, creamy is immediate spit. Nose spitting occurs due to connection of nose-mouth when lying flat. This is commonly physiological GER and improves with age. Advise: - Small, frequent feeds, avoid overfeeding - Keep baby upright 20-30 min after feed, burp in between - Use slow-flow nipple, prepare formula as per label exactly - Continue breast milk, do not change formula without advice - Sleep on back, not flat immediately after feed Red flags - see doctor urgently if: forceful/projectile vomiting, poor weight gain, blood or green vomit, breathing difficulty/choking/bluish color during spit, excessive crying, fever, less urine. Regular follow up for weight as per corrected age is needed for preterm twins. This is educational info only, please consult your pediatrician for proper evaluation.

Milk regurgitation is common in infants, particularly in preterm babies, due to immature gastrointestinal function. Curdled milk coming out of the mouth or nose may occur due to physiological reflux.

Normal

It is quite normal. There are multiple reasons as gastric reflux, overfeed, aerophagia etc. Just monitor for proper weight gain. All you need to do is proper burping/tummy time.

Burp properly

Greetings It is common for late preterm babies to spit up curdled, creamy milk because their digestive systems are still maturing. This frequent spitting up through both the nose and mouth often resembles gastroesophageal reflux, a temporary food intolerance, or simple overfeeding as they transition formula stages. Keeping the infants upright for 30 minutes after feeding and offering smaller, more frequent portions can significantly reduce this backflow.

Do proper burping

Spitting up curdled milk from the mouth and nose is common in premature babies, since the valve between the stomach and feeding tube is still immature at 34 weeks. The milk looks curdled because it is partly digested, and some comes up through the nose simply because the mouth and nose are connected inside. This usually settles on its own as your babies mature over the coming weeks.