Is baby spit-up najis?

It depends on the kind of spit-up. A little milk that comes straight back up is treated like the milk itself and is pure for many scholars. Spit-up that has been in the stomach and changed (sour, curdled) is considered najis by most, but small amounts are widely excused. Drool is pure, and none of it should stop you from praying.
The three things babies bring up
- Drool and saliva: pure. Human saliva is not najis, so a wet shoulder from a teething baby is fine.
- Fresh milk that dribbles out: many scholars treat it like the milk it came from, so it is pure. This is the light, milky "possets" that come out with a burp.
- Spit-up that has changed: a larger, sour or curdled vomit. Most scholars treat vomit as najis once it has changed in the stomach.
Breast milk itself is pure by agreement of all four schools, and the views of each school on vomit are covered separately. See Is vomit najis? and Is breast milk najis?
Hardship is taken into account
Parents of babies spend their days wiped, burped and splashed. Washing everything after every feed would be a real burden, and Islam does not ask for that. Allah says:
When the Prophet ﷺ was told about the Bedouin who urinated in the mosque, he told people to pour water over the place and said: "You have been sent to make things easy and not to make them difficult" (Sahih al-Bukhari 220). That is the spirit scholars use when they excuse small, unavoidable amounts of a baby's spit-up.
What to do in practice
- Small dribble of milk: wipe it and pray. Nothing more is needed in the view of many scholars.
- A large or sour spit-up on your clothes: change your top, or rinse the spot with water. This satisfies all views.
- Not sure it reached your clothes: you can assume your clothes are clean. Certainty is not removed by doubt.
- A faint mark after washing: excused. You do not have to scrub it away completely.
Baby urine has its own rules, because the Prophet ﷺ sprinkled water over the urine of a young boy who had not started eating solid food (Sahih al-Bukhari 223). See How do I clean baby urine for prayer?
Praying while holding your baby
The Prophet ﷺ once prayed while carrying his granddaughter Umama, putting her down when he went into prostration and picking her up when he stood (Sahih al-Bukhari 516). Carrying a baby does not spoil the prayer. See Can I hold my baby while praying?
- Drool and fresh milk are pure; changed vomit is najis for most scholars.
- Small amounts of baby spit-up are excused by many scholars because they are hard to avoid.
- For a big or sour spit-up, rinse the spot or change your top.
- Do not let doubt make you wash everything again and again.
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