Baby vomiting

Introduction

Vomiting in babies commonly occurs, as does posseting (or spitting up) after feeding. Baby vomiting is often caused by a tummy bug and will usually stop in a few days. Although it is often not a sign of anything more serious it can be distressing for both you and your baby, especially if you see your baby projectile vomiting.

This article covers what is baby vomiting, baby vomit vs spit up, possible causes of baby vomiting after feeding, things you can do to help your vomiting baby, and when to get help from a doctor.

What is baby vomiting? and how does this differ to baby spitting up milk?

When babies effortlessly bring up milk (also known as baby spitting up or posseting) during or after a feed it is called reflux (or regurgitation) and is a common occurrence, which improves over time. Most babies will outgrow reflux by the time they are 12 months old. Baby vomiting tends to be more forceful and is often caused by a tummy bug in babies, called gastroenteritis. Gastroenteritis in babies is an upset tummy that can cause diarrhoea and/or vomiting.

Why do babies vomit?

Causes of vomiting in babies include:

• Gastroenteritis: most commonly, baby vomiting is caused by the viral baby tummy bug, gastroenteritis.

• Overfeeding: can also lead to baby vomiting after feeding. Responding to your baby’s early feeding cues, the little signs they make to let you know they’re hungry, or full can help to avoid overfeeding.

• Other causes: sometimes vomiting can be a sign of an underlying issue; such as severe reflux, cow’s milk allergy, or a condition called pyloric stenosis. This a condition that can affect some babies in the early weeks of life and is a narrowing of the passage (pylorus) between the stomach and the small bowel so food is unable to pass through easily; which leads to your baby projectile vomiting. The baby vomit may also be curdled and yellow in colour. It is not known exactly why pyloric stenosis develops in some babies and it is treated by an operation. Speak to your doctor if you have any concerns regarding your baby vomiting.

A tummy bug, such as Gastroenteritis, can sometimes lead to a temporary lactose intolerance in babies. This is when the sugar in milk (lactose) cannot be easily digested. Signs of lactose intolerance may include loose, watery diarrhoea, bloated tummy, wind and nappy rash. This may last a few weeks, speak to your GP if you suspect your baby may have a lactose intolerance.

How long will the vomiting last?

Vomiting in babies does not usually last for more than one to two days, however that can feel a long time when you are worried about your baby. Always trust your instincts and contact your Doctor immediately if you’re worried.

Should I feed baby after vomiting?

It’s important to avoid dehydration in babies, so it is recommended to continue to breast or bottle feed your baby, whichever is their usual milk feed. You may need to try giving smaller feeds more often than usual to help replace the fluids they are losing through being sick. The HSE states that you can give babies on formula or solid foods small sips of water between feeds. It is also important to continue to prepare formula milk at its usual strength, following the instructions on the tin. It is not recommended to give your baby fruit juice, particularly if they have been vomiting (and/or diarrhoea), because it can make it worse.

How to tell if baby is dehydrated?

Signs of dehydration in babies may include:

• fewer wet nappies and/or dark yellow urine (it may be helpful to keep a track of how many wet nappies in case you need to seek medical help)

• few or no tears when they cry

• a sunken soft spot (fontanelle) on their head

• a dry mouth

• being drowsy or irritable

• fast breathing

• cold and blotchy-looking hands and feet

Seek medical advice straight away if you notice any of these signs. Your Doctor or pharmacist may recommend an oral rehydration solution, and if so will recommend the most suitable rehydration solution for your baby.

What can I do to help my baby?

If your baby spits up a lot due to reflux the good news is that there are special techniques to feed a baby with reflux and methods to help soothe a baby with reflux. Read about these suggestions further here.

If your baby is vomiting and you are concerned or recognise any of the signs of dehydration seek medical advice as soon as possible.

During gastroenteritis in babies, it is important to follow good hygiene routines to help stop the spread of infection. Top tips include:

• washing hands with soap (liquid if possible) in warm running water, and carefully drying afterwards (especially after changing nappies and dealing with sickness)

• keeping baby home from nursery or childminders, until 48 hours after the last episode of diarrhoea or vomiting

When should I speak to a doctor?

Other signs that you need to seek medical help include:

• your baby is repeatedly vomiting and is unable to hold down fluids

• their vomit is green or contains blood

• they have been vomiting for more than a day or two

Finally, the majority of babies and young children with vomiting (caused by gastroenteritis) improve quickly without treatment and can be looked after at home safely. Always contact your healthcare professional if you have any concerns.