Why Babies Vomit—and What You Can Do About It
There’s nothing less fun than throwing up, except maybe when it’s baby who’s the one suffering. Not only is she miserable, but you’re also probably worried sick, wondering what to do and how to care for her. As unpleasant as it is, witnessing a baby throwing up is something all parents go through—and more than just once. For the most part, baby vomiting isn’t a major cause for concern. Read on to learn the difference between baby spit-up and vomit and what to do for a baby throwing up.
It can be tough to tell the difference between baby vomit vs spit-up at first—especially if baby is on a milk-only diet, since infant vomit and spit-up look pretty much the same at that point. Once baby starts solid foods, the difference will be more clear: Vomit will often contain regurgitated food and therefore have a thicker consistency. Plus, babies tend to spit up way less frequently once they’re eating solids. But until then, the clue to telling apart baby vomit vs spit-up may lie in baby’s mood immediately after.
“Baby vomiting is the forceful expulsion of the stomach’s contents. The baby is usually irritable and upset by it,” says Anthony M. Loizides, director of the Aerodigestive Center, a division of pediatric gastroenterology and nutrition at Children’s Hospital at Montefiore in New York City. “Spitting up usually looks like the stomach contents are ‘pouring out’ of the mouth, and the baby isn’t bothered by it and instead goes about his business.”
Babies throw up for a number of reasons, and although a stomach bug is often to blame, that’s not always the case. Here are some other things that can lead to baby vomiting:
• A milk or food allergy. “[If the child has a] milk protein allergy, baby vomiting can be related to the exposure to milk proteins either via breastmilk or formula,” says Melanie Greifer, MD, a pediatric gastroenterologist at Hassenfeld Children’s Hospital at NYU Langone in New York City. If baby is throwing up formula, consider switching to a soy-based formula or a hydrolyzed formula, which breaks down the milk particles and makes them easier for baby to digest. Similarly, baby throwing up after breastfeeding can indicate that he’s allergic to something in your diet. If the problem continues, contact a pediatrician or lactation consultant, who can help you begin an elimination diet.
• Eating too much too quickly. Wondering what causes baby vomiting after eating? Both vomiting and spitting up can occur in babies who need to be burped more frequently or are being fed too much milk (either via breast or bottle) to comfortably fit in baby’s small stomach, Greifer says.
• A triggered gag reflex. If baby has a sensitive gag reflex, he’ll be more likely to throw up after a coughing spell or even after tasting food or medication that he really doesn’t like. In these cases, you’ll notice baby coughing and throwing up immediately after swallowing.
• Motion sickness. Just like adults, babies can suffer from motion sickness. This may be the culprit behind baby throwing up if you or your partner suffers from motion sickness as well.
Baby throwing up at night
Parenting comes with its share of Murphy’s Law moments. Does it seem like the second you hit the sack, baby starts throwing up? There’s actually a physiological reason for baby throwing up at night, especially in younger babies who are still exclusively formula- or breastfed[CP2] .
“When a baby lies down at night on her back (the recommended position by the American Academy of Pediatrics), anatomically the position of the stomach is higher than the esophagus, and therefore it’s more likely that a baby may spit up,” Loizides says. Plus, the valve between the stomach and esophagus relaxes more while baby’s sleeping, leading to a baby throwing up more often at night than during the day.
If baby suffers from reflux and is having more spit up or vomiting episodes at night, you can incline the crib mattress using a crib wedge designed specifically for that purpose, or you can simply roll a beach towel and place it under the mattress.
Although a sick baby is never easy to deal with, rest assured that most of the time, when baby’s vomiting with no fever, it’s pretty harmless and likely to pass quickly. There are, however, some situations where baby vomiting is a sign of something more serious. Here are some red flag situations that warrant a professional opinion:
• Baby throwing up clear liquid. A possible cause of baby vomiting is a condition called pyloric stenosis, in which the valve between the stomach and small intestines thickens and prevents food from passing through. The onset of this condition is typically between 2 to 3 weeks of age and often begins as a typical episode of baby throwing up clear liquid after a feeding—but it quickly escalates in both force and number of episodes. Pyloric stenosis is also one of the main reasons for projectile vomiting in babies. The good news is that this condition can be resolved with a simple surgical procedure.
• Baby throwing up blood. If you’ve been through this, you know how terrifying it can be. But if you’re seeing traces of blood in baby’s vomit, it could simply be a sign of a small tear in baby’s esophagus as a result of forceful vomiting or coughing. It may sound scary, but small tears like these heal pretty quickly on their own and don’t call for medical attention. If the tear is significant, you’ll see a large volume of fresh red blood in the vomit—and in that case, head to the emergency room. Regardless of how much red you see when baby is throwing up blood, let your pediatrician know. If baby keeps throwing up milk and the vomit contains traces of blood, it could be a sign of a milk allergy, which you’ll want to resolve as soon as possible.
• Baby vomiting yellow or green bile. If baby is vomiting yellow liquid, it could be a sign of an obstruction in the bowel or intestines—or it could simply indicate that there’s nothing else in baby’s stomach to throw up, so a bit of bile comes up. If you notice baby producing a small amount of frothy yellow vomit at the tail end of a nasty stomach bug with repeated vomiting, give the pediatrician a call. However, if you see baby throwing up green vomit, head to the nearest emergency room, since that’s a sign of a surgical emergency and calls for immediate medical care.
• Baby throwing up with high fever and crying. If baby is throwing up, has a high fever and seems unwell, this should warrant a trip to the pediatrician or even the emergency room. These symptoms are typically associated with a bacterial infection, like meningitis, and can sometimes be indicative of appendicitis as well.
If baby is experiencing a bout of repeated vomiting, don’t be too quick to give him anything to eat or drink, as you’ll likely see it again very soon. Give baby’s system some forced rest during this period, and watch for signs of dehydration, like reduced amount of tears, sunken eyes and a decrease in wet diapers. Most tummy troubles resolve themselves before baby becomes dehydrated—but if you do spot the telltale signs of dehydration and the vomiting isn’t letting up, call the pediatrician, who may give baby IV fluids.
As soon as the episodes begin to lessen, it’s okay to begin offering liquids in small doses. If it’s a breastfed newborn vomiting, it’s best to offer breast milk, since it’s generally easy to digest and therefore well tolerated at this stage. Offer more frequent feedings than usual, but keep the sessions shorter to prevent baby’s tummy from becoming too full. If baby is formula-fed, it’s okay to offer formula: Start with a tablespoon or two at first and offer more if baby’s able to keep it down. Babies 6 months or older can be given a tablespoon or two of water, but avoid electrolyte solution like Pedialyte[CP4] before baby reaches her first birthday, unless your pediatrician advises otherwise.
If you’re wondering how to stop baby from throwing up, we totally understand! But as tempting as it is, you shouldn’t attempt to stop baby vomiting. After all, it’s a sign that there’s something in the body that needs to be removed, whether it’s caused by an overly full stomach or a toxin.
Published September 2017