Baby throwing up milk after feed

Baby Vomiting After Feeding Formula: Causes and Treatment

Your little one is happily gulping their formula while cooing at you. They finish off the bottle in no time flat. But shortly after feeding, it seems to all come out as they vomit.

There are several reasons why your baby might be vomiting after a formula feeding, but it’s important to remember that it can be — and often is — very normal.

It’s common for babies to throw up sometimes after feeding on formula or breast milk. Their shiny new digestive systems are still learning what to do with all the yummy milk coming down into their tummy.

However, if your baby often has a hard time keeping their formula down on a regular and frequent basis, let your pediatrician know.

Having a baby around means getting used to soft mushy stuff coming out fairly often. This includes spit-up and vomit.

Spit-up and vomit might seem pretty much the same — and require similar amounts of cleaning to get them off of your sweater and the sofa — but they’re very different. Spitting up is an easy, gentle dribble of milk. Baby may even smile at you as the curd-like spit-up flows from their mouth.

Spit-up is normal in healthy babies, especially if they’re under the age of 1.

On the other hand, vomit takes more effort, as it comes from deeper in your little one’s stomach. It’s a sign that your baby’s stomach is saying nope, not now, please. You might see your baby strain and recoil just before they projectile vomit. This force happens because vomit is squeezed out by the stomach muscles.

Your baby might also look more uncomfortable during and after vomiting. And vomit looks and smells different. This is because it’s usually formula, breast milk, or food (if your baby is eating solids) mixed with stomach juices.

If you’re not sure whether your baby is vomiting or spitting up, look for other vomiting symptoms, like:

• crying
• gagging
• retching
• turning red
• arching their back

That said, there doesn’t seem to be agreed-upon definitions of these two terms among healthcare providers, caregivers, and others. Plus, their symptoms may overlap. For example, spitting up may sometimes be forceful, and vomiting may sometimes seem painless.

Overfeeding

It’s easier for your baby to overfeed when they’re drinking from a bottle than when they’re breastfeeding. They can also gulp down milk faster from a bottle and rubber nipple. What’s more, because formula is always available, it’s easier for you to give them more milk than they need by accident.

Babies have tiny stomachs. A 4- to 5-week-old infant can only hold about 3 to 4 ounces in their tummy at a time. This is why they need lots of smaller feedings. Drinking too much formula (or breast milk) in one feeding can overfill your baby’s stomach, and it can only come out one way — vomit.

Not burping properly

Some babies need to be burped after every feeding because they swallow lots of air as they gulp down milk. Bottle feeding your baby breast milk or formula may lead to more air-swallowing, as they can gulp even faster.

Too much air in the stomach can make your baby uncomfortable or bloated and trigger vomiting. Burping your baby right after feeding them formula may help prevent this.

To help prevent your baby from swallowing too much air and vomiting after formula feeding, check your baby’s bottle. Make sure you’re using a smaller bottle that’s just big enough to hold a few ounces of milk. Also, check to make sure the nipple hole is not too big, and don’t let your baby continue gulping when the bottle is empty.

Baby or infant reflux

Baby can have acid reflux, indigestion, or occasionally gastroesophageal reflux disease (GERD just like grown-ups! This happens because their stomach and food tubes are still getting used to holding down milk.

Baby reflux happens when milk travels back up toward your baby’s throat and mouth. This usually just causes some painless spitting up, but it can irritate your baby’s throat and trigger gagging and vomiting.

Sometimes, smaller feedings can help prevent baby reflux. If not, don’t worry! Most little ones outgrow baby reflux by the time they’re 1 year old.

Constipation

While simple constipation would be an uncommon cause of vomiting in an otherwise healthy infant, sometimes baby vomiting happens because of what isn’t happening at the other end.

Most babies who are formula-fed need to poop at least once a day. Anything less than your baby’s typical pattern, though, might indicate they’re constipated.

If your baby is vomiting after a formula feeding, they might be constipated if they have other symptoms, including:

• gassiness
• not pooping for longer than 3–4 days
• a swollen or bloated stomach
• a firm or hard stomach
• crying bouts or irritableness
• straining very hard but not pooping or pooping only a little
• small, hard pellet-like poop
• dry, dark poop

Stomach bug

If your baby doesn’t usually vomit after having formula, they might have a stomach bug. Also known as gastroenteritis or the “stomach flu,” a stomach bug is a very common cause of vomiting in babies. Your little one may vomit several times for up to 24 hours.

Other symptoms of a stomach bug include:

• crying
• stomach cramps
• stomach rumbling
• bloating
• diarrhea or watery poop
• mild fever (or none at all in babies)

Allergy

In rare cases, the cause of your baby’s vomiting might be in the formula. Although it’s uncommon for babies to be allergic to cow’s milk, it may happen to up to 7 percent of babies under the age of 1.

Most children outgrow a milk allergy by the time they’re 5 years old, but it can cause vomiting and other symptoms in babies. A cow’s milk allergy might cause vomiting right after your baby eats. It can also cause vomiting and other symptoms hours or rarely days later.

If your baby has an allergy to milk or something else, they might have other symptoms of an allergic reaction, like:

• skin rash (eczema)
• diarrhea
• cough
• hives
• difficulty breathing
• wheezing

Lactose intolerance

An allergy to milk is different than being lactose intolerant. Lactose intolerance usually causes digestive symptoms like diarrhea. It can also make your baby vomit after drinking formula containing cow’s milk.

Your baby might get temporary lactose intolerance after getting a tummy bug or gastroenteritis, although this is uncommon.

Other symptoms include:

• diarrhea or watery poops
• constipation
• bloating
• gassiness
• stomach pain
• stomach rumbling

Note that lactose intolerance is rare in babies under the age of 1.

Other causes

Some common health conditions can cause vomiting at any time, including after breastfeeding or formula feeding. Some rare genetic conditions can also cause vomiting in babies.

Other causes of vomiting in babies include:

• colds and the flu
• ear infections
• some medications
• overheating
• motion sickness
• galactosemia
• pyloric stenosis
• intussusception

In most cases, minor tweaks can help stop your baby’s vomiting. Remedies to stop your baby’s vomiting after formula depend on what’s causing it. Try some of these tried and tested methods to see what helps your baby:

• feed your baby smaller amounts of formula more often
• feed your baby slowly
• burp your baby after the feeding
• hold your baby’s head and chest up while feeding
• hold your baby upright after a feeding
• make sure your baby doesn’t move around or play too much right after a feeding
• try a smaller bottle and smaller-hole nipple to feed
• check the ingredient list on your baby’s formula
• ask your baby’s doctor if you should try a different kind of formula
• talk to your baby’s doctor about a possible allergic reaction
• dress your baby in looser clothing
• make sure their diaper isn’t on too tightly

If your baby has the stomach flu, you’ll both usually just have to ride it out for a day or two. Most babies and children with a stomach bug don’t need treatment.

If your baby is vomiting, see your doctor or pediatrician right away if they:

• are vomiting often
• are vomiting forcefully
• aren’t gaining weight
• are losing weight
• have a skin rash
• are unusually sleepy or weak
• have blood in their vomit
• have green bile in their vomit

Also, see your doctor urgently if your baby has any sign of dehydration from all the vomiting:

• dry mouth
• crying without shedding tears
• a weak or quiet cry
• floppiness when picked up
• no wet diapers for 8 to 12 hours

It’s pretty common for babies to vomit, especially after feeding. This happens for many reasons, including that these little people are still just getting used to keeping down their milk.

Check with your doctor about what you can do. See your doctor urgently if your baby vomits often for any reason.

Vomiting (0-12 Months)

Is this your child's symptom?

• Vomiting (throwing up) stomach contents
• Other names for vomiting are puking, barfing and heaving

Causes of Vomiting

• Viral Gastritis. Stomach infection from a stomach virus is the most common cause. Also called stomach flu. A common cause is the Rotavirus. The illness starts with vomiting. Watery loose stools may follow within 12-24 hours.
• Food Allergy. Vomiting can be the only symptom of a food reaction. The vomiting comes on quickly after eating the food. Uncommon in infants, but main foods are eggs and peanut butter.
• Coughing. Hard coughing can also cause your child to throw up. This is more common in children with reflux.
• Serious Causes. Vomiting alone should stop within about 24 hours. If it lasts over 24 hours, you must think about more serious causes. An example is a kidney infection. A serious cause in young babies is pyloric stenosis. See below for more on this.

Pyloric Stenosis (Serious Cause)

• The most common cause of true vomiting in young babies.
• Onset of vomiting is age 2 weeks to 2 months
• Vomiting is forceful. It becomes projectile and shoots out.
• Right after vomiting, the baby is hungry and wants to feed. ("hungry vomiter")
• Cause: The pylorus is the channel between the stomach and the gut. In these babies, it becomes narrow and tight.
• Risk: Weight loss or dehydration
• Treatment: Cured by surgery.

Vomiting Scale

• Mild: 1 - 2 times/day
• Moderate: 3 - 7 times/day
• Severe: Vomits everything, nearly everything or 8 or more times/day
• Severity relates even more to how long the vomiting goes on for. At the start of the illness, it's common for a child to vomit everything. This can last for 3 or 4 hours. Children then often become stable and change to mild vomiting.
• The main risk of vomiting is dehydration. Dehydration means the body has lost too much fluid.
• The younger the child, the greater the risk for dehydration.

Dehydration: How to Tell

• The main risk of vomiting is dehydration. Dehydration means the body has lost too much water.
• Vomiting with watery diarrhea is the most common cause of dehydration.
• Dehydration is a reason to see a doctor right away.
• Your child may have dehydration if not drinking much fluid and:
• The urine is dark yellow and has not passed any in over 8 hours.
• Inside of the mouth and tongue are very dry.
• No tears if your child cries.
• Slow blood refill test: Longer than 2 seconds. First, press on the thumbnail and make it pale. Then let go. Count the seconds it takes for the nail to turn pink again. Ask your doctor to teach you how to do this test.

When to Call for Vomiting (0-12 Months)

Call 911 Now

• Can't wake up
• Not moving
• You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

• Dehydration suspected. No urine in over 8 hours, dark urine, very dry mouth and no tears.
• Stomach pain when not vomiting. Exception: stomach pain or crying just before vomiting is quite common.
• Age less than 12 weeks old with vomiting 2 or more times. Exception: normal spitting up.
• Vomited 3 or more times and also has diarrhea
• Severe vomiting (vomits everything) more than 8 hours while getting Pedialyte (or breastmilk)
• Head injury within the last 24 hours
• Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
• Vomiting a prescription medicine
• Fever over 104° F (40° C)
• Fever in baby less than 12 weeks old. Caution: Do NOT give your baby any fever medicine before being seen.
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• All other infants (age less than 1 year) with vomiting. See Care Advice while waiting to discuss with doctor.

Seattle Children's Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

• Bellevue
• Everett
• Federal Way
• Seattle

Care Advice for Vomiting

1. What You Should Know About Vomiting:
   • Most vomiting is caused by a viral infection of the stomach.
   • Vomiting is the body's way of protecting the lower gut.
   • The good news is that stomach illnesses last only a short time.
   • The main risk of vomiting is dehydration. Dehydration means the body has lost too much fluid.
   • Here is some care advice that should help.
2. Formula Fed Babies - May Give Oral Rehydration Solution (ORS) for 8 Hours:
   • If vomits once, give half the regular amount of formula every 1 to 2 hours.
   • If vomits formula more than once, offer ORS for 8 hours. If you don't have ORS, use formula until you can get some.
   • ORS is a special fluid that can help your child stay hydrated. You can use Pedialyte or the store brand of ORS. It can be bought in food stores or drug stores.
   • Spoon or syringe feed small amounts. Give 1-2 teaspoons (5-10 mL) every 5 minutes.
   • After 4 hours without throwing up, double the amount.
   • Return to Formula. After 8 hours without throwing up, go back to regular formula.
3. Breastfed Babies - Reduce the Amount Per Feeding:
   • If vomits once, nurse half the regular time every 1 to 2 hours.
   • If vomits more than once, nurse for 5 minutes every 30 to 60 minutes. After 4 hours without throwing up, return to regular nursing.
   • If continues to vomit, switch to pumped breastmilk. (ORS is rarely needed in breastfed babies. It can be used if vomiting becomes worse).
   • Spoon or syringe feed small amounts of pumped milk. Give 1-2 teaspoons (5-10 mL) every 5 minutes.
   • After 4 hours without throwing up, return to regular feeding at the breast. Start with small feedings of 5 minutes every 30 minutes. As your baby keeps down the smaller amounts, slowly give more.
4. Pumped Breastmilk Bottle-Fed Infants - Reduce the Amount per Feeding:
   • If vomits once and bottle-feeding breastmilk, give half the regular amount every 1-2 hours.
   • If vomits more than once within last 2 hours, give 1 ounce (30 mL) every 30 to 60 minutes.
   • If continues to vomit, give 1-2 teaspoons (5-10 mL) every 5 minutes. Only if not tolerating breastmilk, switch to ORS (e. g., Pedialyte) for every 5 minutes for a few hours.
   • After 4 hours without vomiting, return to regular feedings. Start with 1 ounce (30 mL) every 30 minutes and slowly increase as tolerated.
5. Stop All Solid Foods:
   • Avoid all solid foods and baby foods in kids who are vomiting.
   • After 8 hours without throwing up, gradually add them back.
   • If on solid foods, start with starchy foods that are easy to digest. Examples are cereals, crackers and bread.
6. Do Not Give Medicines:
   • Stop using any drug that is over-the-counter for 8 hours. Reason: Some of these can make vomiting worse.
   • Fever. Mild fevers don't need to be treated with any drugs. For higher fevers, you can use an acetaminophen suppository (such as FeverAll). This is a form of the drug you put in the rectum (bottom). Ask a pharmacist for help finding this product. Do not use ibuprofen. It can upset the stomach.
   • Call your doctor if: Your child vomits a drug ordered by your doctor.
7. Try to Sleep:
   • Help your child go to sleep for a few hours.
   • Reason: Sleep often empties the stomach and removes the need to vomit.
   • Your child doesn't have to drink anything if his stomach feels upset and he doesn't have any diarrhea.
8. Return to Child Care:
   • Your child can return to child care after the vomiting and fever are gone.
9. What to Expect:
   • For the first 3 or 4 hours, your child may vomit everything. Then the stomach settles down.
   • Vomiting from a viral illness often stops in 12 to 24 hours.
   • Mild vomiting and nausea may last up to 3 days.
10. Call Your Doctor If:
    • Vomits clear fluids for more than 8 hours
    • Vomiting lasts more than 24 hours
    • Blood or bile (green color) in the vomit
    • Stomach ache present when not vomiting
    • Dehydration suspected (no urine in over 8 hours, dark urine, very dry mouth, and no tears)
    • You think your child needs to be seen
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Last Reviewed: 10/08/2022

Last Revised: 09/21/2022

Copyright 2000-2022 Schmitt Pediatric Guidelines LLC.

Why does the baby spit up after breastfeeding?

Every mother has experienced this phenomenon to some extent - this is completely normal, because in the first months the baby's eating habits are just beginning to form. What are the causes of regurgitation? Can this be prevented? What is considered normal, and when should you see a doctor? Let's find out!

Dry initial milk formula adapted by Valio Baby 1 NutriValio for feeding children from birth to 6 months Read more

Follow-up dry milk formula adapted by Valio Baby 2 NutriValio for feeding children from 6 to 12 months More

Dry milk drink "Baby milk" Valio Baby 3 NutriValio for feeding children over 12 months Read more

Often the cause of regurgitation depends on the chosen method of feeding: whether the mother is putting the baby to the breast or feeding from a bottle.

• Overfeeding the baby. If the baby eats too much, then the excess milk comes out naturally.
• Incorrect breastfeeding technique, as a result of which a large amount of air enters the baby's stomach along with milk. Try to hold the baby so that he completely grasps the nipple and at the same time can breathe freely through his nose.
• Features of the digestive system of children at an early age. In infants up to a year old, the muscles of the esophagus are not yet fully formed, so regurgitation is often a natural process.
• An abrupt change in the position of the child. After feeding, do not turn the baby over, squeeze, swaddle or swing in the stroller.
• Intestinal disorders such as bloating, colic and other causes that prevent normal digestion.
• In rare cases, serious diseases of the digestive system.

Note that regurgitation is more often observed not in newborns, but in children aged about 4 months.

• Abrupt transition from breast milk to formula.
• Unsuitable size and opening of the nipple, due to which the baby takes in a lot of air.
• Tendency to overeat. You should follow the rules of nutrition for babies.
• Inappropriate milk formula. Perhaps the child simply does not tolerate it well, consult a doctor about changing baby food.

Valio Baby's adapted milk formulas are as close as possible in composition to breast milk and contain prebiotics, as well as vitamins and microelements necessary for intestinal health. All components of Valio Baby are natural. A balanced composition allows you to maintain the level of cholesterol in the child's body at an optimal level. The mixtures are designed for three age categories, taking into account the peculiarities of the development of babies in a given period:

• from the first days of life to six months;
• for babies from six months to 1 year;
• and for children over 1 year old.

If the baby is lying on his back and starts spitting up, immediately turn him over on his stomach, or pick him up - this will prevent food from entering the respiratory tract.

If your baby seems to be uncomfortable while feeding, or if he comes off the breast and starts crying, let him burp. This can be done in two ways:

• Place a washcloth over your shoulder to keep it clean. Hold the baby on your chest so that his chin rests on your shoulder. Gently stroke or pat your hand on his back.
• Place the cloth on your lap. Turn the baby over on the tummy and position it perpendicular to your body. Support your chin with one hand and pat or rub your back with the other. Please note that the child's head should be higher than other parts of the body so that blood does not rush to it and food does not reflux into the respiratory tract.

As a rule, spitting up 6-8 times a day (in small portions) does not pose a health risk. Over time, when the baby's muscles get stronger, he will better absorb food. Most children stop spitting up after 6-7 months, but in some situations this problem persists up to one year.

If the spitting up is persistent and strong, prevents weight gain, the child cries after this process, then you should consult a doctor. Such symptoms may indicate that the baby has irritated walls of the esophagus.

Call a doctor immediately if your child is vomiting violently and profusely. This may indicate either the presence of food poisoning, or a disease associated with deformation of the internal organs.

If an infant vomits with greenish bile, this may be a sign of intestinal blockage, which requires urgent hospitalization and possibly even emergency surgery.

Prevention

If your newborn is spitting up a lot after feeding, follow these guidelines:

• Do not breastfeed while baby is squatting or in a car seat as milk or formula may not reach the stomach.
• Create a calm atmosphere. Keep noise and other distractions to a minimum. If the baby is distracted and disturbed by something, there is an increased risk that he will swallow large amounts of air with formula or breast milk. For the same reason, do not let the baby be very hungry.
• Make sure that nothing is pressing on the baby's tummy. Make sure his clothes and diaper are not too tight.
• Avoid driving immediately after feeding.
• Hold the baby for about 30 minutes. upright after eating.
• When breastfeeding, make sure that the baby is properly latching onto the breast (his lips should cover not only the nipple, but also the areola, as far as possible).
• If you are feeding formula or bottled milk, make sure the opening of the nipple is not too small as this can prevent the baby from drinking and cause air to be swallowed. The hole should not be too large, so that the child does not choke.
• Do not overfeed your baby. Try feeding him less milk or formula. Watch the reaction. The baby may agree to drink a smaller volume at a time, however, will want to eat more often.

If regurgitation occurs frequently, after each feed, consult your physician.

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