Reason for baby throwing up

Vomiting in children and babies

It's normal for babies and children to vomit occasionally. In most cases, it will last no longer than one to two days and isn't a sign of anything serious.

The most common cause of vomiting in children and babies is gastroenteritis. This is an infection of the gut usually caused by a virus or bacteria, which also causes diarrhoea. The symptoms can be unpleasant but your child will usually start to feel better after a few days.

However, persistent vomiting can sometimes cause your child to become severely dehydrated and occasionally it can be a sign of something more serious, such as meningitis.

This page outlines what to do if your child keeps vomiting and describes some of the common causes of vomiting in children and babies.

If your child has a high temperature, you can also read a separate page about fever in children.

What to do

If your child vomits, you should keep a close eye on them. Trust your instincts and contact your GP immediately if you're worried.

If the cause is just a tummy bug, your child should still be feeling well enough to eat, play and be their usual self. In this case, keep feeding them as normal and offer them regular drinks (see below).

But if they don't seem themself – for example, if they're floppy, irritable or less responsive – they may be seriously ill, so you should get medical help immediately.

When to get medical advice

You should contact your GP if:

• your child is repeatedly vomiting and is unable to hold down fluids
• you think they're dehydrated – symptoms of dehydration can include a dry mouth, crying without producing tears, urinating less or not wetting many nappies, and drowsiness
• their vomit is green or contains blood
• they have been vomiting for more than a day or two

Go to your nearest accident and emergency (A&E) department if your child is vomiting and develops sudden and severe tummy pain, or they're floppy, irritable or less responsive

Call 999 for an ambulance or go to your nearest A&E department immediately if they're vomiting and have a headache, stiff neck and a rash.

Looking after your child at home

In most cases, you can treat your child safely at home. The most important thing you can do is make sure they keep drinking fluids to prevent dehydration.

If your baby is vomiting, carry on breastfeeding or giving them milk feeds. If they seem dehydrated, they will need extra fluids. Ask your GP or pharmacist whether you should give your baby oral rehydration solution.

Oral rehydration solution is a special powder that you make into a drink. It contains sugar and salts to help replace the water and salts lost through vomiting and diarrhoea.

Children who are vomiting should keep taking small sips of clear fluid, such as water or clear broth. Fruit juice and fizzy drinks should be avoided until they're feeling better. If they're not dehydrated and haven't lost their appetite, it's fine for your child to eat solid foods as normal.

Again, speak to your GP or pharmacist if you're concerned about dehydration. They may recommend an oral rehydration solution for your child. Contact your GP or practice nurse if your child is unable to hold down oral rehydration solution.

If your child has diarrhoea and is vomiting, they shouldn't go to school or any other childcare facility until 48 hours after the last episode of diarrhoea or vomiting.

Read more about treating gastroenteritis in children.

Causes of vomiting in children

There are a number of possible causes of vomiting in children, which are described below.

Gastroenteritis

Gastroenteritis is an infection of the gut. It's a common cause of vomiting in children and usually lasts a few days.

Food allergy

Food allergies can cause vomiting in children, as well as other symptoms, such as a raised, red, itchy skin rash (urticaria) and swelling of the face, around the eyes, lips, tongue or the roof of the mouth.

Watch out for foods that may bring on vomiting and see your GP for a diagnosis if you think your child may have a food allergy.

Other infections

Vomiting can sometimes be a sign of an infection other than gastroenteritis, such as urinary tract infections (UTIs), middle ear infections, pneumonia or meningitis.

Contact your child's GP if they're vomiting and experiencing additional symptoms of an infection, such as a high temperature (fever) and irritability.

Appendicitis

Appendicitis is a painful swelling of the appendix, a finger-like pouch connected to the large intestine. It causes severe tummy pain that gets worse over time.

If your child has tummy pain that's gradually getting worse, contact your GP, or if they aren't open call NHS 24's 111 service immediately. You should call 999 for an ambulance if they have pain that gets worse quickly and spreads across their tummy.

In most cases of appendicitis, the appendix will need to be surgically removed as soon as possible.

Poison

Accidentally swallowing something poisonous can cause your child to vomit. If you think this is the case, contact your GP immediately or take your child to your nearest accident and emergency (A&E) department.

Causes of vomiting in babies

These include:

• gastroenteritis 
• a food allergy or milk intolerance
• gastro-oesophageal reflux – where stomach contents escape back up the gullet 
• too big a hole in the bottle teat, which causes your baby to swallow too much milk
• accidentally swallowing something poisonous
• congenital pyloric stenosis – a condition present at birth where the passage from the stomach to the bowel has narrowed, so food is unable to pass through easily; this causes projectile vomiting
• a strangulated hernia – your baby will vomit frequently and cry as if they are in a lot of pain; this should be treated as a medical emergency
• intussusception (where the bowel telescopes in on itself) – as well as vomiting, your baby may look pale, floppy and have symptoms of dehydration

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: 10/25/2022

Last Revised: 09/21/2022

Copyright 2000-2022 Schmitt Pediatric Guidelines LLC.

What parents need to know: how to help the baby, the causes of regurgitation and their treatment.

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

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

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

First of all, parents need to know that regurgitation in a newborn baby is a completely normal physiological process that is common to almost all babies under 1 year old.

In the first 3 months of a baby's life, regurgitation after feeding is noted in 100% of newborns. In older children, this usually goes away - by 4-6 months, about 60% of babies spit up, at the age of six months to a year - already 20%. Frequent regurgitation is also characteristic of perfectly healthy babies, there may be several reasons for this process.

The most common causes of regurgitation in newborns:

• Overfeeding Everything is extremely simple - there is too much milk or a mixture, the excess is rejected by the child's body.
• Aerophagy. Many babies take in too much air when feeding. This may be due to the temperament of the infant, "hungry" for mother's milk, improper attachment to the breast, or incorrect bottle feeding technique if the baby is artificial.
• Excessive activity after feeding. Parents need to learn how to behave properly with a child - after feeding, you should not squeeze and turn the baby over, rock him in a stroller. Correctly hold the baby in an upright position (column). This will allow excess air to escape.
• Underdevelopment of the esophageal sphincter. This is a special valve that controls the flow of food from the stomach into the esophagus. In children, it is formed only by 1 year.

You don't have to worry about your newborn spitting up after feeding if it happens within 1 hour after the baby has eaten. The natural volume is 1-2 tablespoons. To test this, pour a spoonful of water next to the spit-up stain and compare the stains. Recall that regurgitation in newborns is a normal process in the formation of the gastrointestinal tract. Neither the mood, nor the appetite, nor the well-being of the child suffers from it. The baby should also gain weight steadily and not experience problems with stool and urination.

How to help the baby?

Before feeding, lay the baby on his stomach for a few minutes.

During feeding, after a few minutes, let the baby rest. When formula feeding, make sure that the mixture inside the bottle completely covers the nipple.

After feeding, hold your baby upright for about 10 minutes.

#PROMO_BLOCK#

Reasons for visiting a doctor:

• Vomiting. They may indicate neurological problems or spasms of the digestive tract, which should be treated by a gastroenterologist.
• Late regurgitation. If the baby spit up later than 1 hour after feeding, this may be a symptom of a "lazy stomach". In this case, the baby also often has constipation.
• Frequent regurgitation in a child, if it occurs independently of feeding.
• Restlessness and crying during regurgitation. Most likely, the baby is tormented by colic, the doctor will help you choose a medicine that will alleviate the baby's condition.
• Regurgitation after drinking and eating small amounts of food, accompanied by restlessness and lack of weight gain. They may be a sign of pyloric stenosis (an anatomical defect in which the digestive tube narrows sharply and food does not enter the intestines). Such problems are solved by surgical intervention. It is very important to diagnose pyloric stenosis as early as possible.

Be attentive to your baby. Do not panic in vain, but if you are justified, be sure to seek professional advice from a pediatrician, and also read the article on colic.

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