Why do babies projectile vomit

What Causes Projectile Vomiting in Children? The Impact of Gut Health and Certain Health Conditions

Written by WebMD Editorial Contributors

Projectile Vomiting and Digestion Issues

A child who vomits way too much and with a lot of force may have a problem in their stomach or intestines. One such problem in younger babies is pyloric stenosis. ‌

Pyloric stenosis is a rare condition that affects about three in every 1,000 babies in the U.S. You will see a baby with this condition start projectile vomiting at three to five weeks of age. It happens because the opening at the lower end of the stomach, the pylorus, is too narrow for food or milk to pass through to the small intestine.

Other Symptoms of Pyloric Stenosis. If your baby is projectile vomiting after feeding, you should see your pediatrician immediately. If pyloric stenosis is the cause, the child may also show these symptoms:

Constant hunger
Tightness in the stomach and abdomen
Constipation
Dehydration: an unhealthy loss of body fluid
Weight loss

Gastroenteritis. You may call this infection of your child’s stomach a "stomach flu" or a "bug." It can cause frequent vomiting that lasts a few days. And dehydration may result.

Other Causes of Projectile Vomiting

Food allergy. In some cases, your child may have a food allergy that causes excessive vomiting. It will be accompanied by raised, red, itchy skin, and swelling in the face, eyes, mouth, or tongue.

You should seek immediate medical attention for this reaction. Try to keep an eye on what your child ate before the vomiting began.

Infection. Besides gastroenteritis, other infections that can cause projectile vomiting are ear infections, pneumonia, or meningitis. Projectile vomiting is a severe symptom of these conditions. Your child will also have a high fever and be fussy. ‌

Appendicitis. If your child has intense stomach pain and is projectile vomiting, their appendix may be swollen and close to bursting. This condition requires immediate attention. Their appendix will most likely need to be removed.

Effects of Long-Term Projectile Vomiting

If your baby or child has projectile vomiting that goes on for days, either due to pyloric stenosis or something else, they're in need of medical attention.

You never want a baby or child — or anyone else in your care — to go through dehydration. The quick loss of fluids is tough on a child’s body. It can also bring about infections and affect the kidneys and the brain.

When pyloric stenosis is present, risks are:

Failure to grow and develop properly
Stomach irritation
Jaundice

Treatment for Projectile Vomiting

The best treatment for projectile vomiting is to feed your child plenty of clear fluids. If your child is over the age of two, you’ll need to make sure they are getting plenty of water and electrolytes, minerals their bodies need to work right. Have them drink a little something every quarter-hour or so.

You can also give them chicken noodle soup, with a clear broth, because this puts more fluid in their body. You can also offer clear, pulp-free drinks, including sports drinks, but not sodas or thick fruit juices. ‌‌

Over-the-counter medicine is not recommended to stop the vomiting. These medications can cause other side effects that aren’t good. See treatment from your doctor when your child suffers from projectile vomiting that doesn't seem to slow down. Your doctor will prescribe the right medication, if necessary. ‌

A young baby who is projectile vomiting may need slightly different treatment. However, getting enough fluids is still most important. You can keep breastfeeding or giving formula as needed.

You can also ask your doctor if you should give your baby an oral rehydration solution. This is a powder you can add to your baby’s bottle that has sugar and salts in it.

When to See a Doctor

Unless your child or baby has an underlying condition that you know causes projectile vomiting, you will likely want to see your doctor when it occurs. These signs may mean your child needs quick medical attention:‌

Decreased urination
Vomit that's green in color
Fever of 102 or higher
Lack of tears
Dry mouth
Sunken eyes
Clammy hands and feet
Little to no energy

Your child will need to be treated for dehydration if they experience those symptoms. And your child may be in intense pain.

Remember that projectile vomiting is not "normal" vomiting. And when it happens a lot, it's a cause for concern.‌

Through it all, keep tabs on your child's health and well-being. Comfort and reassure your child to help them calm down once their stomach settles.

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
Virtual Urgent Care

Care Advice for Vomiting

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.
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.
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.
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.
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.
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.
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.
Return to Child Care:
- Your child can return to child care after the vomiting and fever are gone.
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.
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: 03/14/2023

Last Revised: 12/30/2022

All You Need to Know About Projectile Vomiting - Drink-Drink

Projectile Vomiting Compared to Other Types of Vomiting

Projectile Vomiting is a type of severe vomit in which stomach contents can be violently thrown several feet away from you. It usually manifests itself in shorter and more severe attacks than other types of vomiting. It's also more likely that severe vomiting will start suddenly, with little or no warning, rather than after you've been feeling nauseous for a while.

Read on to learn more about this type of vomiting and when you should seek help.

Projectile vomiting in infants and children

Projectile vomiting in infants and children can have several possible causes:

Pyloric stenosis

Pyloric stenosis is a thickening of the muscle where the stomach meets the small intestine. It usually causes symptoms within three to five weeks after birth and blocks the passage of food from the stomach into the duodenum of the small intestine.

Pyloric stenosis requires surgery because if it is allowed to continue, malnutrition, dehydration and stunting will occur.

Other symptoms include:

Less and less bowel focus
Inability to gain weight or weight loss
dehydration
Reductions in your child's stomach after feeding

Reflux

Refluxes - this back into the esophagus. In more severe cases, acid reflux from the stomach causing irritation of the esophagus, known as gastroesophageal reflux disease (GERD), can cause projectile vomiting.

Other symptoms of GERD in infants include:

regurgitation of yellow or green fluid
difficulty breathing
refusal to eat

Gastric obstruction

For example, if your child swallows a small object, it may block the emptying of the stomach.

Infectious disease

Infections, such as those caused by a virus, are a common cause of vomiting in children. Although most of them do not induce projectile vomiting, it is possible. Stomach or intestinal infections in children have the same symptoms as in adults, including diarrhea, fever, and abdominal cramps. They can usually be treated in the same way, with time, rest, rehydration, and light food.

Overeating

Overeating can sometimes lead to projectile vomiting as the stomach tries to expel food it has no room for.

When to call your pediatrician

Projectile vomiting in infants requires medical attention, regardless of the cause. If an older child has had severe vomiting for more than 24 hours, call their doctor. You should also see a doctor if they are vomiting projectiles along with blood in the stool or severe abdominal pain, or if there is blood in the vomit or it looks green.

Projectile vomiting in adults

There are several possible causes of projectile vomiting in adults.

Infectious disease

Infections of the gastrointestinal tract, such as norovirus, cause most cases of vomiting in adults. This is sometimes called the stomach flu. While severe vomiting is not common with these types of infections, it is possible.

In addition to vomiting, symptoms of gastrointestinal infection may include:

abdominal pain
diarrhea
body aches
fatigue

food poisoning

food poisoning can also cause projectile vomiting. This is because your body is trying to get rid of a toxin, such as a bacterium, that contaminates food. Learn how to tell if it's a stomach bug or food poisoning.

Obstacles

Obstruction of the stomach or intestines in adults occurs for many reasons, and such obstructions can cause vomiting. Constipation can be caused by:

Intestinal Inversion (intestines)
Spikes
Gryzh
benign and cancer tumors

Other symptoms of obstruction include:

Strong bloating and pain
Zaporpor or diarrhea, investigation of the degree intestines
decreased appetite

Overeating

Overeating can lead to projectile vomiting in adults as the stomach tries to expel food for which there is no room in it.

When to call your doctor

You should call your doctor if you have:

severe abdominal pain
blood in your vomit or stool
projectile vomiting that lasts more than 24 hours

Projectile vomiting is usually harmless but these are signs of a more serious problem.

Solution

Vomiting is your body's way of getting rid of what it thinks is bad. This means that the best way to treat projectile vomiting in children and adults is to simply wait until it is over.

After your projectile vomiting episode is over, there are things you can do to take care of yourself. Vomiting can lead to dehydration, so it's important to drink water or an electrolyte drink like Gatorade as soon as you can control vomiting.

Once you have learned to hold back liquid, you should also try to eat. It is recommended to start with a small amount of more insipid foods, such as dry toast, bananas, broth, rice, applesauce, or crackers. This is known as the BRAT diet. Don't force yourself to keep eating if you start to feel sick. However, once you can tolerate soft solid foods, try to return to a balanced wholesome diet sooner rather than later if possible.

In infants

The treatment of infants with projectile vomiting depends on the cause. If pyloric stenosis causes vomiting, surgery is needed to widen the pyloric canal and allow food to pass normally from the stomach into the small intestine.

If GERD is causing your child to vomit, feeding more often and eating less food at a time may help. Frequent burping and making sure the baby stays upright for 30 minutes after a feed can also help reduce reflux.

Projectile vomiting caused by a bacterial infection may require an antibiotic or may simply take time to go away.

Complications

The main potential complication of projectile vomiting, as with other types of vomiting, is dehydration. You can treat or prevent dehydration by drinking water or a sports drink as soon as you can control it after vomiting. You can also try sucking on ice cubes. This can help you stay hydrated by controlling how much you drink.

Chronic vomiting can also lead to malnutrition and weight loss because your body throws food away instead of digesting and absorbing nutrients from it. Slow reintroduction of fresh food after vomiting can help you reduce your food intake and avoid these complications.

Projectile vomit is more severe than other types of vomit and is therefore more likely to rupture the esophagus. A rupture of the superficial inner lining (mucosa) of the esophagus near its junction with the stomach is called a Mallory-Weiss rupture. If you have blood in your vomit and abdominal pain after an episode of severe vomiting, you should see your doctor. They can diagnose a tear with an upper GI endoscopy to look at the lower esophagus. In many cases, this heals on its own, but a doctor can repair the tear if needed.

Outlook

Projectile vomiting is often no more dangerous than other types of vomiting, but can be a sign of more serious problems, especially in infants and children. If your child is vomiting projectiles, you should always call their doctor. You should see a doctor if you or your child is vomiting projectiles and severe abdominal pain, blood in the vomit or stool, or if projectile vomiting continues for more than 24 hours. Otherwise, the best thing you can do is rehydrate after you've finished vomiting and introduce food slowly.

Spitting up and vomiting in babies

Spitting up and vomiting in babies is a common reason for visiting a doctor.

Regurgitation and vomiting is a reflex action that occurs when receptors located in various anatomical zones are irritated, incl. in the stomach, esophagus, pharynx, oral cavity. The signal is transmitted to the vomiting center, which is located in the medulla oblongata and a gag reflex occurs.

What is the difference between regurgitation and vomiting?

The difference lies in the volume and kinetics (movement) of the gastric contents expelled to the outside. When regurgitation occurs, leakage occurs without the participation of the diaphragm and abdominal muscles, i. e. passively. There is little content, up to about 10-15 ml. If the child does not swallow it, it quietly expires from the oral cavity. When vomiting, a wave-like bending of the upper half of the body occurs as a result of contraction of the muscles of the diaphragm and the anterior wall of the abdomen, the volume of vomit is greater, and they are erupted with pressure from the oral cavity with an ejection trajectory of up to 50 cm. In children of the first year of life, this is defined by the term "fountain vomiting" .

Regurgitation is observed only in children of the first year of life and, mainly, up to 6 months. Contribute to this anatomical and physiological features of the esophagus and stomach of the baby. Their esophagus is short and wide, the angle of connection of the esophagus with the stomach is less pronounced, and its obturator function is weak. These regurgitations are physiological. They can be after each feeding, up to 15 ml, do not affect the well-being and weight gain of the baby. They can also be caused by excessive feeding, aerophagia (swallowing air while sucking), straining during intestinal colic. The frequency and volume of such regurgitation decreases with the growth of the child. With the introduction of complementary foods, and this is a thicker food, regurgitation stops or becomes much less frequent.

If regurgitation persists in a child older than 1 year, then this is a sign of a pathological process.

Vomiting, in contrast to regurgitation, is accompanied by vegetative symptoms - increased salivation, pallor of the skin, palpitations. This is due to the fact that next to the vomiting center there are additional centers of autonomic regulation, which are reflexively excited, and active biological substances such as serotonin, dopamine, histamine and others are released into the blood.

Regurgitation and vomiting, from the moment of eating, may occur during feeding, after feeding during the first 20-30 minutes or delayed, sometimes after several hours.

Regurgitation and vomiting that occurs immediately after feeding unchanged breast milk or formula may be due to narrowing of the esophagus. If they persist until the next feeding, and the milk / mixture is curdled, has a sour or musty smell, then this is the result of a long standing food in the stomach. The reason for this may be the low tone of the muscle layer of the stomach and, as a result, its peristalsis or narrowing of the output section due to an anomaly in the development or high tone of the sphincter of the lower stomach. With narrowing of the duodenum, bile is present in the regurgitated masses.

Gastroesophageal reflux is a common cause of regurgitation in infants. It is likely that there is a complex problem here, starting with the immaturity of the gastrointestinal tract and disorders of the central nervous system. Perinatal injuries of the central nervous system accompany every second child. Their manifestations are varied. Regurgitation and vomiting can be facilitated by an increase in intracranial pressure, disorders in the segment of the cervical spine, and so on. Therefore, quite often, when carrying out rehabilitation measures for neurological dysfunctions, a positive effect is manifested in the form of a decrease or cessation of regurgitation. A hernia of the esophageal opening of the diaphragm will also manifest itself in a similar way.

We should not forget about allergic gastrointestinal reactions in the form of regurgitation and vomiting. The most common cause of this is cow's milk protein. With intolerance to cow's milk protein, inflammation of the mucous membrane of the esophagus, stomach and intestines occurs. And, as a result of this, regurgitation and vomiting, pain and increased gas formation, diarrhea or constipation.

Rare endocrine disorders (adrenogenital syndrome) are manifested by vomiting in children from the first weeks of life. In such cases, vomiting is frequent, there may be an admixture of bile, the child loses weight due to loss of fluid and nutrients, and severe metabolic disorders develop.

Vomiting can also be caused by an intestinal infection. Viral gastroenteritis is now common. It must be remembered that the younger the child, the more severe the disease. Within a few hours, the child's condition can go from satisfactory to extremely serious.

As you can see, the causes of regurgitation and vomiting in children of the first year of life are quite diverse, but most often these are transient conditions that disappear with the growth of the child.

Prevention of regurgitation in children of the first months of life is quite simple. Don't overfeed your baby. If he cries, it does not always mean that he is hungry. Excess feeding leads to increased gas formation and colic, during which the child is worried, straining, thereby increasing the likelihood of spitting up. After feeding, hold the baby more upright so that he can burp the swallowed air. This will take 15-20 minutes. If the child is bottle-fed, do not change his formula milk without the recommendation of a pediatrician.

If the child has frequent regurgitation and vomiting, it is necessary to consult a pediatrician or gastroenterologist to diagnose the cause.

Welcome

Find us on iTunes!

Popular Posts