Why is my baby throwing up?
Viral illnesses are often to blame, though there are many other reasons a baby might vomit. Although it may be disconcerting for you and scary for your baby – and might even make him cry – throwing up usually isn't serious. (Advice on when to see a doctor or seek emergency care is at the end of this article.)
If your baby's throwing up, you'll want to find out what's causing it, so you can confirm that he's okay and make him more comfortable. Common causes of vomiting in babies include:
During your baby's first few months, throwing up may be linked to feeding problems, such as overfeeding. A less common cause is an allergy to proteins in your breast milk or formula.
Viral or bacterial infection
- Congestion or a respiratory infection can lead to vomiting, especially during a coughing fit. And the mucus from a cold can drip down the back of your child's throat and trigger the gag reflex or irritate the stomach. (You can use a bulb syringe or nasal aspirator to help clear a stuffy nose.)
- Stomach flu (a viral gastrointestinal infection) is another common cause of vomiting. If a viral or bacterial infection affects the lining of your baby's stomach or intestines, other symptoms may include diarrhea, appetite loss, abdominal pain, and fever. Your baby likely will stop throwing up in 12 to 24 hours.
- A urinary tract infection, pneumonia, meningitis, and even an ear infection can also cause nausea and vomiting.
Vitamins and medications
Some vitamins (such as iron), and some medications (such as certain antibiotics, antivirals, and anti-inflammatories like ibuprofen) may cause your baby to throw up. If she's eating solid foods, and if the medication can be taken with food, try giving it to her with her meals or snacks. If she's not eating solid foods yet, try giving it to her right after you breastfeed or bottle-feed her. If that doesn't help, talk with her doctor to see if there's an alternative medication.
A prolonged bout of crying can trigger the gag reflex and make your baby throw up. Although it's troubling for both of you, throwing up during a crying spell won't physically harm your baby. If he appears otherwise healthy, there's no reason to be concerned.
Some babies tend to get motion sickness, which can be a problem if your daily routine includes a car trip. Experts believe that motion sickness happens when there's a disconnect between what your baby sees and what he senses with the motion-sensitive parts of his body, such as his inner ears and some nerves.
Nausea and vomiting are among the symptoms your baby might have if she eats a food she's allergic to. (She might not have a reaction the first time she eats the food.) The most common allergens are cow's milk, eggs, fish, peanuts, shellfish, soy, tree nuts, and wheat.
In most cases, when a baby hits his head when he falls, there's nothing to worry about. But if your baby throws up more than once after a fall or a blow to the head, he may have a concussion. Other symptoms are drowsiness, dizziness, irritability, and confusion. Call 911 if he starts breathing irregularly, has convulsions, or is unconscious.
Your baby could throw up if he swallowed something toxic, such as a drug, plant, medicine, or chemical. Or he may have gotten food poisoning from contaminated food or water. (See "What should I do if I think my baby has swallowed something poisonous?" below.)
Sudden and persistent vomiting can be a symptom of a handful of rare conditions involving an intestinal obstruction, such as intussusception (when one part of the bowel slides into the next part), malrotation (a twisting of the intestines), or Hirschsprung disease (a blockage due to poor muscle movement in the bowel).
Because a blockage can lead to malnutrition, dehydration, and other health problems, they usually require immediate medical attention and possibly surgery.
This rare condition usually develops in the first few weeks of life and causes forceful projectile vomiting. Babies with pyloric stenosis vomit because the muscle leading from the stomach into the intestines thickens so much that stomach contents can't pass through.
Because this condition can lead to malnutrition, dehydration, and other health problems, it requires immediate medical attention. If you think your baby may have this condition, contact his doctor as soon as possible. Pyloric stenosis can be corrected with surgery.
How can I tell if my baby is spitting up or vomiting?
It can be hard to tell the difference, because vomiting and spitting up (gastroesophageal reflux) are similar and both usually occur after feeding, but there are a few clues.
- Spit-up: When your baby spits up, it comes out effortlessly, with little to no force and without seeming to bother her or her tummy. Stomach contents can gurgle up into her throat, or she may also swallow air while feeding. When that air comes back up as a burp, some liquid might come along with it. This is normal in babies and is usually nothing to worry about.
- Vomit: When your baby throws up, the stomach contents shoot out forcefully, causing her distress and discomfort. The amount of vomit is generally much greater than when your baby spits up. She also may have other symptoms, such as fever or fussiness.
What can I do to help when my baby is throwing up?
In most cases your baby will stop throwing up without treatment, but here are some things you can do to help him feel better:
- Keep your baby upright or lying on his stomach or side if he's awake. It may be hard to see your baby distressed, but try to be calm so you can comfort him. Your soothing presence and gentle touch will be reassuring.
- Avoid solid foods for 24 hours after throwing up. If that seems too long, ask your baby's doctor for advice about when to resume feeding solids after vomiting.
- Prevent dehydration by frequently offering fluid (breast milk or formula).
How can I keep my baby from getting dehydrated after vomiting?
The approach to keeping your baby hydrated depends on how much and how often she's throwing up. Dehydration can be a serious problem for babies because vomiting causes your child to lose precious fluids.
- Call your baby's doctor for advice on the best way to rehydrate your baby. If she's vomiting a lot, the doctor may suggest an over-the-counter pediatric electrolyte solution to replace lost fluids, salts, and minerals. The doctor can suggest a specific solution and advise how much to give your baby based on her weight and age.
- If your baby is throwing up frequently (every five or 10 minutes), don't force her to drink the electrolyte solution. But after her tummy's been calm for half an hour or so, offer her small, frequent sips. Try 1 teaspoon (5 cc) every 10 minutes for a couple of hours at first. If she tolerates that well, increase the amount to 2 teaspoons (10 cc) every five minutes. Continue to give her more gradually until the vomiting eases up. If your baby throws up the electrolyte solution, let her doctor know.
- When your baby can tolerate it, resume formula feeding or breastfeeding. Some moms breastfeed a bit while giving their babies electrolyte solution, while others wait. Take your cues from your baby.
- Don't give water, chicken broth, or carbonated drinks – they don't provide the necessary nutrients for a dehydrated baby.
- Don't give your baby fruit juice. The American Academy of Pediatrics (AAP) advises against giving juice to children younger than 1, even when they're not sick.
Should I give my baby medication to treat vomiting?
No. Don't give your baby any prescription or over-the-counter anti-nausea medication unless the doctor recommends it.
Can my baby choke on vomit while he's sleeping?
Many parents worry that a baby who's been throwing up might choke if he's put to sleep on his back. But this is extremely unlikely if:
- Your baby normally sleeps on his back, as doctors recommend.
- Your baby doesn't have a physical condition that makes it difficult for him to clear his airway.
Research shows that otherwise healthy babies can sleep safely on their back – even if they've been throwing up – because an infant's body has reflexes (head turning, coughing, and swallowing) that prevent fluids from entering the airway.
What's more, it actually may be easier for your baby to keep his airway clear of fluid when he's sleeping on his back because of the way his trachea (windpipe) and esophagus (tube from throat to stomach) are positioned in his body.
Multiple sudden infant death syndrome (SIDS) studies show no evidence that babies who sleep on their back are more likely to choke on vomit than babies who sleep on their stomach. One major study in the United States found that the number of aspiration-related deaths dropped significantly over a five-year period in the early 1990s when parents started putting their babies to sleep on their back.
But in babies with certain conditions, choking on vomit is possible because they may not be able to keep their airway clear when sleeping. If your baby has a birth defect that could cause food and liquid to pass into the windpipe (like a cleft palate or a laryngeal cleft), the doctor may ask you to put your baby to sleep on his stomach or side so he doesn't choke.
Can I do anything to prevent my baby from throwing up or spitting up?
You won't always be able to keep your baby from getting sick with the illnesses that cause vomiting, but here are helpful strategies:
- If your baby spits up after feedings, give her smaller amounts and burp her more often. Don't bounce her on your knee, put her in a bouncy chair, or let her get too active right after she eats – the food needs time to settle in her tummy. Keeping her upright for about half an hour after she's finished eating also helps.
- To minimize motion sickness, schedule plenty of stops during your trips to give your baby a chance to get some fresh air and calm her tummy. If she's eating solids, give her a small snack before the trip – having something in her stomach will help. And offer plenty of fluids to keep her hydrated.
- If your baby has a lot of phlegm and mucus from a respiratory infection, try using a bulb syringe to clear her nose. She probably won't enjoy it, but it isn't painful and may provide some relief.
After vomiting, when can my baby eat solids again?
Your baby's doctor may recommend keeping your baby off solid foods for a certain period of time after any illness that causes vomiting. After that, if your baby's vomiting diminishes or stops and his appetite returns, you can slowly reintroduce his usual diet of solids, including complex carbohydrates (like cereals and rice), lean meats, yogurt, fruits, and vegetables. But steer clear of fatty foods because they're harder to digest.
Note: This differs from the BRAT diet (bananas, rice, applesauce, and toast) that doctors used to prescribe. Studies show that reintroducing a standard diet can shorten recovery time because it restores essential nutrients that the body needs to fight infection.
My baby is throwing up but has no fever. Does that mean it's something she ate?
There are many reasons why your baby might throw up but not have a fever (see "Why is my baby throwing up?" above). She may simply have eaten too much, or she might not tolerate a car ride. On the other hand, she might have an obstruction or something else that needs immediate medical attention. Use the guidelines below to help figure out when to seek medical care. But if you have any doubts or concerns, don't hesitate to call her doctor.
When should I call my baby's doctor?
Call the doctor if your baby:
- Has been throwing up for more than 24 hours. For some illnesses, this is normal, but check with the doctor to be sure.
- Is younger than 3 months and has a fever with a rectal temperature of 100.4 degrees Fahrenheit or higher. Her doctor will want to examine her right away. If she's between 3 months and 6 months, call if her fever reaches 101 degrees F or higher, and if she's older than 6 months, call for a temperature of 103 degrees F or higher.
- Shows signs of becoming dehydrated. These can include dark yellow urine, decreased urination (more than six hours without a wet diaper), dry lips and mouth, lethargy, and crying without tears if she's more than a month old. (It can take a month or longer for a newborn baby to shed her first tears.)
- Is unusually fussy.
- Has blood in her vomit. A little blood is usually nothing to worry about because the force of throwing up can irritate the lining of the esophagus. Your baby's vomit may also be tinged with blood if she swallowed some from a recent nosebleed or cut in her mouth. But call the doctor if your baby continues to have blood in her vomit or if the amount increases. If the blood resembles dark coffee grounds, go to the emergency room right away.
- Has violent, persistent vomiting within half an hour of eating. This may be a sign of pyloric stenosis. Contact the doctor as soon as possible.
- Shows signs of jaundice, including skin or the whites of her eyes looking yellow.
- Has watery stools. She may have diarrhea, which can also quickly lead to dehydration.
What are signs that my baby needs emergency care?
Call 911 immediately if your baby:
- Is having trouble breathing.
- Shows signs of severe dehydration, like sunken eyes, hands and feet that feel cold or look splotchy, or sunken fontanels (the soft spots on his head).
Take your baby to the emergency room if he:
- Seems to be in severe pain. Your baby obviously can't explain what's going on, but you can probably tell when he's in considerable pain. He could have a blockage in his bowel or some other problem that needs immediate attention.
- Has vomit with blood that resembles dark coffee grounds or contains bile (a greenish yellow fluid). The doctor will probably want to see a sample of the vomit if it contains blood or bile, so try to save some in a plastic baggie. Bile can indicate that the intestines are blocked, a condition that needs immediate attention.
- Has a swollen, tender abdomen. This could indicate a buildup of fluid or gas, a blocked intestine, a hernia, or some other digestive tract problem. Blockages are uncommon but serious.
- Throws up more than once after suffering a head injury, which may indicate a concussion.
What should I do if I think my baby has swallowed something poisonous?
If you suspect your baby has swallowed something poisonous, immediately call the American Association of Poison Control Centers' national emergency hotline at (800) 222-1222.
If you can identify what she's swallowed – for example, you find an empty medicine bottle – tell the medical experts what it is, and they'll tell you what to do.
Experts no longer advise keeping syrup of ipecac or activated charcoal on hand in case of a poisoning emergency. Ipecac is not an effective treatment for poisoning; if you have ipecac in your home, the AAP recommends that you dispose of it immediately and safely. Activated charcoal hasn't been proven a safe or effective remedy to give to children at home. (Never throw away any medications in a garbage can that your baby can get into.)
Protect your child by poison-proofing your home.