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Is it normal for my baby to vomit?It's common for babies to vomit often in the early weeks as they adjust to feeding and as their bodies develop. You can tell when your baby is vomiting, rather than just bringing up small quantities of milk (possetting), because there will be a lot more coming out. Vomiting can be frightening for your baby, so he's likely to cry.
Everything from car sickness to indigestion can cause your baby to be sick. Even a prolonged bout of crying or coughing can trigger this reflex. So you may see quite a lot of vomiting in your baby's first few years.
An attack of vomiting will generally subside six hours to 24 hours after it starts. Your baby shouldn't need any particular treatment, apart from drinking plenty to ensure he stays hydrated. As long as your baby seems otherwise healthy and continues to gain weight, there's usually no need to worry. Trust your instincts, though, and call your GP if you are worried.
When should I worry?During your baby's first few months, vomiting is probably caused by mild feeding problems, such as his tummy being too full. After the first few months, a sudden onset of vomiting is more likely to be caused by a tummy infection, such as gastroenteritis. This type of infection is often accompanied by diarrhoea.
Your baby may also be sick when he has:
A food allergy can sometimes cause vomiting. If your baby stops eating the food that triggers an allergic reaction, he may stop being sick. However, make an appointment with your doctor before removing foods from your baby's diet (NHS 2011c).
Occasionally, vomiting can be a symptom of more serious illnesses. Call your doctor if you notice any of the following warning signs in your baby:
- Signs of dehydration, including a dry mouth, lack of tears, sunken fontanelle, floppiness, and fewer wet nappies than usual (fewer than six nappies a day).
- Refusal to breastfeed or drink his formula milk.
- Vomiting for more than 12 hours, or vomiting with great force.
- A non-blanching rash, which is a rash that doesn’t fade when the skin is pressed.
- Sleepiness or severe irritability.
- A bulging fontanelle.
- Shortness of breath.
- A swollen abdomen.
- Blood or bile (a green substance) in the vomit (see below).
- Persistent forceful vomiting in a newborn within half an hour of eating (see below).
Blood or bile in the vomit: This is usually nothing to worry about if your baby was well before he vomited. It may happen when the force of regurgitation causes tiny tears in the blood vessels lining the food pipe. Your baby's vomit may also be tinged with red if he has swallowed blood from a cut in his mouth, or has had a nosebleed in the past six hours.
However, call your doctor if your baby continues to have blood in his vomit or if the amount is increasing. The doctor will probably want to see a sample of the vomit if it contains blood or bile, so, although it may be an unpleasant task, try to save some. Green bile can indicate that the intestines are blocked, a condition that needs immediate attention (NICE 2009: 21).
Persistent or forceful vomiting in a newborn within half an hour of eating: This may be due to pyloric stenosis, which is a rare condition. Pyloric stenosis is most likely to begin when your baby is a few weeks old, but could show up at any time before he reaches four months.
Pyloric stenosis causes the valve leading from the stomach into the intestines to thicken so much that it won't open up enough to let food through (NICE 2009: 21). This causes your baby to vomit. The problem is simple to remedy with minor surgery, but it does require immediate medical attention.
How should I deal with vomiting?Usually, vomiting is nothing to worry about, and soon gets better. Here's what you can do to help your baby recover:
- Keep him hydrated: When your baby vomits, he's losing precious fluids. It's important to replace them so he doesn't get dehydrated. To do this, you may be able to give him sips of oral rehydration solution (ORS), a few times an hour, alongside his usual breastmilk or full-strength formula, and water. Check with your pharmacist or health visitor before trying this, though. Don't give your baby fruit juices or fizzy drinks (NHS 2009b; NICE 2009: 138).
- Ease him back into his routine: If your baby hasn't vomited for 12 hours to 24 hours, you can begin moving back to his usual diet. But keep giving him plenty of fluids (NHS 2011b) such as his usual milk. If your baby is eating solid foods, start with easy-to-digest foods such as cereal or yoghurt. You can also try using frozen clear liquids, such as ice lollies, if your child is over 12 months.
- Help him rest: Sleep may also help to settle your baby. The stomach often empties into the intestines during sleep, relieving his need to vomit.
Don't give your child anti-nausea medicines (prescription or over-the-counter), unless your GP has prescribed them.
If your baby attends childcare or nursery, keep him at home until at least 48 hours after his last episode of vomiting (NICE 2009: 139).
More tips for you:
Last reviewed: May 2013
NHS. 2011a. How can I tell if my baby is ill? NHS Choices. nhs.uk [Accessed March 2013]
NHS. 2011b. Diarrhoea and vomiting in children. NHS Choices. nhs.uk [Accessed March 2013]
NHS. 2011c. Vomiting in children and babies. nhs.uk [Accessed March 2013]
NICE. 2009. National Institute of the Health and Care Excellence. Diarrhoea and vomiting caused by gastroenteritis: diagnosis, assessment and management in children younger than five years. nice.org.uk [Accessed March 2013]