Key takeaways: Spit-up is effortless and common. Vomiting is more forceful. Most vomiting is caused by viruses and passes within a day or two. Offer small, frequent feeds and watch wet diapers. Green (bile-colored) vomit, blood, projectile vomiting in a young baby, or signs of dehydration need prompt medical care.
Seeing your baby vomit can be scary. Most of the time it’s a short-lived stomach virus, but some signs need attention.
Spit-Up vs. Vomiting
- Spit-up: small amounts that flow out easily, often after feeds. Very common and usually normal.
- Vomiting: forceful, often larger amounts. Can be a sign of illness.
Common Causes
- Viral gastroenteritis (stomach bug), often with diarrhea.
- Other infections, such as ear infections or urinary tract infections.
- Overfeeding.
- Coughing that triggers vomiting.
- Food allergies or intolerances.
Causes That Need Urgent Care
- Pyloric stenosis: projectile vomiting in babies, typically a few weeks old.
- Intestinal blockage, such as intussusception or malrotation, often with green vomit.
- Head injury.
- Serious infections such as meningitis.
Caring for a Baby Who Is Vomiting
- Breastfed babies: keep nursing, possibly shorter, more frequent feeds.
- Formula-fed babies: offer smaller amounts more often.
- Oral rehydration solution: your doctor may advise small, frequent sips (such as 1 teaspoon every few minutes) for older babies.
- Hold your baby upright after feeds.
- Place your baby on their back to sleep; healthy babies can protect their airway.
Signs of Dehydration
- Fewer wet diapers.
- Dry mouth, no tears.
- Sunken soft spot.
- Unusual sleepiness.
Seek medical care right away if your baby: has green or yellow-green vomit, blood or “coffee grounds” in vomit, projectile vomiting, a swollen or hard belly, vomiting with a fever in a baby under 3 months, signs of dehydration, vomiting after a head injury, or is very sleepy or hard to wake. Call 911 for a baby who is unresponsive or has trouble breathing.
The Bottom Line
Most vomiting is from viruses and passes quickly. Offer small, frequent feeds and know the warning signs that need urgent care.
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Sources
- American Academy of Pediatrics. Vomiting in babies and children. HealthyChildren.org. https://www.healthychildren.org
- King CK, Glass R, Bresee JS, Duggan C; Centers for Disease Control and Prevention. Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR Recomm Rep. 2003;52(RR-16):1-16.
- Rosen R, Vandenplas Y, Singendonk M, et al. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of NASPGHAN and ESPGHAN. J Pediatr Gastroenterol Nutr. 2018;66(3):516-554.
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
