Vomiting is very common in babies. Sometimes it can be entirely normal, like when babies spit up mouthfuls of breastmilk or formula after eating. Sometimes it can be a sign of illness or a blockage somewhere in the intestines. Less commonly, it can even be a sign of accidental poisoning or be caused by a bad bump to the head.
If your child is younger than one year and is vomiting, this health decision guide will help you understand more about what may be causing it and help you know when to call your doctor. Please note, this guide is not meant to take the place of a visit to your doctor’s office.
Vomiting sometimes is a sign of serious illness.
Do any of the following statements describe your baby?
- He has a fever (a rectal temperature reading of 100.4F or higher).
- His stomach looks swollen or hard, and is painful to the touch.
- He is acting like his head hurts (touching it, holding it) or he is having difficulty moving his head.
- He is refusing to drink or eat.
- He hasn’t had wet diaper for more than six hours.
- He has not had a bowel movement in several days.
- He seems extremely tired or weak.
- He seems confused.
- He is very cranky (irritable).
- He has dark red spots on his skin that don’t get paler when you press on them.
Your baby is vomiting but does not have a fever, is moving his head, arms and legs normally, is eating and drinking, and does not seem extremely tired, confused, or cranky. That is reassuring.
Do any of the following statements describe your baby’s vomit?
- The vomit is greenish-yellow.
- There is blood in the vomit.
- The vomit looks like coffee grounds.
You have said that your baby is vomiting but the vomit is not greenish-yellow and does not have blood in it or look like coffee grounds.
Could your baby have accidentally swallowed something poisonous, such as a plant or medicine? Could he have inhaled some kind of toxic fumes or chemicals?
That is good. Remember, it only takes a few seconds for babies and toddlers to get into something dangerous. Keep the number for the poison control center (800-222-1222) near your phone.
Has your baby had a bad bump to the head in the past few days, or was he shaken by anyone?
You do not think that your baby hit his head or that he was exposed to anything poisonous.
Is your baby younger than three months old?
Many older babies vomit or spit up.
Does your baby frequently spit up after feeding?
Many young babies vomit or spit up.
When your baby vomits, does it shoot out of the mouth forcefully, even landing a few feet away?
Your baby is vomiting but not too forcefully.
Does your baby spit up breastmilk or formula very frequently?
Your baby doesn’t usually spit up after feeding. The vomiting is something new.
Does your baby also have diarrhea?
Your baby is vomiting but does not have diarrhea.
Have you recently started giving your baby solid foods or introduced any new foods to your baby’s diet?
Your baby has not just started solid foods or tried any new foods recently. That makes it unlikely that a food allergy is causing the vomiting. Keep in mind, though, that an allergy to a certain food can appear even after your child has eaten that food several times.
Has your baby started taking any prescription medication, over-the-counter medications, vitamins or other nutritional supplements?
If you are breastfeeding your baby, are you taking any medications or nutritional supplements?
Your baby has been vomiting but he is not taking any medication or nutritional supplement or getting it through breastmilk.
Did the vomiting happen during or immediately after your baby was traveling in a car, train, or boat?
You have answered “no” to all the questions about common reasons for vomiting in infants.
Call your doctor to go over your baby’s symptoms again and decide whether or when a visit to the office makes sense.
Your baby may have motion sickness. He most likely will start to feel better after the movement stops. Keep him calm, and offer him clear fluids. Call your doctor if he continues to vomit.
Call your doctor immediately. The medication may be causing your baby to vomit.
When babies try solid foods for the first few times, they often spit out more than they swallow. Babies also may spit out a new food because the taste is not familiar to them. Sometimes vomiting can be a sign of a food allergy.
Call your doctor if your baby has been vomiting for more than a few days, if the vomiting is getting worse (more forceful, or so frequent that he’s having trouble keeping things down) or green, or if your baby gets new symptoms like fever, diarrhea, rash, irritability, or unusual sleepiness.
Call your doctor. Vomiting and diarrhea together can be a sign of gastroenteritis, which is an infection of the stomach and intestines caused by viruses or bacteria. Babies with vomiting and diarrhea can become dehydrated easily. Your doctor will check to see whether your baby is dehydrated. You can help prevent this by offering your baby lots of liquids to drink.
Spitting up after eating is common in babies because the muscle between the stomach and the esophagus (the tube connecting the stomach and the mouth) is not yet fully developed and stomach contents can easily come back up. This condition is called reflux. Discuss this with your doctor at your baby’s next visit.
Call your doctor if the spitting up seems to bother your baby (for example if he cries when he spits up), or if you think your baby is not gaining the right amount of weight, or if your baby starts spitting up much more, or forcefully.
Call your doctor immediately. Your baby’s vomiting may be caused by a problem with the stomach muscle, called pyloric stenosis.
Seek emergency medical care immediately. Your baby may be vomiting because of an injury to the brain.
Seek emergency medical care immediately. Your baby may be vomiting because he was exposed to something poisonous. Call the poison control center (800-222-1222) for more information.
Get emergency care now! Your baby’s vomiting may be caused by a serious problem with his intestines.
Seek emergency medical care immediately.Your baby’s vomiting and other symptoms may be due to a serious illness.
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