The reasons for vomiting in babies can range from indigestion and prolonged crying to anomalies of the gastrointestinal tract. Although there is no need to worry about occasional vomiting in babies, frequent vomiting requires medical care to identify and treat the cause. It is also essential to seek medical care to avoid the risk of dehydration.
Know more about the causes, treatment, home remedies for vomiting in babies, and when to seek medical care.
Common Causes Of Vomiting In Babies
Babies may vomit due to various reasons. These include (1):
A baby’s esophagus (food pipe) is not yet matured, so milk may back up into the food pipe after feeding. This may cause milk to come out from the baby’s mouth or nose. The process of bringing up or gastroesophageal reflux after breastfeeding or bottle feeding is called spitting up, or posseting(2). The condition normally gets better with time and especially when solids are introduced in the diet. Reflux usually clears up within 18 months as the baby grows.
2. Stomach flu
Stomach flu, also called viral gastroenteritis, stomach bug, or tummy bug, is a viral infection of the stomach. In addition to vomiting, diarrhea, fever, and tummy pain are some symptoms of tummy bugs. Babies may have vomiting for a couple of days in the case of stomach flu.
Vomiting and diarrhea can be seen in many other gastrointestinal or organ system infections since the immune system is fighting against it. Urinary tract infections (UTI) and chest infections are common infectious causes of vomiting in babies.
4. Food allergies
Allergies or intolerance to food may cause vomiting in babies. This may also cause lips and eye swelling and itchiness. Maternal dietary factors can be a cause of allergies in breastfed babies. Milk, eggs, nuts, fish, seeds, and wheat are common allergens. Allergic reactions and symptoms, such as vomiting, may develop from minutes to hours after exposure to allergens.
5. Food poisoning
It may happen in bottle-fed or weaning babies. Unsterilized bottles, stale food, and food or water contaminated with Salmonella or E. coli bacteria could cause food poisoning, leading to vomiting and diarrhea.
Babies who crawl or walk may accidentally swallow poisonous substances, which could cause vomiting. You can avoid this by keeping toxic and dangerous chemicals and substances out of the baby’s reach.
7. Overfeeding or overeating
Breastfed or bottle-fed babies may vomit if they are overfed. Large holes in the feeding bottles can be a reason for overfeeding in most bottle-fed babies. Overfeeding a weaning baby could also lead to vomiting.
8. Congenital pyloric stenosis
Congenital pyloric stenosis is the narrowing of the pylorus (part of the stomach connecting to the intestine) from birth. This condition prevents food from entering the intestines from the stomach and causes forceful vomiting. Pyloric stenosis may also cause nutritional deficiencies. The condition is normally not visible at birth but slowly develops over time and symptoms get worse by four to six weeks. Babies are very hungry but vomit projectile shortly after the feed.
9. Strangulated hernia
During hernia, intestines push out from the abdominal cavity through the weakened area of the abdominal muscle. A strangulated hernia is a condition where the blood supply to the herniated section of the intestine is cut off. Vomiting, incessant crying due to pain,and diapers with blood (blood in stools) may indicate strangulated hernia, and it requires emergency medical care.
Intussusception or telescoping of the intestine is a condition when one segment of the intestine folds into another. Although it can happen anywhere in the intestine, telescoping is common at the ileocecal junction, where the small intestine and large intestine are connected. Severe vomiting, paleness, dehydration, and floppy (hypotonic) look are common symptoms. You may also notice red jelly-like stools in babies.
Babies with infections tend to have vomiting with fever. However, structural and functional anomalies, such as reflux and pyloric stenosis, may not always cause fever. Therefore, fever cannot be considered a primary symptom to assess the severity of vomiting or a factor to determine the need for medical care.
When To See A Doctor
If the baby is less than three months old, then see a doctor soon after the first signs of vomiting. Although occasional vomiting is normal, babies who are sick, dehydrated, or have frequent vomiting should be taken to a doctor.
You may seek immediate medical care in the following situations (3).
- Vomiting that lasts more than a day or frequent vomiting can indicate infections or structural anomalies.
- Projectile (forceful) vomiting may indicate pyloric stenosis in the babies.
- Greenish-yellow or green color vomit can be due to intestinal obstruction (blockage).
- Blood or coffee-ground appearance of vomiting can indicate bleeding in the GI tract. If you notice blood in a breastfed baby’s vomit, ensure there are no cracks or bleeding in nipples since babies may swallow the blood while feeding.
- Blood in diapers can be an indication of infection or allergy since it may cause blood in stools.
- Refusing to eat or consume breast milk for a few hours.
- Signs of dehydration, such as sunken eyes, dry mouth, and crying without tears.
- Swollen belly or the abdomen seems painful to touch.
- Dark urine or the baby does not pass urine.
- Fussy and crying for a long time or having a high fever.
Babies may become dehydrated from continuous vomiting. They may also accidentally inhale the vomit, which can increase the risk of aspiration pneumonia.
Home Remedies For Baby Vomiting
The main aim of home treatments is to prevent dehydration due to water and electrolyte loss through vomiting. You may try home remedies for baby vomiting after discussing it with a pediatrician. They may recommend home care based on your baby’s weight, age, and symptoms.
The home care to prevent dehydration may include:
- Breastfeed babies need to be fed more often, and you may return to a normal feeding schedule once the vomiting is stopped.
- Formula-fed babies need an oral rehydration solution (ORS) every 15 minutes for two to three hours. While you can purchase the over-the-counter ORS, consult the healthcare provider for the dosage. It may vary depending on the baby’s weight, diet, and severity of vomiting.
- Weaning infants can be gradually put backto solid foods as vomiting lessens.
When To Feed The Baby After Vomiting?
The following tips may help you decide when to feed and not feed your baby after vomiting.
- You may offer breastfeeding or bottle feeding after throwing up. If your baby is ready to eat, you may feed them right away.
- Give a small amount of breast milk or fluids after vomiting and observe if they are vomiting again.
After vomiting, feeding breast milk or liquids may help settle down nausea in babies and ease the throat irritation.You may offer water with a spoon or in a bottle to babies older than six months.
- If the baby resists feeding after vomiting,wait for a while before trying again.
If the baby has earache or fever, you may give pain medication such as acetaminophen after consulting the pediatrician. The medication can relieve symptoms before feeding again. If your baby has severe vomiting and refuses to feed, seek help from a pediatrician. Not feeding after vomiting could increase the risk of dehydration.
Treatment For Vomiting In Babies
Pediatricians examine the baby and ask about the signs and symptoms before beginning the treatment. If your baby has normal vomiting without any concerning cause, they may not prescribe medications.
Depending on the cause, the following treatment options are recommended (4).
- Oral rehydration solution can be given to babies who can drink without vomiting again.
- Babies with severe dehydration and those who refuse oral intake of fluids may require intravenous (IV) fluids and electrolytes.
- Antibiotics are prescribed for bacterial infection
- Viral gastroenteritis and other viral infections are usually treated with fluids and other supportive therapies.
- Structural anomalies and conditions may require surgical correction to cure the vomiting.
Note: Medications (antiemetics) to stop vomiting are not given to children younger than two years due to their potential side effects.
If your baby has vomiting, then avoid sending them to daycare to prevent the spread of any infections that led to vomiting. Vaccinations against rota virus and good personal hygiene can reduce the risk of vomiting due to pathogens. Be alert to any signs and indicators of structural anomalies, and do not hesitate to consult a pediatrician if you have concerns about your baby’s vomiting.
2. What is baby reflux? Symptoms and support; NCT UK
3. Vomiting (0-12 Months); Seattle Children’s Hospital
4. Vomiting in Infants and Children; MSD Manua