Is It Normal For Babies To Spit Up Blood?

✔ Research-backed

Breastfed babies often spit up thin milky fluid, while formula-fed babies spit up a type of material that looks like cottage cheese. However, if you see your baby spitting up blood, you might be extremely worried as a concerned parent.

Spitting up fluids through the nose and mouth is pretty common in babies. But if you see your tiny tot spitting up bright brown or red blood alongside milky fluid, you may be alarmed.

Spitting up blood may not always be an indicator of a medical condition in babies. If your baby is active and healthy, it is highly unlikely that an underlying condition is the reason for them spitting up blood. However, it is wise to consult a pediatrician and get a thorough checkup. Read on to know the common causes of babies spitting up blood and when to be concerned.

In This Article

Is It Normal For Babies To Spit-up Blood?

Neonates may spit pink-tinged flecks due to swallowed maternal blood during delivery

Image: IStock

Spitting-up of blood is definitely a concern in babies, whether neonatesiNewborns less than four weeks old or infants. Neonates may spit-up of red or pink-tinged flecks could be due to swallowed maternal blood during delivery. This happens in the first few days after delivery. For older breastfeeding babies, bloody vomit could be due to the ingesting maternal blood or swallowing blood from cracked and sore nipples. But in both cases that is flecks of blood.

Causes Of Baby Spitting Up Blood

There could be several reasons why the baby spits up blood. The severity of it may also vary from baby to baby.

1. Cracked and sore nipples

Healthy infant may spit a little blood if they swallow it from the mother’s sore nipple

Image: IStock

In most breastfeeding babies, the blood the baby spits up is usually from the mother and not from the baby’s body system (1). It can happen if you have sore or cracked nipples. It is common for nursing moms, especially those who have just started nursing to experience irritation in the nipples due to the pulling and pressure, or because of the exposure of skin to saliva. It may turn so bad that the skin cracks and bleeds. It subsides with the healing of nipples.

Most of the time, a healthy breastfeeding infant who spits up a little blood would have swallowed it from the mother’s sore nipple. The blood irritates the tummy, and it regurgitates. If you do not see any crack, try to express some milk and check if it emits a blood tinge. However, the blood is streaks of blood, never frank bloodiVisible presence of blood in stool . Always check the mother’s nipples for cracks.

A new dad and vlogger recall how they identified the reason behind his daughter May’s blood-streaked spit-up. He explains, “We switched to bottle-feeding to eliminate any blood from the cracked nipple. So, for the next four or five feeds, we exclusively bottle-fed. We monitored her temperature, the amount she fed, and the stools. For the next three stools she passed, we kept an eye.

“For the first two, there were still these black streaks. However, for the third one, it seems that the black streaks have decreased significantly, much less. By the fourth stool, it returned to normal, and there were no more black streaks in the stools. So that confirms that it was due to the micro-cracks that my wife probably had during direct latching, but she was not aware of them (i).”

If you observe blood in your breast milk or on your nipple, offer some sugar water or plain water to your baby after feeding, so that the blood clears away from their tummy. Stop feeding through the cracked nipple for a few days until it heals. You can use a nipple shieldiA breastfeeding tool shaped like a shield placed over the nipples , which is available in pharmacies, to avoid irritation to the healing nipple. You can still breastfeed your baby from the same breast.

The blood that passes with the breast milk will also mix with the food in the intestine, and sometimes result in the appearance of bloody stools.

If you find no blood from the nipple, or if your baby is on formula feed and you can still find them spitting blood, your baby should be immediately taken to the doctor.

2. Swallowed blood during delivery

If your baby spits up blood shortly after birth, there is nothing to worry about. It may be the maternal-fetal blood your baby might have swallowed during delivery (2). The blood usually subsides after one or two days, but if it continues to come, consult a doctor.

protip_icon Did you know?
The Apt-Downey test is an effective method to determine if the blood in the spit-up is from the newborn or mother (12). This test determines blood source based on the conversion of hemoglobin to hematin when mixed with alkali.

3. Forceful spitting up

If babies forcibly spit up, they may have tiny tears in the blood vessel of the esophagus

Image: IStock

In rare cases, your baby may forcibly spit up, causing a tiny tear in the blood vessel present in the esophagus. It is nothing of worry again, as it heals quickly with time (3).

4. Esophagitis

It is an inflammation that damages the tissues in the esophagus, the muscular tube that delivers food from the mouth to the stomach (4).This sometimes occurs as a medication side effect when the baby is given medicines, such as anti-inflammatories or antibiotics, causing gastritisiInflammation of the stomach lining .

5. Clotting disorders

Pediatric blood clotting disorders occur when the blood clotting process in the body is abnormal (5). For instance, clotting disorders such as sickle cell disease cause blood cells to stick and prevent smooth blood flow, resulting in pulmonary embolism (6) (7). A pulmonary embolism occurs when a blood clot migrates to the lung, leading to elevated blood pressure in the pulmonary arteries. This condition is often characterized in babies by shortness of breath, chest pain, and coughing up blood (hemoptysis) (8) (9).

protip_icon Nutrition fact
You may increase the nutritional value of idli by adding ground sesame seeds to the idli batter, as they are rich in vitamins, minerals, fiber, fat, and protein (1).

When To Call The Doctor?

Call the doctor if the baby has fever and is reluctant to feed

Image: Shutterstock

If none of the above causes are the reasons behind your baby spitting up blood, and if it continues to persist, you should take them to a pediatrician.

If your baby is having symptoms like green vomitingiVomit with bile and is usually green or greenish-yellow in color , abdominal distentioniSwelling of stomach , fever, or lethargy, reluctance to feed, you need to seek immediate medical care. Blood spit-up due to gastrointestinaliRelating to the stomach and intestine issues could be a sign of a major underlying medical concern, such as gastrointestinal bleeding or hematemesis (a condition marked by vomiting blood) (in rare cases).

Tips To Reduce Spitting Up In Babies

Burp your baby after each feeding session

Image: IStock

Follow some simple tips to bring down the frequency of your baby spitting up (10):

1. Burp your baby

Take time to burp your baby after each feeding session. It can keep the air from building up in your baby’s stomach and avoid spit-ups.

2. No physical activity

Keep your baby upright for at least 30 minutes after every feed. Avoid immediate active play or use of swings. Also avoid pressing on a baby’s belly (tummy time) right after eating.

4. Small and frequent feedings

Try smaller and frequent feeding sessions. As the baby’s stomach is small, do not overfeed him in a single session.

protip_icon Quick tip
In breastfeeding babies, spit-up may occur due to sensitivity to a food in the mother’s diet. Identifying and removing the specific food can reduce spit-up frequency (13).

Frequently Asked Questions

1. Does spit-up mean overfeeding?

Babies spitting up milk after feeding can often be related to overfeeding breastmilk or formula (3).

2. Why is my baby spitting up purple?

Purple spit-ups mainly occur if your baby is treated for GERDiCondition in which stomach acid moves up into the food pipe and irritates the lining with (es)omeprazole. It is not a cause for concern but should be considered as a sign indicating the reduced efficacy of the treatment (11).

When a baby spits up blood, it is concerning to a parent. A baby spitting up blood could be due to benign or concerning reasons. If your baby is spitting up blood, consult a pediatrician to know the exact cause. Also, note if you have sore or cracked nipples as the baby may accidentally follow blood from there, thus giving the impression of spitting up blood. You may also try the above tips to ensure the baby is not strained after feeding, which could help avoid forceful blood-spitting.

Infographic: Babies Spitting Up Blood: Signs You Should Not Ignore

Babies spitting up blood could be a concerning sight for parents; however, when they do this occasionally, it may not be due to a serious pathological condition. Nevertheless, contact a pediatrician instantly if your baby is spitting up blood too often and has additional symptoms, such as those listed in this infographic.

babies spitting up blood (infographic)

Illustration: Momjunction Design Team

Key Pointers

  • Spitting up red or pink-tinged specks may result from the mother’s painful nipples or from swallowing maternal blood during delivery.
  • Spitting up blood in babies can also be caused by forceful spitting up and esophagitis.
  • Burping after every feeding, using a nipple shield if the mother has sensitive nipples, and refraining from giving the baby medications that could result in esophagitis are all ways to lessen spitting up in babies.
  • A pediatrician should be consulted if the baby continues to spit up blood, exhibits symptoms like fever, lethargy, or green vomiting, or if the blood does not stop after a few days.
baby spitting up blood_illustration

Image: Stable Diffusion/MomJunction Design Team


Gain insights about why your baby is spitting up, when you should be concerned about it and tips to help contril the same.

Personal Experience: Source

References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.

1. Unusual appearances of breastmilk; Australian Breastfeeding Association
2. Vomiting in neonates; Victorian Agency For Health Information
3. Spitting Up – Reflux; Seattle Children’s
4. Esophagitis in Children; Boston Children’s Hospital
5.Pediatric Blood Clotting Disorders; UT Health San Antonio
6.Complications of Sickle Cell Disease; Centers for Disease Control and Prevention
7. Natasha Bala et al; Prevalence and Risk Factors for Pulmonary Embolism in Pediatric Sickle Cell Disease: A National Administrative Database Study; National Center for Biotechnology Information
8.Pulmonary Embolism; Nationwide Children’s Hospital
9. Sahnoun M et al; Massive Pulmonary Embolism as a Rare Cause of Sudden Infant Death: Medico-legal Implications; Neonatal and Pediatric Medicine
10.Why Babies Spit Up;Healthy Children; American Academy of Pediatrics
11. Florence van Hunsel et al.; (2016); (Es)omeprazole and Discoloration of Regurgitated Gastric Contents in Infants: Worrying for Care-Takers and a Sign of a Reduced Bioavailability; National Library Of Medicine
12. M H Moustafa et al.; (2005); “My two-week-old daughter is throwing up blood”; National Library Of Medicine
13.Why is my baby spitting up so much breast milk?; Texas Children’s Hospital.

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Dr. Mubina Agboatwalla

Dr. Mubina AgboatwallaMBBS, DCH, MCPS

Dr. Mubina Agboatwalla is a well-known pediatrician, practicing paediatrics since the last 20 years in Karachi Pakistan. She is the head of the department of Pediatrics in Karachi Liaquat Hospital, as well as her private practice in three specialist clinics in Pediatrics. She is also a Public Health Specialist specializing in preventive health including nutrition, breastfeeding and infectious diseases especially...read full bio