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My baby is vomiting

Most babies vomit small amounts from time to time and bring up some milk when they burp. This is known as possetting and is usually nothing to worry about. You can tell when your baby is vomiting rather than posseting because there will be a lot more coming out.

Vomiting is also very common (up to half of all babies) and in most cases will improve with time. Although it might look like they are vomiting a lot, most babies continue to grow normally and do not seem particularly upset by it.

As long as your baby seems otherwise healthy and continues to gain weight, there's usually no need to worry or seek further help. There are some simple things you can do to help – click here for more information.

However, vomiting can occasionally be a sign of an underlying problem such as severe reflux, milk allergy, pyloric stenosis, a stomach bug or infection (see below). Below are some signs to look out for if you are worried.

When should you worry?

If your child has any of the following:

  • Has dark green or blood stained vomit
  • Breathing very fast, too breathless to talk, eat or drink
  • Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
  • Breathing that stops or pauses
  • Is pale, blue, mottled or feels unusually cold to touch
  • Difficult to wake up or very sleepy
  • Weak, high-pitched cry or can’t be settled
  • Has a fit (seizure)
  • Has a rash that does not disappear with pressure (the ‘Glass Test’)
  • Has a temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red or amber features

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Vomits forcefully (shoots across the cot or the room)
  • Not gaining weight
  • Blood in poo
  • Constantly arching their back and crying
  • Breathing a bit faster than normal or working a bit harder to breathe
  • Dry skin, lips or tongue
  • Not had a wee or wet nappy in last 8 hours
  • Poor feeding (less than half of their usual amount)
  • Irritable (Unable to settle them with cuddles, toys or feeding)
  • Jaundice (yellow skin) after 2 weeks of age
  • Getting worse and I am still worried

You need to contact a doctor or nurse today.

Please call your GP surgery (or call NHS 111 if your GP surgery is closed).

If symptoms persist for 4 hours or more and you have not been able to speak to either a member of
staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red
features.

 

If none of the above features are present

  • Continues to feed well
  • Has plenty of wet nappies
  • Baby wakes up or cries regularly for feeds
  • Additional advice is also available to young families for coping with crying of well babies – click here.

Self care

 

Continue providing your child’s care at home. If you are still concerned about your child contact your Health Visitor or call your GP surgery (call NHS 111 if your GP surgery is closed).

To find your local health visitor click here   

 

Survey for parents/carers - what was the outcome of you looking at this page?

Conditions that can cause a baby to vomit:

  • Some degree of reflux is completely normal in babies as the muscue at the end of the food pipe, which keeps food in the stomach, is still developing. Reflux may cause your baby to bring up milk after a feed, and can also give him/her hiccups. As long as your baby is growing normally and doesn't seem very upset, there is no need to worry.
  • However, more severe reflux can cause your baby to cry and be sick, especially after feeding. This more severe kind of reflux is called gastro-oesophageal reflux disease (GORD). It happens when your baby’s tummy is full, and food and stomach acid come back up the food pipe, causing pain and discomfort.

  • Do
    • do ask a health visitor for advice and support
    • do get advice about your baby's breastfeeding position or how to bottle feed your baby

    • do hold your baby upright during feeding and for as long as possible after feeding
    • do burp your baby regularly during feeds
    • do give formula-fed babies smaller feeds more often
    • do make sure your baby sleeps flat on their back (they should not sleep on their side
    or front)

  • Don’t
    • do not change your diet if you're breastfeeding
    • do not raise the head of their cot or Moses basket

  • Click here to watch a video on reflux by Best Beginnings.

If you’ve tried the suggestions above and your baby’s reflux hasn’t improved, you should contact your GP surgery. They will check your baby’s symptoms, ask about the formula you’re using (if your baby isn’t exclusively breastfed), and may prescribe medication.

  • Cow's milk proteins are found in standard infant formula milk and can also be present in your breast milk if you eat or drink dairy products like milk, cheese, or yogurt.
  • If your baby has a cow's milk allergy, they may vomit after feeding. It can be difficult to tell the difference between this and reflux. But if your baby has problems with cow's milk, they may also have:
    • eczema
    • colic
    • diarrhoea or constipation
    • trouble gaining enough weight
    • a history of allergies in your close family
  • If you’re worried your baby might have a problem with cow's milk, speak with your Health visitor or make a routine appointment with your GP surgery.
  • If you breastfeed your baby, you could try cutting cow's milk from your diet for 2 weeks. If your baby is formula-fed, trying a hypoallergenic formula may help.
  • Speak to a health care professional before trying these. They will check your baby's symptoms first, so they can be sure of what's causing them.

 

  • This is a rare condition that can cause your baby to continuously vomit forcefully within half an hour of feeding. The vomiting is projectile over some distance.
  • Pyloric stenosis is most likely to begin when your baby is about six weeks old, but could show up at any time before they reach four months of age. It can sometimes run in families, and boys are about four times more likely to get it than girls.
  • It happens because the muscle controlling the valve leading from the stomach into the intestines has thickened, stopping enough food and milk to get through, so it stays in the stomach and then comes back up. The problem is easily corrected with minor surgery.

  • If your baby's vomiting begins suddenly, or if they also have diarrhoea, they may have a tummy bug (gastroenteritis) although his is less common than in older children.
  • Gastroenteritis is usually caused by a viral infection and does not need specific treatment. Vomiting usually stops within 6 to 24 hours.
  • Do not stop giving your baby milk. Keep feeding your baby as usual. If you’re breastfeeding, continue. If your baby is on formula, don’t water it down.
  • Babies under 6 months old are more likely to get dehydrated, so it’s important to make sure they’re drinking enough. If you are worried that they are becoming dehydrated please use the above table and seek the help you need.
  • Give your baby oral rehydration fluids in between feeds or after each watery stool. Your pharmacist will be able to advise you about which solution is best for your baby. Little and often tends to work best – in hospital, babies are given 1 or 2 tablespoons (5-10 mls) of fluid to drink every 5-10 minutes. You can try using a syringe to give fluids to your child.

Your baby may be vomiting because they have an infection. This is usually associated with a temperature above 38°C / 100.4°F. Although the most likely cause is a viral infection, other causes include urinary tract infections or very occasionally a more serious illness such as meningitis or sepsis. Signs of a serious infection include:

  • becomes pale and floppy going blue around the lips
  • is agitated or excessively miserable when touched
  • becomes difficult to wake up
  • is finding it hard to breathe
  • develops a rash that does not disappear with pressure (the Glass Test)

Your child needs urgent help if any of these features are present - go to the nearest hospital emergency (A&E) department or phone 999.

Well baby who is vomiting 

  • If you are breastfeeding, seek advice from a breastfeeding specialist, either a specially trained health visitor or a breastfeeding counsellor. It is possible that your baby is not latching on properly. 
  • If you are bottle feeding, ensure your baby is in the right position (sitting almost upright) and that you use the recommended amount of powder (it is quite easy to use too much if you have changed product, or using a different scoop than the one provided in the tin).
  • It is also quite easy to give your baby too much milk when you are bottle feeding.Their stomach is only small and most babies need little and often: 6-7 feeds per day is the norm, including at night. A well baby does not need more than 150ml/kg/day of feeds over 24hours. . Your health visitor can help review how much milk you baby should need and the timing of the feeds.
  • However, if after 2 weeks you are still concerned, seek advice from your health visitor or GP.

Where should you seek help?

  • If it is non-urgent, speak to your local pharmacist or health visitor.
  • If your child has any of the above amber features, urgently see your GP. If your GP surgery is closed, please call NHS 111.
  • You should only call 999 or go your nearest A&E department in critical, life threatening situations or red signs above.

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians. 

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
find a service