During your baby’s first year of life, there’s likely to be one or two curve balls thrown in your direction. Feeding your baby can be an enjoyable way to help your baby’s development, but it can also come with its fair share of questions, worries and surprises.
As strange as it is to watch your baby projectile vomit across a room (it happens), baby vomiting is a common occurrence. However, it raises a lot of questions. Questions like, why do babies vomit? Why is my baby vomiting after feeding? and should I feed my baby after vomiting?
Here we’re providing the answers to those questions, to help you stay calm and in control when it comes to feeding your baby.
Baby spit up vs baby vomit - what’s the difference?
Baby posseting/spit up
In the first few days or weeks of life, your baby might bring up small amounts of milk during a feed. This is commonly known as posseting or spit up1. It’s usually nothing to worry about, and can happen whether your baby is breast or formula fed.
When your baby spits up, it could be due to a cough, or because they’ve been crying. It’s also possible that your baby has indigestion or reflux. Whatever the cause, rest assured that it tends to settle down as your baby’s gut matures2.
Reflux is very similar to posseting and happens because the muscles at the top of your baby’s food pipe (oesophagus) aren’t yet fully developed, so milk is able to come back up again.
Ultimately, the experience tends to be worse for parents, with your baby being completely unphased!
Whilst spit up usually flows from your baby’s mouth during or after a feed, baby vomiting happens with some amount of force3. Vomiting is a very common, often non-specific, but distressing symptom for both babies and parents. It’s advisable to seek medical advice if your baby is vomiting milk consistently, even if they have no fever, as it's possible that another issue may be at play.
Baby vomiting after feeding, why does it happen?
There are lots of reasons why babies vomit, the vast majority of which are easily managed.
A common cause of vomiting is gastroenteritis, an inflammation of the gastrointestinal tract. You’ll typically hear it referred to as a tummy bug or food poisoning. The most common cause of gastroenteritis is rotavirus4, but there are other viruses and bacteria that could also be the cause, such as E. Coli and salmonella.
Whilst unpleasant, tummy bugs usually resolve themselves within a week, and there are some simple steps you can take to prevent them occurring in the first place. For example, if you’re bottle feeding either breast or formula milk, it’s recommended that you fully sterilise all of your baby’s feeding equipment5 before and after each and every feed.
If you’re weaning your baby, make sure that all food is prepared by paying attention to basic hygiene measures such as clean hands, equipment, and surfaces6, as well as ensuring food is cooked thoroughly.
Lactose intolerance or tummy troubles?
Sometimes, gastroenteritis can result in a lactose intolerance. If this is the case, symptoms usually subside after few days or weeks7. Look out for diarrhoea and runny stools and if you suspect that a tummy bug is lurking, have a chat with your GP.
Dehydration in babies
If your baby’s been suffering with a tummy bug, it’s worth keeping an eye out for symptoms of dehydration which include8:
- A dry mouth, fewer tears and fewer wet nappies.
- Dark yellow urine.
- A sunken fontanelle (the soft spot on the top of your baby’s head).
- Blotchy and cold feet and hands.
Prevention is better than the cure, so if your baby has been ill, make sure that you give them plenty of liquids in the form of their usual milk, be it breast milk or formula milk .
Some dehydration do’s and don’ts
It may take a little while for your baby to get back to drinking the amount of milk they’re used to after a tummy bug. To help them keep their milk down, give them small sips, around five mls, every five minutes - little and often is the key.
If you find that your baby is struggling to manage even small amounts of milk, it’s best to speak with your GP who’ll give your baby a thorough check and may prescribe oral rehydration salts, and paracetamol or ibuprofen if they’re in pain.
Whilst it might be tempting to top up your baby’s fluid intake to help them get over a tummy bug, never dilute breast or formula milk with water, or give your baby fruit juices or other non-milk drinks.
In some cases, baby vomiting can signal an allergy or intolerance to cow’s milk, and if you suspect that this might be the case, it’s best to talk your baby’s symptoms through with your GP.
Whilst baby projectile vomit can happen as a one off, if it’s happening on a regular basis then it’s possible that they have a condition known as pyloric stenosis.
It’s caused by a narrowing of the opening between the stomach and the small bowel9 and means that milk is unable to get to the gut in order to be digested. Instead, undigested milk builds up and eventually causes your baby to projectile vomit.
If your baby has pyloric stenosis, it’s likely to be picked up early and treated immediately with surgery. As a condition, it’s uncommon, but if you have any concerns, always discuss them with your GP.
My baby is vomiting curdled milk, should I be worried?
A baby vomiting curdled milk can feel (not to mention look and smell) unsettling. It can occur in either breast or formula fed babies, and is usually the result of milk being mixed with stomach acid, causing it to curdle10.
It’s important to remember that your baby spitting up curdled milk is not usually a cause for concern, but always keep an eye out for any changes to your child’s feeding or spit up habits.
Should I feed my baby after vomiting?
If your baby’s been vomiting, it’s possible that they’ll feel a little hungry and dehydrated. As such, you should continue feeding your baby their usual breast or formula milk feeds11. Once the vomiting has stopped, offer your baby a feed. Start with small amounts and if they’re comfortable, follow their lead and let them take what they need.
How to avoid baby vomiting after feeding
Baby vomit is part of the course when it comes to parenting, but there are things you can do to limit the amount of muslin cloths you find yourself going through on a daily basis. For example12:
- Let gravity do its thing and hold your baby upright during a feed and for as long as possible afterwards.
- Try carrying your baby in a sling to keep them upright.
- If your baby is formula fed, give them smaller feeds, more often.
- Make sure that your baby is laid on their back to sleep.
Avoid raising the head of the cot or changing your diet if you’re breastfeeding, and instead speak to your health visitor or GP to get the advice and guidance that you need.
When should I seek help?
Chances are there’s nothing to worry about your baby vomit as it is very common when it comes to babies. However, you should always get medical help and advice if your baby13:
- Isn’t gaining weight.
- Is consistently vomiting large amounts of milk.
- Starts to vomit bile or yellow liquid.
- Projectile vomits within 30 minutes of feeding.
Is at risk of becoming severely dehydrated.
Here at Aptaclub, our aim is to provide you with the information you need to embrace your baby’s growth and development, as well as the possible solutions to common issues that you might find yourself dealing with.
Dr Punam Krishan
Dr Punam Krishan is an NHS GP and media doctor with a specialist interest in public health, family and lifestyle medicine. She is also a honorary senior clinical lecturer at the University of Glasgow. Alongside this, Punam is a writer and director of the British Society of Lifestyle Medicine.
- National Childbirth Trust (NCT). What is baby reflux? [online] 2019. Available at https://www.nct.org.uk/baby-toddler/feeding/common-concerns/what-baby-reflux-symptoms-and-support. Accessed March 2021.
- National Health Service (NHS). Reflux in babies [online] 2019. Available at https://www.nhs.uk/conditions/reflux-in-babies/. Accessed March 2021.
- Mayo Clinic. Spitting up in babies: What’s normal and what’s not [online] 2021. Available at https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/healthy-baby/art-20044329#:~:text=What%20is%20the%20difference%20between,than%20dribbling%20from%20the%20mouth. Accessed April 2021.
- National Health Service (NHS). Rotavirus vaccine overview [online] 2020. Available at https://www.nhs.uk/conditions/vaccinations/rotavirus-vaccine/. Accessed March 2021
- National Health Service (NHS). Sterilising baby bottles [online] 2019. Available at https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/bottle-feeding/sterilising-baby-bottles/#:~:text=It%27s%20important%20to%20sterilise%20all,in%20particular%20diarrhoea%20and%20vomiting.&text=You%20can%20also%20turn%20teats,them%20in%20hot%20soapy%20water. Accessed March 2021.
- National Health Service (NHS) Start 4 life [online]. Available at https://www.nhs.uk/start4life/weaning/safe-weaning/. Accessed March 2021.
- National Health Service (NHS). What should I do if I think my baby is allergic or intolerant to cow’s milk? [online] 2019. Available at https://www.nhs.uk/common-health-questions/childrens-health/what-should-i-do-if-i-think-my-baby-is-allergic-or-intolerant-to-cows-milk/. Accessed March 2021.
- National Health Service (NHS). Dehydration [online] 2019. Available at https://www.nhs.uk/conditions/dehydration/. Accessed March 2021.
- Great Ormond Street Hospital (GOSH) NHS Foundation Trust. Pyloric Stenosis [online]. Available at https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/pyloric-stenosis/. Accessed March 2021.
- National Health Service (NHS). Great Ormond Street Hospital for Children NHS Trust. Pyloric Stenosis [online]. Available at https://www.gosh.nhs.uk/conditions-and-treatments/conditions-we-treat/pyloric-stenosis/. Accessed March 2021.
- National Institute for Care and Excellence (NICE). Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management [online] 2009. Available at https://www.nice.org.uk/guidance/cg84/chapter/1-Guidance#nutritional-management. Accessed April 2021.
- National Health Service (NHS). reflux in babies [online] 2019. Available at https://www.nhs.uk/conditions/reflux-in-babies/. Accessed March 2021.
- National Health Service (NHS). Diarrhoea and vomiting [online] 2020. Available at https://www.nhs.uk/conditions/diarrhoea-and-vomiting/. Accessed March 2021.
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