Newborn Vomiting

Vomiting in newborns is a common concern for new parents, and it's understandable—seeing your baby spit up or vomit can be alarming. While most cases are harmless and part of normal development, there are times when vomiting may signal an underlying issue that needs medical attention.

This blog will help you understand the differences between normal spit-up and concerning vomiting, and when it’s important to call your pediatrician.

What’s Normal? Spit-Up vs. Vomiting

Spit-up is the gentle flow of milk that comes up after feeding. It usually happens without force and often accompanies burping. Spit-up is common in newborns, especially during the first few months, because their digestive systems are still developing.

Vomiting, on the other hand, is more forceful. It involves strong abdominal contractions and often projects milk or formula several inches from the baby’s mouth.

Common Causes of Vomiting in Newborns

1. Immature Digestive System (Reflux)
• Known as gastroesophageal reflux (GER), this occurs when stomach contents flow back into the esophagus.
• Most babies outgrow reflux by 12–18 months.
2. Overfeeding
• Feeding more than the stomach can handle may lead to vomiting.
• Watch for signs your baby is full and avoid forcing feeds.
3. Swallowing Air
• Inadequate burping or bottle feeding can lead to trapped air, which can cause vomiting.
4. Motion or Handling After Feeding
• Moving your baby too quickly or laying them flat right after a meal can trigger vomiting.

When to Be Concerned

Call your pediatrician if your newborn experiences:

• Projectile vomiting (forceful vomiting more than once a day)
• Green or yellow vomit
• Blood in the vomit (bright red or like coffee grounds)
• Poor weight gain or weight loss
• Lethargy, irritability, or signs of dehydration (few wet diapers, dry mouth, sunken soft spot)
• Persistent vomiting after every feed
• Vomiting that starts after the first few days of life and worsens

Serious Conditions to Rule Out

While most vomiting in newborns is benign, a few conditions may require urgent evaluation:

• Pyloric stenosis – A rare condition where the muscle at the outlet of the stomach thickens, blocking food passage. It typically presents with projectile vomiting between 2–6 weeks of age.
• Gastroenteritis – Infection of the stomach and intestines, often with diarrhea and fever.
• Milk protein intolerance – A reaction to proteins in breastmilk or formula.
• Intestinal obstruction – May present with bile-stained vomiting and a swollen abdomen.

Tips for Managing Mild Vomiting and Spit-Up at Home

• Keep baby upright for 20–30 minutes after feeding.
• Feed smaller amounts more frequently.
• Burp baby regularly during and after feeds.
• Ensure a proper latch during breastfeeding or correct bottle-nipple size.
• Avoid bouncing or active play immediately after feeding.

When to Call Us

If you're unsure whether your baby’s vomiting is normal or concerning, don’t hesitate to call our office. We’re here to help guide you, offer reassurance, or evaluate your baby in person if needed. 

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Schedule an appointment with Dr. Sima Stein, MD (San Jose) here: Book Online with Dr. Stein yelp.com+11doctor-stein.com+11doctor-stein.com+11