My baby is vomiting

Most babies vomit small amounts from time to time. Possetting is when they bring up a small amount of milk when burping or after a feed. It is usually nothing to worry about. When a baby is vomiting there is a lot more milk coming out.

 

Vomiting happens in up to half of all babies. In most cases it will improve with time. It might look like they are vomiting a lot but most babies continue to grow normally and are not distressed by it.

As long as your baby is otherwise healthy and is gaining weight, there's usually no need to worry or seek further help. There are some simple things you can do to help.

Vomiting can sometimes be a sign of an underlying problem such as severe reflux, milk allergy, pyloric stenosis, a stomach bug or infection. There is more information on these below.

When should you worry?

If your child has any of the following:

  • Green vomit (like the colour of spinach or green washing up liquid)
  • Pale, mottled or abnormally cold to touch
  • Extremely agitated (crying inconsolably despite distraction)
  • Floppy or very lethargic (difficult to wake)
  • Stiff for a prolonged period or has rhythmic, jerky movements of arms or legs that does not stop when you touch it (a fit/seizure)
  • Blue around the lips or has difficulty breathing
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (fever is common in babies up to 2 days after they receive vaccinations)
  • A rash that does not disappear with pressure (see the “Glass Test”)

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)
  • Increasingly sleepy and not waking for feeds when normally would
  • No wet nappies in the last 8 hours
  • Dry mouth or sunken fontanelle (soft spot on the head)
  • Trouble putting on weight or is constantly arching their back and crying when feeding
  • Blood in the poo
  • Is getting worse or you are worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

We recognise that during the current COVID-19 crisis, at peak times, access to a health care professional may be delayed. 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, then consider taking them to your nearest A&E

If your baby has none of the above amber or red features and:

  • 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.

Self care

Continue providing your child’s care at home. If you are still concerned about your child contact your Health Visitor or call NHS 111 – dial 111

Conditions that can cause a baby to vomit:

  • Most babies experience some degree of reflux. This is because the muscular valve 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 them hiccups. As long as your baby is growing normally and is not showing any marked signs of distress then there is no need to worry.
  • More severe reflux can cause your baby to cry and be sick, often after feeding. The long name for severe reflux is gastro-oesophageal reflux disease (GORD). This means that when your baby's tummy is full, food and stomach acid flow back up their food pipe causing discomfort and pain.
  • You can ask your Health Visitor for advice and support. They can advise you about breastfeeding positioning or formula feeding. Holding your baby upright after feeding can help. Burp your baby regularly during feeds. For formula fed babies smaller feeds more often can help. Make sure your baby sleeps flat on their back.
  • If your baby still has frequent reflux and is distressed, or you are concerned speak to your GP.
  • Information is available on nhs.uk

  • Cow's milk proteins are found in many types of formula milk. Sometimes they can make their way into your breastmilk if you eat or drink milk or other dairy products, such as cheese and yoghurt.
  • 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. If your baby has problems with cow's milk, they may also have:

            - colic

            - eczema

            - watery or slimey poo or constipation

            - blood in their poo

            - trouble putting on weight

            - other family members with allergies

If you're worried that your baby has problems with cow's milk speak to your Health Visitor or GP. Treatment involves removing all cow's milk from your baby's diet for a period of time. Your GP can advise on how to do this.

For more information see nhs.uk

 

  • Pyloric stenosis is a rare condition that can cause your baby to vomit forcefully within half an hour of feeding.
  • It happens because the muscle controlling the valve leading from the stomach into the intestines has thickened. This stops enough milk getting through. The milk stays in the stomach and is vomited back up.
  • Pyloric stenosis is most likely to begin when your baby is about 6 weeks old. It can happen any time up to 4 months of age. It can sometimes run in families. Boys are more likely to get it than girls.
  • It is easily corrected with minor surgery.

  • If your baby's vomiting begins suddenly, or if they also have watery poo, they may have a tummy bug (gastroenteritis). Gastroenteritis is usually caused by a viral infection. Vomiting will generally get better 1-2 days after it starts.
  • Do not stop giving your baby milk. If you are breastfeeding, continue doing so. If your baby has formula milk, do not dilute it.
  • Babies under 6 months of age are at more risk of becoming dehydrated than older children. It is important to make sure that they are drinking enough.
  • Consider giving your baby oral rehydration solution (ORS) in between feeds or after each watery stool. Your local community 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 little and often by mouth to your child.

Your baby may be vomiting because they have an infection. They will often have a fever. All babies under 3 months old with a temperature of 38C or above should be urgently reviewed by a healthcare professional.

Vomiting can be caused by a viral infection. Other causes include urinary tract infections or more serious illnesses such as meningitis or sepsis.

Signs of a serious infection include:

  • Pale and floppy going blue around the lips
  • Fretful or excessively miserable when touched
  • Difficult to wake
  • Struggles to breathe
  • Develops a rash that does not disappear with pressure (the Glass Test)

Your child needs urgent help if they have any of these. Go to the nearest hospital emergency (A&E) department or phone 999.

What can you do?

If you are breastfeeding seek advice from your midwife or Health Visitor. There are simple measures which may help. 

If you are bottle feeding try having your baby in a more upright position when feeding. Make sure you use the recommended amount of powder. It is easy to use too much if you have changed product or are using a different scoop than the one provided in the tin.

When you are bottle feeding it can be easy to give your baby too much milk. Their stomach is only small. Most babies need little and often feeds. 6 to 8 feeds per day, including overnight, is normal. There are simple measures which may help. Your Health Visitor can help advise you.

If after 2 weeks you are still concerned seek advice from your Health Visitor or GP.

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?

All community pharmacies across England are required to be Healthy Living Pharmacies. This means that they are able to offer advice about a range of healthy living matters which includes eating a healthy diet. They can provide information leaflets and give parents/carers and young people more information about other organisations that might be able to also help them with healthy eating.

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, or the child and adolescent mental health services.

 

Contact your local Health Visiting Team:

Bradford Health Visitors or call - 01274 221223

Wakefield Health Visitors or call - 01924 310130

Craven Health Visitors or call - 01423 544265

Leeds Health Visitors or call - 0113 843 5683

Calderdale Health Visitors or call - 030 0304 5555 (local rate number)

Kirklees Health Visitors or call - 030 0304 5555 (local rate number)

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 about what Health Visitors do: 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.

Contact your local school nursing team:

Bradford School Nurses01274 221203

Wakefield School Nurses01924 310130

Leeds School Nurses - 0113 843 5683

Calderdale School Nurses030 3330 9974 (local rate number)

Kirklees School Nurses0300 304 5555 (local rate number)

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.

All children should be registered with a GP. Anyone in England can register for free with a GP surgery. You do not need proof of address or immigration status, ID or an NHS number.

How to find your local GP.

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.

Please note, the online version of NHS 111 is only recommended for children over the age of five. If your child is under five years old, please phone 111.

NHS 111 can also direct you to your nearest urgent treatment centre (minor injuries unit or walk-in centre).

Find your local urgent treatment centre.

When to visit an urgent treatment centre.

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
  • breathing difficulties
  • severe bleeding that cannot be stopped
  • major trauma such as road traffic collisions

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