My baby is vomiting
Most babies bring up small amounts of milk from time to time, especially when they burp. This is called posseting and is usually nothing to worry about. You’ll know your baby is vomiting instead of posseting because a lot more will come out.
Vomiting is also very common (it happens in up to half of all babies) and usually gets better with time. Even if it seems like your baby is vomiting a lot, most babies still grow normally and don’t seem too upset by it.
As long as your baby is healthy and gaining weight, there’s usually no need to worry or get extra help.
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 rib 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 ring your GP surgery or call NHS 111 - dial 111
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
- Addition information is available about infant crying and how to cope – click here.
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.
Conditions that can cause a baby to vomit:
Reflux
It’s normal for babies to have some reflux because the muscle at the end of their food pipe, which keeps food in their stomach, is still developing. Reflux might make your baby bring up milk after feeding and can also cause hiccups. As long as your baby is growing well and doesn’t seem very upset, there’s no need to worry.
However, more severe reflux can make your baby cry and vomit, especially after feeding. This more serious 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
- ask a health visitor for advice and support
- get advice about your baby's breastfeeding position or how to bottle feed your baby
- hold your baby upright during feeding and for as long as possible after feeding
- burp your baby regularly during feeds
- give formula-fed babies smaller feeds more often
- 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
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.
Milk allergy
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 will also have some of these signs:
- Eczema
- Colic
- Diarrhoea, constipation or blood in their poo
- 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.
A stomach bug (gastroenteritis)
If your baby suddenly starts vomiting or has diarrhoea, they might have a tummy bug called gastroenteritis although his is less common than in older children. This is usually caused by a virus and doesn’t need special treatment. Vomiting usually stops within 6 to 24 hours.
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.
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 Your health visitor can help review how much milk you baby should need and the timing of the feeds.
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 features, urgently see your GP. For an urgent out-of-hours GP appointment, call NHS 111.
- You should only call 999 or go to your nearest A&E department in critical or life threatening situations.
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
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- 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?
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
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- 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 to the child and adolescent mental health services.
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?
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 to the child and adolescent mental health services.
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?
Midwives provide advice, care and support for women and their babies during pregnancy, labour and the early postnatal period. They provide health education and parenting advice until care is transferred to a health visitor. This usually happens when your baby is about 2 weeks old.
Sound Advice
A midwife is an expert in normal pregnancy and birth.
Midwives provide advice, care and support for women and their babies during pregnancy, labour and the early postnatal period. They provide health education and parenting advice until care is transferred to a health visitor. This usually happens when your baby is about 2 weeks old.
Sound Advice
A midwife is an expert in normal pregnancy and birth.
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:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- 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?
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:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- 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?
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
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
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.
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.
