My baby is vomiting. What Should I do?
Vomiting is common in infants as a variety of reasons such as excessive crying, coughing, or even car rides can trigger this behaviour. In most cases, it is not a cause of concern, especially if it subsides within 24 hours.
Signs of vomiting
It is helpful to distinguish between vomiting and possetting. While vomiting may be a symptom of a more serious condition, possetting is merely the regurgitation of small amounts of milk. The latter often occurs shortly after feeds and is quite harmless.
Causes of vomiting
Possetting occurs in young babies because there is a valve mechanism in the passage between their stomach and their throat that is not quite fully developed. As they get older, this mechanism will mature and prevent the regurgitation. In these early days, they are also getting used to feeding.
Babies may vomit when they have swallowed too much air or milk during feeding. This happens when the teat flow from the bottle or the ‘let-down’ reflex from the mother’s breast is too fast. For similar reasons, vomiting may also be more frequent for colicky babies.
Vomiting can also be a symptom of something more serious. Some potential causes include:
- Gastroenteritis (more commonly known as stomach flu)
In this case, the vomiting is likely accompanied by diarrhoea
- Ear infection
- Pyloric Stenosis
This rare congenital condition refers to the obstruction of the stomach’s opening to the small intestines.
- Intestinal blockage (such as a hernia)
- Food or milk intolerance
- Accidental intake of drug or poison
Risks of vomiting
Severe and persistent vomiting, if left untreated, can cause dehydration and weight-loss. These can then lead to more serious conditions. Look out for signs of dehydration that include no tears when crying, sunken eyes, a sunken fontanelle (the soft spot on your baby’s head), dry mouth/ tongue, irritable or listless behaviour, as well as lower than normal urine output (less than 6 wet nappies in a 24-hour period). While mild vomiting is often not cause for concern, seek medical advice if you think your baby is not gaining weight normally.
Dealing with vomiting
To minimise milk regurgitation after feeding, ensure that your baby is not swallowing too much air during the feeding session. Try investing in a bottle that helps reduce colic. Ensure that the baby is allowed to rest in between feedings and is burped frequently, especially if you are bottle-feeding. You may wish to prop your baby up, keeping them at an angle during and for a while after feeding. Once you need to lay them flat, lay them on their right side to prevent reflux, if possible for about an hour. This allows time for the contents of their stomach to empty. Be careful not to overfeed your baby.
When your baby is vomiting, it is best to make sure that they are kept hydrated. If your baby is having trouble keeping milk down during their regular feeding schedule, try feeding in smaller quantities but more frequently. You may need to feed them an oral rehydration solution (ORS) as advised by the doctor. Do not feed them any anti-nausea medication or any other drug unless medically advised. Allow them to rest as much as possible.
When to seek medical help
Do not be afraid to consult your doctor if you are worried that your baby may be sick. You should also seek medical help when you observe the following:
- Your child’s vomiting is accompanied with diarrhoea and/or fever (38 degrees C or higher for infants younger than 3 months, 39 degrees C or higher for those 3 months or older)
- Your child’s vomitus is greenish, or is tinged with blood
- The vomiting is forceful/ projectile, and occurs after every feed
- The vomiting is persistent
- Your child appears unwell and/or is intensely crying while vomiting
- Any signs of dehydration as described above
- Any swelling in the abdomen
- Any signs of weight loss