- Some degree of reflux is completely normal in babies as 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, 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
- If you have tried the measures described above and seen no improvement, see your GP. They will review your child’s symptoms and ask you about the formula you have used, and may possibly prescribe an antacid designed for babies
- Click here to watch a video on reflux by Best Beginnings
My baby is vomiting
Most babies vomit small amounts from time to time and bring up some milk when they burp. This is known as possetting and is usually nothing to worry about. You can tell when your baby is vomiting rather than posseting because there will be a lot more coming out.
Vomiting is also very common (up to half of all babies) and in most cases will improve with time. Although it might look like they are vomiting a lot, most babies continue to grow normally and do not look particularly distressed by it.
As long as your baby seems otherwise healthy and continues to gain weight, there's usually no need to worry or seek further help. There are some simple things you can do to help – click here for more information.
However, vomiting can occasionally be a sign of an underlying problem such as severe reflux, milk allergy, pyloric stenosis, a stomach bug or infection (see below). Below are some signs to look out for if you are worried.
When should you worry?
If your child has any of the following:
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Green vomit (like the colour of spinach or green washing up liquid)
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Has blue lips
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Is pale, mottled and feels abnormally cold to touch
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Has pauses in their breathing lasting more than a few seconds or has an irregular breathing pattern
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Shows signs of working hard to breathe. These include constantly breathing fast, flaring of the nostrils, drawing in of the muscles below the ribs or making a grunting noise every time they breathe out
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Is too breathless to feed
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Is extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
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Is stiff or rigid or makes repeated, jerky movements of arms or legs that doesn't stop when you hold them (a fit or seizure)
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Develops a rash that does not disappear with pressure (the ‘Glass Test’)
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Is under 3 months of age with a temperature of 38°C or 100.4°F or above (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:
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Vomits forcefully (shoots across the cot or the room)
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Not interested in feeding and or seems dehydrated (no tears, sunken soft spot on the head, drowsy or no wet nappies in the last 8 hours)
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Is becoming drowsy (excessively sleepy) or irritable (unable to settle them)
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Has trouble putting on weight or is constantly arching their back and crying when feeding
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Ongoing vomiting with blood in the poo
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Is getting worse or if you are worried
You need to contact a doctor or nurse today.
Please call your GP surgery or contact NHS 111 - call 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 and your baby:
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Continues to feed well
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Has plenty of wet nappies
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Watch them closely for any change and monitor for any red or amber symptoms
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:
- Cow's milk proteins are found in many types of formula milk. They'll also 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. But if your baby has problems with cow's milk, they may also have:
- eczema
- colic
- diarrhoea or constipation
- trouble putting on enough weight
- history of allergies in your close family
If you're worried that your baby has problems with cow's milk, there are steps you can take. If you breastfeed your baby, you could try cutting cow's milk from your diet for 2 weeks. If your baby is formula-fed, a hypoallergenic formula may be needed.
Talk to your doctor before trying these, though. They will check your baby's symptoms first, so they can be sure of what's causing them.
Click here to watch a video on milk allergy by Best Beginnings.
- This is a rare condition that can cause your baby to vomit forcefully within half an hour of feeding
- Pyloric stenosis is most likely to begin when your baby is about six weeks old, but could show up at any time before they reach four months of age. It can sometimes run in families, and boys are about four times more likely to get it than girls
- It happens because the muscle controlling the valve leading from the stomach into the intestines has thickened, stopping enough food and milk to get through, so it stays in the stomach and then comes back up. The problem is easily corrected with minor surgery
- If your baby's vomiting begins suddenly, or if they also have diarrhoea, they may have a tummy bug (gastroenteritis). Gastroenteritis is usually caused by a viral infection and needs no specific treatment. An attack of vomiting will generally subside six hours to 24 hours after it starts
- Do not stop giving your baby milk. If you are breastfeeding, continue doing so. If your child is on formula, do not dilute it
- Babies under 6 months of age are at more risk of becoming dehydrated than older children, which is why it is important to make sure that they are drinking enough. Give your baby oral rehydration fluids in between feeds or after each watery stool. Your 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 to your child
Your baby may be vomiting because they have an infection. This is usually associated with a temperature above 38°C or 100.4°F. Although the most likely cause is a viral infection, other causes include urinary tract infections or very occasionally a more serious illness such as meningitis or sepsis. In a baby, signs of a serious infection include:
- becoming pale and floppy or having blue lips
- being fretful or excessively miserable when touched
- becoming difficult to rouse
- finding it hard to breathe
- developing a rash that does not disappear with pressure (the Glass Test)
Your child needs urgent help if any of these features are present - go to the nearest hospital emergency (A&E) department or phone 999.
What should you do?
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.
However, if after 2 weeks you are still concerned, seek advice from your health visitor or GP.
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
For wear and tear, minor trips and everything in between
Self-care
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?
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?
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?
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 or 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, you can call 111 or use 111 online.
Please note that 111 online is for people aged 5 and over. Call 111 if you need help for a child under 5.
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.