Is it normal for babies to be sick after feeding

Reflux in babies - NHS

Reflux is when a baby brings up milk, or is sick, during or shortly after feeding. It's very common and usually gets better on its own.

Check if your baby has reflux

Reflux usually starts before a baby is 8 weeks old and gets better by the time they're 1.

Symptoms of reflux in babies include:

bringing up milk or being sick during or shortly after feeding
coughing or hiccupping when feeding
being unsettled during feeding
swallowing or gulping after burping or feeding
crying and not settling
not gaining weight as they're not keeping enough food down

Sometimes babies may have signs of reflux but will not bring up milk or be sick. This is known as silent reflux.

Things you can try to ease reflux in babies

Your baby does not usually need to see a doctor if they have reflux, as long as they're happy, healthy and gaining weight.

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)

Non-urgent advice: See a GP if your baby:

is not improving after trying things to ease reflux
gets reflux for the first time after they're 6 months old
is older than 1 and still has reflux
is not gaining weight or is losing weight

Urgent advice: Ask for an urgent GP appointment or call 111 if your baby:

has vomit that's green or yellow, or has blood in it
is projectile vomiting (being sick with more force than usual)
has blood in their poo
has a swollen or tender tummy
has a very high temperature or they feel hot or shivery
keeps being sick and cannot keep fluid down
has diarrhoea that lasts for over a week or has signs of dehydration
will not stop crying and is very distressed
is refusing to feed

Also call your GP or 111 if you have any other concerns about your baby.

Treatment for reflux in babies

A GP or specialist may sometimes recommend treatments for reflux.

If your baby is formula-fed, you may be given:

a powder that's mixed with formula to thicken it
a pre-thickened formula milk

If the thickening powder does not help or your baby is breastfed, a GP or specialist might recommend medicines that stop your baby's stomach producing as much acid.

Very rarely, surgery might be needed to strengthen the muscles to stop food or milk travelling back up. This is usually only after trying other things or if their reflux is severe.

Causes of reflux

Reflux usually happens because your baby's food pipe (oesophagus) has not fully developed, so milk can come back up easily.

Your baby's oesophagus will develop as they get older and the reflux should stop.

Page last reviewed: 13 December 2021
Next review due: 13 December 2024

Baby Vomiting After Feeding Formula: Causes and Treatment

Your little one is happily gulping their formula while cooing at you. They finish off the bottle in no time flat. But shortly after feeding, it seems to all come out as they vomit.

There are several reasons why your baby might be vomiting after a formula feeding, but it’s important to remember that it can be — and often is — very normal.

It’s common for babies to throw up sometimes after feeding on formula or breast milk. Their shiny new digestive systems are still learning what to do with all the yummy milk coming down into their tummy.

However, if your baby often has a hard time keeping their formula down on a regular and frequent basis, let your pediatrician know.

Having a baby around means getting used to soft mushy stuff coming out fairly often. This includes spit-up and vomit.

Spit-up and vomit might seem pretty much the same — and require similar amounts of cleaning to get them off of your sweater and the sofa — but they’re very different. Spitting up is an easy, gentle dribble of milk. Baby may even smile at you as the curd-like spit-up flows from their mouth.

Spit-up is normal in healthy babies, especially if they’re under the age of 1.

On the other hand, vomit takes more effort, as it comes from deeper in your little one’s stomach. It’s a sign that your baby’s stomach is saying nope, not now, please. You might see your baby strain and recoil just before they projectile vomit. This force happens because vomit is squeezed out by the stomach muscles.

Your baby might also look more uncomfortable during and after vomiting. And vomit looks and smells different. This is because it’s usually formula, breast milk, or food (if your baby is eating solids) mixed with stomach juices.

If you’re not sure whether your baby is vomiting or spitting up, look for other vomiting symptoms, like:

crying
gagging
retching
turning red
arching their back

That said, there doesn’t seem to be agreed-upon definitions of these two terms among healthcare providers, caregivers, and others. Plus, their symptoms may overlap. For example, spitting up may sometimes be forceful, and vomiting may sometimes seem painless.

Overfeeding

It’s easier for your baby to overfeed when they’re drinking from a bottle than when they’re breastfeeding. They can also gulp down milk faster from a bottle and rubber nipple. What’s more, because formula is always available, it’s easier for you to give them more milk than they need by accident.

Babies have tiny stomachs. A 4- to 5-week-old infant can only hold about 3 to 4 ounces in their tummy at a time. This is why they need lots of smaller feedings. Drinking too much formula (or breast milk) in one feeding can overfill your baby’s stomach, and it can only come out one way — vomit.

Not burping properly

Some babies need to be burped after every feeding because they swallow lots of air as they gulp down milk. Bottle feeding your baby breast milk or formula may lead to more air-swallowing, as they can gulp even faster.

Too much air in the stomach can make your baby uncomfortable or bloated and trigger vomiting. Burping your baby right after feeding them formula may help prevent this.

To help prevent your baby from swallowing too much air and vomiting after formula feeding, check your baby’s bottle. Make sure you’re using a smaller bottle that’s just big enough to hold a few ounces of milk. Also, check to make sure the nipple hole is not too big, and don’t let your baby continue gulping when the bottle is empty.

Baby or infant reflux

Baby can have acid reflux, indigestion, or occasionally gastroesophageal reflux disease (GERD just like grown-ups! This happens because their stomach and food tubes are still getting used to holding down milk.

Baby reflux happens when milk travels back up toward your baby’s throat and mouth. This usually just causes some painless spitting up, but it can irritate your baby’s throat and trigger gagging and vomiting.

Sometimes, smaller feedings can help prevent baby reflux. If not, don’t worry! Most little ones outgrow baby reflux by the time they’re 1 year old.

Constipation

While simple constipation would be an uncommon cause of vomiting in an otherwise healthy infant, sometimes baby vomiting happens because of what isn’t happening at the other end.

Most babies who are formula-fed need to poop at least once a day. Anything less than your baby’s typical pattern, though, might indicate they’re constipated.

If your baby is vomiting after a formula feeding, they might be constipated if they have other symptoms, including:

gassiness
not pooping for longer than 3–4 days
a swollen or bloated stomach
a firm or hard stomach
crying bouts or irritableness
straining very hard but not pooping or pooping only a little
small, hard pellet-like poop
dry, dark poop

Stomach bug

If your baby doesn’t usually vomit after having formula, they might have a stomach bug. Also known as gastroenteritis or the “stomach flu,” a stomach bug is a very common cause of vomiting in babies. Your little one may vomit several times for up to 24 hours.

Other symptoms of a stomach bug include:

crying
stomach cramps
stomach rumbling
bloating
diarrhea or watery poop
mild fever (or none at all in babies)

Allergy

In rare cases, the cause of your baby’s vomiting might be in the formula. Although it’s uncommon for babies to be allergic to cow’s milk, it may happen to up to 7 percent of babies under the age of 1.

Most children outgrow a milk allergy by the time they’re 5 years old, but it can cause vomiting and other symptoms in babies. A cow’s milk allergy might cause vomiting right after your baby eats. It can also cause vomiting and other symptoms hours or rarely days later.

If your baby has an allergy to milk or something else, they might have other symptoms of an allergic reaction, like:

skin rash (eczema)
diarrhea
cough
hives
difficulty breathing
wheezing

Lactose intolerance

An allergy to milk is different than being lactose intolerant. Lactose intolerance usually causes digestive symptoms like diarrhea. It can also make your baby vomit after drinking formula containing cow’s milk.

Your baby might get temporary lactose intolerance after getting a tummy bug or gastroenteritis, although this is uncommon.

Other symptoms include:

diarrhea or watery poops
constipation
bloating
gassiness
stomach pain
stomach rumbling

Note that lactose intolerance is rare in babies under the age of 1.

Other causes

Some common health conditions can cause vomiting at any time, including after breastfeeding or formula feeding. Some rare genetic conditions can also cause vomiting in babies.

Other causes of vomiting in babies include:

colds and the flu
ear infections
some medications
overheating
motion sickness
galactosemia
pyloric stenosis
intussusception

In most cases, minor tweaks can help stop your baby’s vomiting. Remedies to stop your baby’s vomiting after formula depend on what’s causing it. Try some of these tried and tested methods to see what helps your baby:

feed your baby smaller amounts of formula more often
feed your baby slowly
burp your baby after the feeding
hold your baby’s head and chest up while feeding
hold your baby upright after a feeding
make sure your baby doesn’t move around or play too much right after a feeding
try a smaller bottle and smaller-hole nipple to feed
check the ingredient list on your baby’s formula
ask your baby’s doctor if you should try a different kind of formula
talk to your baby’s doctor about a possible allergic reaction
dress your baby in looser clothing
make sure their diaper isn’t on too tightly

If your baby has the stomach flu, you’ll both usually just have to ride it out for a day or two. Most babies and children with a stomach bug don’t need treatment.

If your baby is vomiting, see your doctor or pediatrician right away if they:

are vomiting often
are vomiting forcefully
aren’t gaining weight
are losing weight
have a skin rash
are unusually sleepy or weak
have blood in their vomit
have green bile in their vomit

Also, see your doctor urgently if your baby has any sign of dehydration from all the vomiting:

dry mouth
crying without shedding tears
a weak or quiet cry
floppiness when picked up
no wet diapers for 8 to 12 hours

It’s pretty common for babies to vomit, especially after feeding. This happens for many reasons, including that these little people are still just getting used to keeping down their milk.

Check with your doctor about what you can do. See your doctor urgently if your baby vomits often for any reason.

Spitting up and vomiting in infants

Spitting up and vomiting in babies is a common reason for visiting a doctor.

Regurgitation and vomiting is a reflex action that occurs when receptors located in various anatomical zones are irritated, incl. in the stomach, esophagus, pharynx, oral cavity. The signal is transmitted to the vomiting center, which is located in the medulla oblongata and a gag reflex occurs.

What is the difference between regurgitation and vomiting?

The difference lies in the volume and kinetics (movement) of the gastric contents expelled to the outside. When regurgitation occurs, leakage occurs without the participation of the diaphragm and abdominal muscles, i.e. passively. There is little content, up to about 10-15 ml. If the child does not swallow it, it quietly expires from the oral cavity. When vomiting, a wave-like bending of the upper half of the body occurs as a result of contraction of the muscles of the diaphragm and the anterior wall of the abdomen, the volume of vomit is greater, and they are erupted with pressure from the oral cavity with an ejection trajectory of up to 50 cm. In children of the first year of life, this is defined by the term "fountain vomiting" .

Regurgitation is observed only in children of the first year of life and, mainly, up to 6 months. Contribute to this anatomical and physiological features of the esophagus and stomach of the baby. Their esophagus is short and wide, the angle of connection of the esophagus with the stomach is less pronounced, and its obturator function is weak. These regurgitations are physiological. They can be after each feeding, up to 15 ml, do not affect the well-being and weight gain of the baby. They can also be caused by excessive feeding, aerophagia (swallowing air while sucking), straining during intestinal colic. The frequency and volume of such regurgitation decreases with the growth of the child. With the introduction of complementary foods, and this is a thicker food, regurgitation stops or becomes much less frequent.

If regurgitation persists in a child older than 1 year, then this is a sign of a pathological process.

Vomiting, unlike regurgitation, is accompanied by vegetative symptoms - increased salivation, pallor of the skin, palpitations. This is due to the fact that next to the vomiting center there are additional centers of autonomic regulation, which are reflexively excited, and active biological substances such as serotonin, dopamine, histamine and others are released into the blood.

Regurgitation and vomiting, from the moment of eating, may occur during feeding, after feeding for the first 20-30 minutes or delayed, sometimes after several hours.

Regurgitation and vomiting that occurs immediately after feeding unchanged breast milk or formula may be due to narrowing of the esophagus. If they persist until the next feeding, and the milk / mixture is curdled, has a sour or musty smell, then this is the result of a long standing food in the stomach. The reason for this may be the low tone of the muscle layer of the stomach and, as a result, its peristalsis or narrowing of the output section due to an anomaly in the development or high tone of the sphincter of the lower stomach. With narrowing of the duodenum, bile is present in the regurgitated masses.

Gastroesophageal reflux is a common cause of regurgitation in infants. It is likely that there is a complex problem here, starting with the immaturity of the gastrointestinal tract and disorders of the central nervous system. Perinatal injuries of the central nervous system accompany every second child. Their manifestations are varied. Regurgitation and vomiting can be facilitated by an increase in intracranial pressure, disorders in the segment of the cervical spine, and so on. Therefore, quite often, when carrying out rehabilitation measures for neurological dysfunctions, a positive effect is manifested in the form of a decrease or cessation of regurgitation. A hernia of the esophageal opening of the diaphragm will also manifest itself in a similar way.

We should not forget about allergic gastrointestinal reactions in the form of regurgitation and vomiting. The most common cause of this is cow's milk protein. With intolerance to cow's milk protein, inflammation of the mucous membrane of the esophagus, stomach and intestines occurs. And, as a result of this, regurgitation and vomiting, pain and increased gas formation, diarrhea or constipation.

Rare endocrine disorders (adrenogenital syndrome) are manifested by vomiting in children from the first weeks of life. In such cases, vomiting is frequent, there may be an admixture of bile, the child loses weight due to loss of fluid and nutrients, and severe metabolic disorders develop.

Vomiting can also be caused by an intestinal infection. Viral gastroenteritis is now common. It must be remembered that the younger the child, the more severe the disease. Within a few hours, the child's condition can go from satisfactory to extremely serious.

As you can see, the causes of regurgitation and vomiting in children of the first year of life are quite diverse, but most often these are transient conditions that disappear with the growth of the child.

Prevention of regurgitation in children of the first months of life is quite simple. Don't overfeed your baby. If he cries, it does not always mean that he is hungry. Excess feeding leads to increased gas formation and colic, during which the child is worried, straining, thereby increasing the likelihood of spitting up. After feeding, hold the baby more upright so that he can burp the swallowed air. This will take 15-20 minutes. If the child is bottle-fed, do not change his formula milk without the recommendation of a pediatrician.

If the child has frequent regurgitation and vomiting, it is necessary to consult a pediatrician or gastroenterologist to diagnose the cause. To make a diagnosis, it is sometimes enough to carry out simple and affordable diagnostic methods in a polyclinic. These include an ultrasound of the stomach and, if necessary, stool tests. However, the approach in each case is individual. Examination and treatment will be assigned to your baby, depending on the diagnosis. Perhaps it will be preventive measures or a certain milk formula, perhaps drug therapy. Rarely, but it happens that it is necessary to examine the child in a hospital and surgical treatment.

A newborn vomited up - what to do, causes and how to help

The urge to vomit in a newborn is an alarming symptom that should not be ignored. They may be the result of accidental ingestion of a small object by a baby, intoxication, acute appendicitis, intestinal obstruction, or other diseases. The most harmless reason that a child vomited is overeating.

Physiological causes of vomiting

Sometimes vomiting is a short-term phenomenon that is not associated with pathology or disease. What could be the reasons that a healthy newborn vomited:

overeating - the baby ate too much breast milk or formula;
the baby is teething, and vomiting is a sign of temporary malaise;
child swallows air while feeding;
wrong daily routine, severe fatigue;
active play and activity immediately after eating.

If the baby feels well, you need to help him calm down and give him a drink of warm boiled water. Put the baby to sleep on the side. The baby will relax, the contents of the stomach will move into the intestines, and vomiting attacks will not recur. Try not to bathe the baby, do not shake immediately after eating. Keep track of the amount of food he gets to avoid overeating.

The introduction of a new mixture can also cause vomiting. Check with your pediatrician to make sure there are no other causes. Your doctor can help you find other foods that are right for your child.

Sometimes babies feel sick after crying for a long time, for example, the mother left, and the baby is very bored or hungry. If there are no other alarming symptoms, calm the baby as soon as possible, shake, feed, sing a gentle song. If vomiting recurs later, you need to call the pediatrician.

Symptoms and possible causes of vomiting

Most often, vomiting is a signal of diseases that can be identified by additional symptoms.

Poisoning or intestinal infections

The symptoms of poisoning and intestinal infection are very similar: the newborn is sick, his stool changes, his tummy hurts and his temperature rises. The child should be given constant water to drink so that dehydration does not occur. In any of these conditions, you need to urgently call a doctor.

Concussion

Babies are very mobile, if a child hits his head or falls, you need to urgently call an ambulance. A concussion is accompanied by vomiting, crying, temporary loss of consciousness, pallor, drowsiness, and impaired coordination of movements.

Foreign body

Swallowing a small object can also cause vomiting without vomiting in neonates. The baby may begin to salivate profusely, have breathing problems, he may vomit with mucus and blood in the vomit. If you suspect that the baby has swallowed any object, call an ambulance.

Appendicitis

This phenomenon is rare in newborns. If appendicitis is inflamed, the baby has a very sore tummy, when stroking or probing, the pain and crying intensify. There is nausea, weakness, restless behavior. Inflammation of appendicitis in infants is life-threatening, you need to urgently call an ambulance.

Allergic reaction, food intolerance

If a child has an intolerance to certain foods or an allergy to them, vomiting is accompanied by diarrhea, skin rashes, the baby is capricious, restless. With such symptoms, you need to contact a pediatrician and an allergist.

Acute infections

SARS, pyelonephritis, pneumonia can provoke a gag reflex without vomiting in a newborn from severe coughing spells and general weakness. With a high temperature, sore throat, cough, you need to call a pediatrician at home to examine the child and prescribe appropriate treatment.

Intestinal obstruction

This is a dangerous disease. It can be congenital or acquired. Accompanied by severe bloating, bile impurities are observed in vomiting. The baby cries a lot, the stool changes to a state of red jelly. Feeding is stopped and urgently seek medical help - the disease is life-threatening.

Congenital pathologies of the digestive system

Congenital pathologies lead to serious problems with digestion. If you notice that the child is restless during feeding, his stool is broken, his tummy is swollen, he is gaining weight poorly or losing it, consult a doctor. It is necessary to undergo an examination of the gastrointestinal tract and pass additional tests.

Neurological disorders

The main causes of gag reflex without vomiting in the newborn are neurological disorders. They occur most often in premature babies, in children with underweight. The cause of such disorders may be birth trauma, asphyxia or fetal hypoxia. With such pathologies, gag reflexes are accompanied by hyperactivity, chin tremor, strabismus, convulsions. You need to contact a neurologist and undergo inpatient treatment.

Heat stroke

Heat stroke is accompanied by nausea, skin redness, dizziness, rapid breathing. Also, the child develops lethargy, dry skin. Call the doctors, before they arrive, put the child in a cool place on the barrel.

How to distinguish vomiting from regurgitation

Spitting up is a natural process. The baby spits up a few minutes after feeding. It is not dangerous, it is a normal physiological process. If the baby gets a large amount of air into the tummy (swallowed while eating), then after regurgitation the discomfort disappears, he immediately feels better.

Vomiting is the result of reflex contraction of the muscles of the abdominal cavity and diaphragm, it is accompanied by rapid breathing, profuse salivation.

The main differences between vomiting and regurgitation:

Why vomiting is dangerous

Vomiting is a protective reflex of the body. So he gets rid of foreign bodies, removes toxins, microorganisms, excess food. Most often, vomiting is a symptom of diseases that are dangerous for the baby:

Vomiting itself is dangerous due to possible dehydration of the body. The baby loses not only the liquid, but also the mineral salts dissolved in it. The water-salt balance is disturbed, this affects the general condition of the crumbs. For newborns, this is especially dangerous, because dehydration occurs rapidly, and replenishing a full supply of fluid is not so easy.
The second danger of vomiting is the inhalation of vomit. During an attack, the baby should be held upright, for safety reasons, you need to ensure that the baby's head lies on its side in a dream.
Weight loss due to food rejection is also dangerous. This is especially important for premature babies or babies with a small body weight.

If the baby has vomited, carefully monitor his condition and well-being. Make sure it's not spitting up. If in doubt, it is better to call a doctor anyway, rather than wait for more serious symptoms.

When to call a doctor

It is always better to play it safe and call a doctor if you are not sure about your baby's health. In which cases it is necessary to seek medical help:

the baby is vomiting, but he did not poop;
the child is crying, restless, his stomach hurts;
repeated vomiting;
symptoms of dehydration appear;
vomiting accompanied by diarrhoea;
vomiting is a fountain;
before vomiting the baby fell or hit his head hard;
in the vomit there is blood, brown or black blotches;
the child does not eat or drink;
with vomiting comes out completely everything that the child ate and drank;
he has a high temperature;
the baby is lethargic, sleepy.

Treatment

Vomiting in children may require enterosorbent. It is believed that this tool binds and removes from the body toxic metabolites, allergens, bacteria, viruses and other harmful compounds that can provoke vomiting.

For the smallest, that is, children under two years old, when choosing an enterosorbent to alleviate the conditions that caused vomiting, you can be guided by the statement of ANSM (France). So, in March 2019, this French regulator published information that raw materials for the production of clay-based powder enterosorbents may contain lead. This harmful substance can penetrate into the bloodstream and in certain concentrations have a depressing effect on the development of the baby.

The Russian Society of Obstetricians and Gynecologists (ROAG) designated the Russian "Enterosgel" as the first choice for the treatment of conditions requiring the use of an enterosorbent in young children, pregnant and lactating women. "Enterosgel" is a molecular sponge that is not absorbed into the blood and works only in the lumen of the gastrointestinal tract. A homogeneous gel-like form with a neutral smell and taste simplifies the use of "Enterosgel" even for the smallest. It is important that "Enterosgel" promotes the healing of microtraumas on the mucous membranes of the gastrointestinal tract and minimizes the risk of constipation during use due to the formula saturated with water.

The main danger of vomiting is dehydration. It is urgent to call a doctor so that he establishes the cause of vomiting and prescribes the appropriate treatment. Also, the doctor prescribes electrolyte solutions, which need to replenish the fluid lost by the body.

What to do while waiting for the doctor

keep the child upright;
after each bout of vomiting, wash the child, clean his mouth and nose;
try not to disturb the child unnecessarily, do not carry him from place to place;
it is possible to feed milk or a mixture familiar to the baby if there are no other dangerous symptoms;
try to give the baby some water to drink;
do not give any medication until the doctor arrives;
do not give the newborn prebiotics, probiotics, zinc, enterosorbents, antidiarrheal drugs (if diarrhea has joined) - the doctor should prescribe treatment, it is dangerous to experiment in the treatment of such a small child.

What to give your baby to drink

Give your baby plenty of fluids to prevent dehydration. It is best to put the baby to the breast more often. If the doctor has already suggested which pharmacy solutions of electrolytes can be used, use them. If there are no such appointments, you can make the solution yourself. How to cook:

take 1 liter of boiled water;
add 1 level teaspoon of salt;
4-5 level teaspoons of sugar.

Mix everything thoroughly, store in the refrigerator for no more than a day. Give your child a few milliliters every five to ten minutes. To do this, take a syringe, remove it from it and put the tip with a needle away and gently squeeze the liquid into the baby's mouth with such a harmless piston.