My baby is sick after every feed

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

Children and vomiting - Better Health Channel

Summary

Read the full fact sheet

Mild vomiting is normal in most babies and improves over time.
Most babies need only simple treatment, or none at all.
Changing feeding and sleeping positions may help.
Medicine should not be given unless prescribed by your doctor.
Give a child who is unsettled after vomiting a drink or a little food.
If your child seems unwell or shows any worrying symptoms, see a doctor.

Vomiting can be part of many illnesses in children and babies. It is not usually a major concern as long as your child seems well in other ways.

Vomiting is common for babies and young children. Vomiting occurs when food is brought back up from the stomach. The amount of vomit can often seem larger than it actually is.

Types of vomiting

There are different types of vomiting, including:

Possetting – this is when your baby vomits up small amounts after a feed.
Reflux – this vomiting is common in babies. It is caused when the valve at the top of the stomach accidentally opens. The contents of the stomach come back up the food pipe (oesophagus) slowly. Reflux does not harm babies. They usually grow out of it by the time they are walking.
Projectile vomiting – this is when your baby brings up the stomach contents in a forceful way. The amount of milk or food can seem large on the floor, but is usually only the amount of the last feed. Babies may projectile vomit occasionally, but if it happens after every feed, see your doctor right away as it may be due to a blockage caused by thickening of the muscle at the outlet of the stomach.

Causes of vomiting

Vomiting is usually caused by:

minor infections like 'gastro' or the common cold
gastro-oesophageal reflux
motion sickness from travelling in a moving vehicle.

Sometimes, vomiting may be part of a more serious illness. Children may vomit if they have an infection, such as a urinary tract infection or meningitis, a bowel obstruction or appendicitis. If vomiting progresses to fever and diarrhoea, it will usually be caused by a virus infection. If this persists for 12 hours or more, dehydration is likely. so see your doctor or local hospital emergency department without delay.

Treatment for vomiting

Most babies and children vomit easily and recover quickly. After vomiting, your child may be hungry and thirsty. Give plenty to drink so your child does not become dehydrated. If your child keeps on vomiting and looks unwell, see your doctor. Do not use medication to try and stop the vomiting.

Reflux vomiting can be prevented or reduced

Different positions for feeding or in bed can help reduce your baby’s chance of vomiting. You can try to:

Feed your baby in an upright position.
Prop your baby up after feeds.
Lay your baby on the left side.
Avoid bouncing your baby after feeding.

To help with mild reflux, you can thicken your baby’s food with cornflour or infant food thickener. If your child is uncomfortable after vomiting or will not settle, try giving milk or water. This will wash any acid back into the stomach. Some babies get heartburn, which is a burning sensation in the chest. They may be unsettled after feeding or when lying flat. Your doctor can suggest an antacid to relieve heartburn.

When to see your doctor

Take your baby to the doctor if any of these symptoms occur:

poor weight gain because of the loss of feeds in vomiting
coughing or choking spells
blood or yellow-green bile in the vomit
heartburn
vomiting increases or becomes forceful after every feed
your baby seems unwell.

Where to get help

Your doctor
NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
Your local maternal and child health nurse
The 24 hour Maternal and Child Health Telephone Service. Tel.13 22 29
Your local hospital emergency or casualty department

Things to remember

Mild vomiting is normal in most babies and improves over time.
Most babies need only simple treatment, or none at all.
Changing feeding and sleeping positions may help.
Medicine should not be given unless prescribed by your doctor.
Give a child who is unsettled after vomiting a drink or a little food.
If your child seems unwell or shows any worrying symptoms, see a doctor.

This page has been produced in consultation with and approved by:

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, aerophagy (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 regurgitation 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.

Viral gastroenteritis (children)

Most diarrhea and vomiting in children is caused by a virus. This is viral gastroenteritis. Many people call it "stomach flu" but it has nothing to do with the flu. This virus infects the stomach and intestinal tract. The disease lasts from 2 to 7 days. Diarrhea means loose or watery stools that are different from a baby's normal bowel movements.

The child may also have the following symptoms:

The main danger of this disease is that it leads to dehydration. This is the loss of a large amount of water and mineral salts by the body. In such cases, fluid loss by the body must be replenished. This is done with oral rehydration solution. These solutions are available from pharmacies and most grocery stores without a prescription.

Antibiotics do not help with this disease.

Home care

Follow your pediatrician's instructions.

If you give medicine to your child:

Do not use over-the-counter diarrhea medications unless your doctor tells you to.
Acetaminophen or ibuprofen can be used for pain and fever. Or another medicine as prescribed.
Aspirin as an antipyretic is contraindicated in children under 18 years of age. Its use can lead to serious liver problems and a life-threatening condition called Reye's syndrome.

To prevent the spread of disease:

Remember that washing your hands with soap and clean running water or using an alcohol-based disinfectant is the best way to prevent the spread of infection.
Teach all family members when and how to wash their hands. Wet your hands with clean running water. Apply soap to the back of your hands, between your fingers and under your nails. Rub your hands for at least 20 seconds. If you need a timer, try singing "Happy Birthday to You!" twice. from the beginning to the end. Rinse your hands well and dry with a clean towel.
Wash your hands before and after caring for your sick child.
Clean the toilet after each use.
Dispose of soiled diapers in an airtight container.
Keep the child away from other people until the doctor says so.
Wash your hands before and after preparing food.
Wash hands and utensils after using cutting boards, countertops and knives that have been in contact with raw food.
Keep raw meat away from cooked and ready-to-eat foods.
Please note that people with diarrhea or vomiting should not prepare food for others.

How to properly water and feed

The main goal in the treatment of vomiting or diarrhea is to prevent dehydration. To do this, the child should often consume liquids in small portions.

Fluid is now more important than food. Give a small amount of liquid at a time, especially if the child has stomach cramps or is vomiting.
For diarrhea: If you are giving milk to a baby and the diarrhea does not stop, refuse the milk. In some cases, milk can make diarrhea worse. If this happens, use an oral rehydration solution. Eliminate apple juice, soda, sports or other sweetened drinks. Drinks with sugar can make diarrhea worse.
For vomiting: Start with oral rehydration solution at room temperature. Give 1 teaspoon (5 ml) every 5 minutes. Even if the child is vomiting, continue to give the solution. Most of the fluid will be absorbed despite vomiting. After 2 hours without vomiting, start with a small amount of milk or formula and other liquids. Increase the amount depending on tolerance. Do not give your child plain water, milk, formula, or other liquids until the vomiting stops. Give more oral rehydration solution as vomiting decreases. Increase the interval between doses. Continue until the child has urine and is no longer thirsty (no interest in drinking). If there has been no vomiting within 4 hours, resume feeding solid food. After 24 hours without vomiting, resume normal eating.
As you feel better, you can gradually resume your child's normal diet. Don't force your child to eat, especially if they have stomach pain or cramps. Do not feed your baby large portions at a time, even if he is hungry. Tobacco smoke can make a child feel worse. Over time, the child can be given more food, provided it is tolerated. Foods that are allowed include cereals, mashed potatoes, applesauce, mashed bananas, crackers, dry toast, rice, oatmeal, bread, noodles, pretzel, rice or noodle soups, and cooked vegetables.
If symptoms return, return to a simple or no therapeutic diet.

Postoperative care

See your pediatrician or follow his instructions. If a stool or culture test is taken, see your doctor for results as directed.

Call 911

Call 911 if your child has any of these symptoms:

Labored breathing
Confusion
Extreme drowsiness or loss of consciousness
Trouble walking
Rapid pulse
Chest pains
Neck stiffness
Convulsions

When to seek medical help

Seek immediate medical attention in the following cases:

Abdominal pain worse
Constant pain in the right lower abdomen
Recurrent vomiting after first 2 hours of fluid intake
Episodic vomiting for more than 24 hours

Continuous severe diarrhea for more than 24 hours
Blood in stool or vomit
Child drinks less liquid than usual
Darkening or no urine for 6 to 8 hours in older children, 4 to 6 hours in toddlers
Whims or crying when the child cannot be soothed
Unusual drowsiness
New skin eruptions
Diarrhea lasting more than 10 days
Temperature (see Temperature and children below)

Temperature in children

Use a digital thermometer to take your baby's temperature. Never use a mercury thermometer. There are various types and ways of using digital thermometers. For example:

Rectal. For children under 3 years of age, rectal temperature is the most accurate.
Frontal (temporal). It is used for children aged 3 months and older. If a child under 3 months of age has signs of illness, this method can be used for the first measurement. The doctor may also check the rectal temperature for confirmation.
Ear (tympanic). The ear method is accurate for children 6 months and older, but not younger.
Axillary (axillary). This is the least reliable method, but can be used for the first measurement to test a child of any age who is showing signs of illness. The doctor may also check the rectal temperature for confirmation.
Oral (oral). Do not take oral temperature until the child is 4 years old.

Use the rectal thermometer with care. For correct use, follow the manufacturer's directions. Insert it carefully. Make a note on it and make sure it will not be used orally. It can carry germs from the stool. If a rectal thermometer doesn't work for you, ask your doctor which thermometer is best to use. When you tell a doctor about your child's temperature, tell him what type of thermometer you took it with.

Here are some tips to help you know if your baby has a fever. Your child's doctor may give you other values. Follow your healthcare provider's instructions.

Temperature readings for infants up to 3 months: