Concerned about your baby vomiting (being sick)?

Use the table below to help you know what to do if your baby is unwell. If your baby is vomiting but not unwell you can find more information in other sections.

If your baby has any of the following:  Has a green vomit (like the colour of spinach or green washing up liquid)  Is  pale, mottled or cold to touch  Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless they have had their vaccinations within the last 48 hours) or is 3-6 months of age with a temperature of 39°C or above  Is breathing faster than usual  Is going blue or finding it hard to breathe Is distressed or crying inconsolably (you can't settle them with toys, milk  or by picking them up)  Becomes floppy or difficult to wake  Has a fit/seizure. A seizure is when your baby is stiff for a long time or has jerking movements of arms or legs that do not stop when you hold their arms or legs)  Has a rash that does not go away when you press on it (see the “Glass Test”)

You need help now. Go to the nearest Hospital Emergency Department or phone 999

If your baby has any of the following:  Vomits forcefully (sick shoots across the cot or the room)  Is more sleepy and is not waking for feeds  Has not had a wet nappy in the last 8 hours  Has a dry mouth or flattened soft spot on their head  Is being sick with blood in the vomit or poo  Is getting worse or you are worried	You need to see a doctor or nurse today. Phone your GP practice or call NHS 24 - dial 111

If none of the above features are present and your baby:  Keeps feeding well  Has plenty of wet nappies (at least 6 in a 24 hours)  Is waking up for feeds	Self care You can keep looking after your child at home . If you are still concerned you can  call NHS 111 – dial 111

• If you are breastfeeding, get advice from a breastfeeding specialist. Your health visitor or an infant feeding advisor can help. You can find more information on breast feeding on the page Breastfeeding your baby  
• If you are bottle feeding, it may help to place your baby in a more upright position. Make sure that you use the right amount of formula milk powder. It can be easy to use too much if you have changed milks or are using a different scoop than the one given in the tin
• It can also be easy to give your baby too much milk when you are bottle feeding. Their stomach is only small. Most babies need little and often: 6-7 feeds per day is normal, including at night. Your health visitor can help with how much milk you baby needs and how often. They will let you know when your baby needs to see a doctor 

There are different reasons why your baby might be being sick. Below we look at some of these briefly. This will give you some basic information about some of the reasons your baby might be being sick. It is not a guide to help you diagnose your baby. It is important that you follow the traffic light advice above if your baby is unwell. Speak to health a professional if you are concerned about your baby. Always get help if you feel your child is getting worse.

Gastro-oesophageal Reflux Disease (GORD) 

Some reflux is very normal in babies. The muscle at the end of the food pipe, which keeps milk in the stomach, is still developing. Reflux may cause your baby to bring up milk after a feed, and can also give them hiccups. If your baby is growing and is not distressed there is no need to worry.

More severe reflux may cause your baby to cry or seem uncomfortable after feeding. More severe reflux is  known as gastro-oesophageal reflux disease (GORD) and means that at times milk and stomach acid flow back up their food pipe causing discomfort. 

Gastroenteritis (A viral or bacterial infection causing vomiting and/or diarrhoea) 

If your baby's vomiting starts suddenly, or if they also have diarrhoea, they may have gastroenteritis. Gastroenteritis is usually caused by a viral infection. If your baby has a viral gastroenteritis they often start to get better within 24 hours.

Do not stop giving your baby milk. 

Babies under 6 months of age are at more risk of getting dehydrated than older children. It is important to make sure that they are drinking enough. Little and often tends to work best.

If your baby is breastfed then you should keep trying to give small breast feeds often.

If your baby is formula fed do not dilute the formula. Offer small feeds often.

You should not use fruit juices and fizzy drinks for rehydration or in babies under 6 months of age

Infection 

Your baby may be vomiting because they have an infection. If your baby has an infection they will often have a high temperature above 38°C / 100.4°F. The most likely cause is a viral infection. However, if your baby has a bacterial infection this can be serious. Bacterial infections should be treated as soon as possible.

Cow’s Milk Protein Allergy (Non-IgE CMPA) 

Some babies have a non- IgE mediated cow’s milk protein allergy (Non Ig-E CMPA) which can make them vomit along with other symptoms. A non-IgE mediated cow’s milk protein allergy is unlikely to make your baby vomit without other symptoms.

Allergy UK have information on immediate Cow’s Milk Allergy and  Non-IgE mediated CMPA. It is important not to make changes to your diet or your baby’s formula milk without getting help and advice. 

If your baby has any signs of an immediate reaction  get help straight away. Signs of an immediate reaction include swelling of the lips or the tongue or finding it hard to breathe. You need to phone 999 or go the nearest Emergency Department if you see these signs.