Most baby vomiting is caused by a short-lived stomach bug and will stop on its own within 12 to 24 hours. Your main job during that window isn’t to stop the vomiting itself, but to keep your baby hydrated, feed in small amounts, and watch for warning signs that something more serious is going on. Here’s how to handle it step by step.
Spitting Up vs. Vomiting
Before anything else, it helps to know what you’re actually dealing with. Spit-up rolls out of a baby’s mouth effortlessly, often with a burp, and usually amounts to a couple of tablespoons or less. Vomiting is more forceful, involves a larger volume, and your baby’s abdominal muscles visibly contract. Projectile vomiting, where the contents fly out with real force, is a distinct category that warrants closer attention, especially in newborns (more on that below).
Occasional spit-up in a baby under 12 months is completely normal and rarely needs any intervention. True vomiting, especially if it happens more than once, calls for the hydration and feeding strategies outlined here.
Small, Frequent Fluids First
For the first 12 to 24 hours after vomiting starts, the priority is fluids, not food. If your baby is breastfed and has vomited once, nurse on one side every one to two hours. If your baby has vomited more than once, shorten the feed to about five minutes every 30 to 60 minutes. Smaller volumes are less likely to come back up.
For bottle-fed babies who have vomited once, offer half the usual amount every one to two hours. If vomiting has happened more than once in the past two hours, drop down to about one ounce (30 mL) every 30 to 60 minutes. If even that won’t stay down, try giving one to two teaspoons (5 to 10 mL) every five minutes using a spoon or small syringe. This slow drip approach gives the stomach time to absorb fluid without triggering another episode.
An oral rehydration solution (like Pedialyte) can replace lost electrolytes. For mild dehydration, the general guideline is roughly 50 to 60 mL per kilogram of your baby’s weight, spread over four hours. For moderate dehydration, that rises to 80 to 100 mL per kilogram over the same period. A spoon or syringe every minute or two is a practical way to deliver it.
How to Track Hydration
Wet diapers are your best real-time hydration monitor. After the first week of life, a well-hydrated baby produces at least six wet diapers in 24 hours, with no longer than eight hours between wet diapers. If your baby falls below that threshold, or if you notice a dry mouth, no tears when crying, or a sunken soft spot on the head, dehydration is becoming a concern and you should contact your pediatrician promptly.
When to Reintroduce Regular Feeding
Once your baby has kept fluids down for a few hours, you can start moving back toward normal feeds. If you’re breastfeeding, simply increase nursing time and frequency. If your baby is formula-fed, return to full-strength formula at regular volumes. The old advice to restrict babies to the BRAT diet (bananas, rice, applesauce, toast) is outdated. The American Academy of Pediatrics, the CDC, and the WHO all recommend resuming age-appropriate foods as soon as rehydration is underway. Breastfeeding should continue throughout, and formula-fed babies should return to their standard formula rather than switching to a diluted or special version.
Restricting a baby to bland or limited foods can actually slow nutritional recovery. If your baby is old enough for solids, offer the same foods they normally eat once the vomiting has settled.
Positioning and Prevention
How you hold your baby during and after feeds makes a real difference, especially for babies prone to reflux-related vomiting. Keep your baby upright against your body for at least 30 minutes after every feed. This lets gravity help keep stomach contents down while the stomach empties naturally. Avoid bouncing, vigorous play, or laying your baby flat immediately after eating.
Burp your baby at natural pauses during the feed rather than waiting until the end. For bottle-fed babies, a slow-flow nipple reduces the amount of air swallowed, which cuts down on the pressure that pushes milk back up.
Don’t Give Over-the-Counter Anti-Nausea Medicine
It’s tempting to reach for something in the medicine cabinet, but over-the-counter anti-nausea and anti-diarrheal medications are not recommended for infants. Antidiarrheal medicines are generally unhelpful for infectious causes and can prolong the illness. Stomach medicines containing salicylates should never be given to children. If vomiting is severe enough that you’re considering medication, that’s a signal to call your pediatrician rather than self-treat.
Red Flags That Need Emergency Care
Most vomiting episodes resolve without medical help, but certain signs mean your baby needs to be seen immediately:
- Green or yellow-green vomit. This indicates bile and can signal a bowel obstruction.
- Blood in the vomit, or vomit that looks like dark coffee grounds.
- Your baby is floppy, unusually irritable, or less responsive than normal.
- Sudden, severe abdominal pain (babies will typically draw their knees up and scream inconsolably).
- A stiff neck, rash, or sensitivity to bright lights, which can point to meningitis.
- You suspect your baby swallowed something toxic.
If your baby can’t keep any fluids down at all, or if vomiting persists beyond 24 hours, contact your pediatrician even if none of the above red flags are present.
Pyloric Stenosis: A Special Case in Newborns
If your baby is between three and six weeks old and has started vomiting forcefully after every feed, pyloric stenosis is a possibility worth knowing about. This condition happens when the muscle controlling the outlet of the stomach thickens and blocks food from passing through. The hallmark is projectile vomiting that gets progressively worse over days. You may notice a wave-like motion across your baby’s stomach right after eating, just before the vomiting starts. A doctor can sometimes feel an olive-sized lump in the baby’s abdomen during an exam. Pyloric stenosis is corrected with a straightforward surgical procedure, and babies typically recover quickly afterward.