While infant vomiting is common, often a temporary response, it can also signal a more serious issue. Knowing how to react effectively supports the infant’s comfort and well-being.
First Actions After Your Infant Vomits
Immediately after an infant vomits, ensuring their airway is clear is the first priority. Gently turn the baby’s head to the side or hold them face down across your arm to help the vomit drain and prevent choking. Once the immediate episode passes, clean the infant thoroughly to remove any residue, as stomach acid can irritate sensitive skin.
Observe the infant’s general state, noting their alertness and skin color. Distinguishing between normal spit-up and true vomiting is important; spit-up is typically an effortless overflow of milk, whereas vomiting involves a forceful expulsion of stomach contents. Vomiting often results from a stomach infection or overfeeding, but sometimes it can be triggered by coughing or motion sickness.
Reintroducing Feeding Safely
After vomiting, allow the infant’s stomach to rest for 30 to 60 minutes. This pause helps the digestive system calm before reintroducing fluids. The goal is to prevent dehydration by rehydrating the infant.
For breastfed infants, continuing breastfeeding is generally recommended, as breast milk is easily digestible and helps with rehydration. Offer shorter, more frequent feeds, such as nursing for 1 to 2 minutes every 10 minutes, or 5 minutes every 30 to 60 minutes if vomiting persists. If the infant continues to vomit, pumped breast milk given in very small amounts, like 1 to 2 teaspoons every 5 minutes by spoon or syringe, might be better tolerated.
For formula-fed infants, or breastfed infants who are not tolerating direct feeds, oral rehydration solutions (ORS) can be given. These solutions, available commercially, contain the precise balance of water, salts, and sugars needed to replace lost fluids and electrolytes. Administer ORS in small, frequent amounts, such as 1 to 2 teaspoons every 5 minutes, gradually increasing the quantity as tolerated. If ORS is not available, formula can be given in smaller amounts until an ORS can be obtained.
Solid foods should be avoided while an infant is actively vomiting. Once the infant has gone approximately 6 to 8 hours without vomiting and is tolerating liquids, bland, easily digestible foods can be slowly reintroduced. Examples include infant cereals, crackers, or plain toast, gradually returning to their normal diet over the next day or two.
Signs Your Infant Needs Medical Help
Seek immediate medical attention if an infant’s vomiting is serious. Dehydration is a concern, with symptoms including a sunken soft spot on the head, sunken eyes, or few to no tears when crying. Other indications of dehydration include a dry mouth, reduced urination (fewer wet diapers than usual), or appearing unusually drowsy or irritable.
Medical evaluation is also necessary if the infant experiences projectile vomiting, or if the vomit contains blood or appears green (bile). A high fever, severe abdominal pain, or lethargy are also warning signs. If vomiting persists for an extended period, generally more than 12-24 hours for older infants or if the infant is under three months old with a fever, seek professional medical advice.