- Some degree of reflux is completely normal in babies as the muscular valve at the end of the food pipe, which keeps food in the stomach, is still developing. Reflux may cause your baby to bring up milk after a feed, and can also give him/her hiccups. As long as your baby is growing normally and is not showing any marked signs of distress, there is no need to worry.
- More severe reflux can cause your baby to cry and be sick, often after feeding. The long name for severe reflux is gastro-oesophageal reflux disease (GORD). This means that when your baby's tummy is full, food and stomach acid flow back up their food pipe causing discomfort and pain.
- If you have tried the measures described above and seen no improvement, see your GP. They will review your child’s symptoms and ask you about the formula you have used, and may possibly prescribe an antacid designed for babies.
- Click here to watch a video on reflux by Best Beginnings.
My baby is vomiting
Most babies vomit small amounts from time to time and bring up some milk when they burp. This is known as possetting and is usually nothing to worry about. You can tell when your baby is vomiting rather than posseting because there will be a lot more coming out.
Vomiting is also very common (up to half of all babies) and in most cases will improve with time. Although it might look like they are vomiting a lot, most babies continue to grow normally and do not look particularly distressed by it.
As long as your baby seems otherwise healthy and continues to gain weight, there's usually no need to worry or seek further help. There are some simple things you can do to help – click here for more information.
However, vomiting can occasionally be a sign of an underlying problem such as severe reflux, milk allergy, pyloric stenosis, a stomach bug or infection (see below). Below are some signs to look out for if you are worried.
When should you worry?
If your child has any of the following:
- Green vomit (like the colour of spinach or green washing up liquid)
- Becomes pale, mottled or abnormally cold to touch
- Becomes extremely agitated (crying inconsolably despite distraction)
- Becomes floppy or very lethargic (difficult to wake)
- Becomes stiff for a prolonged period or has rhythmic, jerky movements of arms or legs that does not stop when you touch it (a fit/seizure)
- Is going blue around the lips or has difficulty breathing
- A rash that does not disappear with pressure (see the “Glass Test”)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
- Vomits forcefully (shoots across the cot or the room)
- Becoming increasingly sleepy and not consistently waking for feeds
- No wet nappies in the last 8 hours
- Has a dry mouth or sunken fontanelle (soft spot on the head)
- Has trouble putting on weight or is constantly arching their back and crying when feeding
- Ongoing vomiting with blood in the poo
- Is getting worse or you are worried
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest ED.
- If none of the above features are present
- Continues to feed well
- Has plenty of wet nappies
- Baby wakes up or cries
regularly for feeds
- Additional advice is also available to young families for coping with crying of well babies – click here.
Self care
Continue providing your child’s care at home. If you are still concerned about your child contact your Health Visitor or call NHS 111 – dial 111
Conditions that can cause a baby to vomit:
- Cow's milk proteins are found in many types of formula milk. They'll also make their way into your breastmilk if you eat or drink milk or other dairy products, such as cheese and yoghurt.
- If your baby has a cow's milk allergy, they may vomit after feeding. It can be difficult to tell the difference between this and reflux. But if your baby has problems with cow's milk, they may also have:
- eczema
- colic
- diarrhoea or constipation
- trouble putting on enough weight
- history of allergies in your close family
If you're worried that your baby has problems with cow's milk, there are steps you can take. If you breastfeed your baby, you could try cutting cow's milk from your diet for 2 weeks. If your baby is formula-fed, trying a hypoallergenic formula may help.
Talk to your doctor before trying these, though. They will check your baby's symptoms first, so they can be sure of what's causing them.
Click here to watch a video on milk allergy by Best Beginnings.
- This is a rare condition that can cause your baby to vomit forcefully within half an hour of feeding.
- Pyloric stenosis is most likely to begin when your baby is about six weeks old, but could show up at any time before they reach four months of age. It can sometimes run in families, and boys are about four times more likely to get it than girls.
- It happens because the muscle controlling the valve leading from the stomach into the intestines has thickened, stopping enough food and milk to get through, so it stays in the stomach and then comes back up. The problem is easily corrected with minor surgery.
- If your baby's vomiting begins suddenly, or if they also have diarrhoea, they may have a tummy bug (gastroenteritis). Gastroenteritis is usually caused by a viral infection and needs no specific treatment. An attack of vomiting will generally subside six hours to 24 hours after it starts.
- Do not stop giving your baby milk. If you are breastfeeding, continue doing so. If your child is on formula, do not dilute it.
- Babies under 6 months of age are at more risk of becoming dehydrated than older children, which is why it is important to make ensure that they are drinking enough. Give your baby oral rehydration fluids in between feeds or after each watery stool. Your pharmacist will be able to advise you about which solution is best for your baby. Little and often tends to work best – in hospital, babies are given 1 or 2 tablespoons (5-10 mls) of fluid to drink every 5-10 minutes. You can try using a syringe to give fluids to your child.
Your baby may be vomiting because they have an infection. This is usually associated with a temperature above 38°C / 100.4°F. Although the most likely cause is a viral infection, other causes include urinary tract infections or very occasionally a more serious illness such as meningitis or sepsis. Signs of a serious infection include:
- becomes pale and floppy going blue around the lips
- is fretful or excessively miserable when touched
- becomes difficult to rouse
- is finding it hard to breathe
- develops a rash that does not disappear with pressure (the Glass Test)
Your child needs urgent help if any of these features are present - go to the nearest hospital emergency (A&E) department or phone 999.
What should you do?
If you are breastfeeding, seek advice from a breastfeeding specialist, either a specially trained health visitor or a breastfeeding counsellor. It is possible that your baby is not latching on properly. Click here for more information.
If you are bottle feeding, ensure your baby is in the right position (sitting almost upright) and that you use the recommended amount of powder (it is quite easy to use too much if you have changed product, or using a different scoop than the one provided in the tin).
It is also quite easy to give your baby too much milk when you are bottle feeding.Their stomach is only small and most babies need little and often: 6-7 feeds per day is the norm, including at night (click here for more information). Your health visitor can help review how much milk you baby should need and the timing of the feeds.
However, if after 2 weeks you are still concerned, seek advice from your health visitor or GP.
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.