Should Your Newborn Be Fed After Vomiting?

Vomiting is a common occurrence in newborns and can be caused by various factors, including overfeeding, acid reflux, or a stomach bug. While it can be worrying for parents, vomiting is often not a cause for concern and usually stops within 24 hours. However, it is important to monitor your newborn's health and look out for signs of dehydration, such as a decrease in the number of wet nappies or dark yellow urine. In most cases, you can continue feeding your baby after vomiting, but it is recommended to start with small amounts of milk and gradually increase the amount as they keep it down. If your baby is vomiting frequently or shows other signs of illness, it is important to seek medical advice.

When to feed your baby after vomiting

It is common for babies to vomit, especially after feeding, and this usually isn't something to worry about. Their new digestive systems are still getting used to feeding on, digesting, and eliminating milk. However, vomiting can also be a sign of illness or complications, so it's important to know when and how to feed your baby after they have vomited.

When to Feed Your Baby Again

If your baby is hungry and takes to the bottle or breast after vomiting, you can go right ahead and feed them. It's a good idea to start with small amounts of milk and wait to see if they vomit again. If your baby is at least 6 months old and doesn't want to feed after vomiting several times, offer them water. Wait a while and then try feeding them again.

When Not to Feed Your Baby

If your baby is vomiting due to an earache or fever, it's best to give them medication first and then wait 30 to 60 minutes before feeding them again. If your baby is vomiting due to motion sickness, it's better not to feed them afterward. Instead, wait until you are out of the car to feed them.

When to See a Doctor

If your baby is vomiting a lot or seems unwell, call your pediatrician immediately. Take your baby to a doctor if they are showing other signs of illness, such as lethargy, sleepiness, or a lack of interest in feeding. Also, look out for signs of dehydration, such as a lack of tears when crying, no wet diapers for 8 to 12 hours, or a sunken fontanelle (the soft spot on the top of their head).

Preventing Vomiting

To help prevent vomiting after feeding, burp your baby often, and hold them upright for at least 30 minutes after feeding. Give your baby smaller, more frequent feeds and avoid overfeeding. If your baby is formula-fed, check that the bottle and nipple hole are the correct size, and don't let them continue sucking when the bottle is empty.

Remember, vomiting is usually nothing to worry about, but if you are concerned, trust your instincts and call your baby's doctor.

How to prevent vomiting

Vomiting is common in newborns and usually stops within 24 hours. However, if your baby is vomiting frequently, there are several ways to help prevent it:

• Feed your baby smaller amounts of formula more frequently.
• Feed your baby slowly.
• Burp your baby during and after feeding.
• Hold your baby upright for at least 30 minutes after feeding.
• Avoid active play or too much movement after feeding.
• Try using a smaller bottle with a smaller-hole nipple.
• Check the ingredient list on your baby's formula and consider trying a different type if necessary.
• Dress your baby in loose clothing and ensure their diaper isn't too tight.
• If your baby is constipated, talk to your doctor about possible remedies.
• If your baby has a stomach bug, you may need to ride it out for a day or two, but most babies will not require treatment.
• If your baby is vomiting due to an earache or fever, give them medication first and wait 30 to 60 minutes before feeding.
• If your baby is vomiting from motion sickness, it is best not to feed them afterward.

What to do if your baby is vomiting

It is common for babies to vomit, and in most cases, it is not a sign of anything serious. Vomiting can be caused by many things, but it is most commonly the result of gastroenteritis (the "stomach flu"). Other causes include food allergies, infections, appendicitis, and swallowing something poisonous. If your baby is vomiting, there are several things you can do to help:

• Offer small amounts of liquid to your baby. For babies, this could be about 1 tablespoon of oral electrolyte solution (ORS) every 15-20 minutes, or shorter but more frequent breastfeeding. For older children, offer 1-2 tablespoons every 15 minutes of ORS, ice chips, flat ginger ale or lemon-lime soda, clear broth, ice pops, or diluted juice.
• If your baby vomits again, wait 20-30 minutes and start over.
• Slowly increase the amount of liquids once there has been no vomiting for 3-4 hours.
• After 8 hours without vomiting, breastfeed your baby as usual and, if formula-fed, gradually introduce it again (1-2 ounces).
• Return to a regular diet after 24 hours without vomiting. However, continue to avoid fruit juice and fizzy drinks until your baby is feeling better.
• Make sure your baby is staying hydrated. If you think they may be dehydrated, take them to the doctor. Signs of dehydration include a dry mouth, sunken eyes, decreased urination, crying without producing tears, and drowsiness.
• Avoid milk products and solid foods until at least 8 hours after the last episode of vomiting.
• If your baby is formula-fed, check the hole in the bottle teat is not too big, as this can cause your baby to swallow too much milk and trigger vomiting.
• Dress your baby in loose clothing and ensure their diaper is not on too tightly.
• If your baby is vomiting forcefully, isn't gaining weight, is unusually sleepy or weak, or has blood in their vomit, take them to the doctor.
• If your baby has green bile in their vomit, this could be a sign of pyloric stenosis, a condition where the passage from the stomach to the bowel has narrowed. This requires medical attention.

When to call the doctor

If your baby is vomiting, it is important to monitor them and their behaviour for any other symptoms. If you are concerned about your baby's vomiting, it is always best to seek medical advice. Here are some signs and symptoms that indicate you should call your doctor:

• Dehydration: If your baby shows signs of dehydration, such as a sunken fontanelle (the soft spot on their head), fewer wet nappies than usual, and dark yellow urine, it is important to call the doctor. Dehydration can occur quickly in babies and children, so it is crucial to address this as soon as possible.
• Refusal to feed: If your baby refuses to feed or drink water, it is important to seek medical advice. This can lead to dehydration and malnutrition if left unaddressed.
• Prolonged vomiting: If your baby has been vomiting for 12 hours or longer, or if it has been going on for more than a day or two, it is important to call the doctor. Prolonged vomiting can lead to dehydration and malnutrition.
• Blood or bile in vomit: If your baby's vomit contains blood or green bile, it could indicate a serious issue. Call your doctor immediately if you notice any blood or green bile in your baby's vomit.
• Lack of tears: Crying without shedding tears is another sign of dehydration. If your baby cries and does not produce tears, it is important to seek medical attention.
• Lack of responsiveness: If your baby seems lethargic, sleepy, floppy, or uninterested in feeding, it could be a sign of dehydration or another underlying issue. Contact your doctor if your baby exhibits these behaviours.
• Weight loss: If your baby is losing weight and not thriving, it is important to seek medical advice. This could indicate that your baby is not getting enough nutrients and may be related to their vomiting.
• Other signs of illness: If your baby has a temperature, diarrhoea, a rash, or any other symptoms in addition to vomiting, it is important to take them to a doctor. These could be indicators of an infection or other illness.
• Vomiting after introducing solids: If your baby has recently started solids and is vomiting, it could be due to overfeeding or an inability to digest solid foods properly. Consult your doctor for advice on introducing solids and managing your baby's diet.
• Forceful vomiting: If your baby is vomiting forcefully, it could be a sign of a blockage or another serious condition. Projectile vomiting or forceful vomiting after most or all feeds should be evaluated by a doctor.
• Head injury: If your baby has had a head injury within the last 24 hours and is also vomiting, it is important to seek immediate medical attention.
• Weak immune system: If your baby has a weakened immune system due to conditions such as sickle cell disease, HIV, cancer, organ transplant, or the use of oral steroids, and they are vomiting, it is crucial to call the doctor.
• High fever: A fever over 104° F (40° C) in a baby is considered an emergency. Do not give your baby any fever medication before seeking medical attention.
• Behavioural changes: If your baby seems distressed, unusually irritable, or their behaviour changes significantly, it is important to trust your instincts and call the doctor. You know your baby best, so if you feel that something is not right, don't hesitate to seek medical advice.

How to tell if your baby is dehydrated

Vomiting is common in babies and can happen for many reasons. Most of the time, it is nothing serious, but it can sometimes lead to dehydration, which can be dangerous for babies if left untreated.

• A dry or sticky mouth
• Few or no tears when crying
• Sunken eyes
• In newborns, a sunken soft spot (fontanelle) on the top of the head
• Reduced urination or fewer wet diapers than usual
• Drowsiness or dizziness
• Constipation or fewer bowel movements
• Cold or discoloured hands and feet
• Floppiness when picked up

If you notice any of these signs, it is important to take your baby to a doctor or seek medical advice. Dehydration can be treated at home with extra fluids, but in more severe cases, your baby may need treatment in a hospital.

To prevent dehydration, offer your baby frequent feedings of small amounts, and burp them often. If your baby is vomiting, you can continue to feed them but start with small amounts of milk and see if they vomit again. If your baby is at least 6 months old and doesn't want to feed after vomiting, offer them water.

Frequently asked questions