Newborns And Vomiting: What's Normal And What's Not?

Newborns have underdeveloped immune systems, making them more susceptible to infections and other illnesses. It is common for newborns to get sick, especially in the first month of their lives, and they can exhibit a range of symptoms, from mild cold symptoms to more severe issues. Parents often have concerns about whether certain behaviours are typical or indicative of sickness. This article will explore the signs and symptoms of illness in newborns and provide guidance on when to seek medical advice.

Vomiting and diarrhoea

Treatment

If your baby is suffering from vomiting and diarrhoea, there are a few things you can do to help:

• Keep giving them lots of fluids to avoid dehydration. If your baby is formula-fed or on solid foods, give them small sips of water between feeds.
• Carry on breast or bottle-feeding. If your baby is being sick, try giving them smaller feeds more often than usual.
• If your baby is old enough to eat solid foods, wait until they feel able to eat and then avoid fatty or spicy foods.
• If your baby is in discomfort, you can give them paracetamol, but be sure to check the leaflet first.

When to Seek Medical Advice

Most babies with diarrhoea and vomiting do not need medical treatment, but trust your instincts. If your baby has a very high temperature or is showing signs of dehydration, contact your GP or a medical professional for advice.

Call your doctor or seek urgent medical advice if:

• Your baby is under eight weeks old and you are very worried about them.
• Your baby's vomiting lasts longer than one to two days, or they have diarrhoea for longer than five to seven days.
• Your baby seems to be deteriorating rather than getting better.
• Your baby has a temperature of over 38°C if they are less than three months old, or a temperature over 39°C if they are between three and six months old.
• Your baby has blood or mucus in their stool.
• Your baby's vomit is bile-stained (green) or contains blood.
• Your baby has severe abdominal pain.
• Your baby is vomiting constantly and cannot keep fluids down.
• Your baby is vomiting and develops a sudden and severe tummy ache, or they are floppy, irritable or less responsive.
• Your baby is vomiting and has a headache, stiff neck and a rash.
• You think your baby might be getting dehydrated. Dehydration can be very serious in newborns.

Signs of fever

It is normal for newborns to get sick because their immune systems are not yet fully developed. Newborns are susceptible to viruses and bacteria, and they can easily pick up infections from other children. The common cold and ear infections are two of the most common infections in newborns.

A fever is a single temperature reading of 100.4 degrees Fahrenheit or greater. A baby's normal temperature averages 98.6 degrees F. A fever is a rectal temperature of 100.4 degrees F or higher, or an armpit temperature of 99 degrees F or higher.

• Feeling excessively warm, especially when it's not hot in the room
• Seeming "off" and not wanting to feed
• Skin that is flushed or excessively pale
• Crying/fussiness: Prolonged episodes of inconsolable crying could be a sign of fever
• Excessive fatigue: Newborns who favour napping over eating may have a fever
• Reduced appetite: Take your baby's temperature if they suddenly lose interest in food
• Cold/flu symptoms: Check your baby's temperature if they have a cough or congestion
• Spitting up: More frequent and excessive spitting up could be a sign of vomiting
• Pulling at the ear: Ear infections can cause pain and discomfort
• Skin rash: Any type of rash should be evaluated by a doctor

If your newborn has a fever, it is important to take them to the nearest emergency department. Fevers in newborns can be a sign of a serious bacterial infection that requires urgent medical treatment.

Respiratory issues

Respiratory illnesses are common in newborns and can include colds, croup, pneumonia, ear infections, and stomach bugs. Newborns are at a higher risk of infections as they do not have a mature immune system. Their immune systems are underdeveloped, so they don't recognise many germs, making it easier for them to get sick and for infections to take hold.

Colds

Colds are very common in newborns and children. Children under six years old will have, on average, six to eight colds a year. Cold symptoms can include a stuffy nose, runny nose, fever, and sneezing. Colds can last around 10 days, but congestion can linger for longer. Summer colds are less common but can be caused by an enterovirus.

Ear Infections

Ear infections often occur as a complication of a cold. They are very common in children under three years old. Symptoms include a lack of energy, rubbing or pulling on the ear, not responding to quieter sounds, and irritability. Fluid may also drain from the ear.

Other Respiratory Issues

Other respiratory issues can include whooping cough (pertussis), which can be life-threatening and requires immediate medical attention. Respiratory syncytial virus (RSV) is another common respiratory infection in newborns.

Warning Signs

Warning signs of respiratory issues in newborns include:

• Bluish or gray lips, tongue, or face
• Trouble breathing, such as rapid, slow, or noisy breathing, or pauses in breathing
• Fever
• Not drinking fluids well
• Sleeping more than normal
• Listlessness or lethargy
• Not feeding well
• Irritability

Feeding problems

Feeding is the one reliable measure of a newborn's well-being. Newborns should be feeding well and often. If your baby isn't feeding well, or has abruptly changed their feeding pattern, you should call your baby's doctor.

Signs of Feeding Problems

• Has to be woken up for feeds or can't finish feeds
• Is hard to wake up for feeds
• Is refusing to feed or missing several feedings
• Is having trouble sucking at your breast or bottle
• Isn't hungry
• Is having problems spitting up
• Is losing weight
• Is unsettled during feeding
• Is crying and not settling
• Is not gaining weight
• Is vomiting forcefully or projectile vomiting
• Is spitting up large amounts of milk after most feedings
• Has diarrhoea
• Has a swollen or tender tummy
• Has blood in their poo
• Has green or yellow vomit, or vomit with blood in it
• Is not keeping fluid down
• Is not urinating regularly

If your baby is formula-fed, vomiting may be due to overfeeding or an intolerance to formula. If your baby is breastfed or formula-fed, they may have a physical condition that prevents normal digestion and causes vomiting. Discoloured or green-tinged vomit may mean that your baby has an intestinal obstruction.

If your baby is breastfed, do not change your diet. If formula-fed, give smaller feeds more often. Hold your baby upright during feeding and for as long as possible after feeding. Burp your baby regularly during feeds. Make sure your baby sleeps flat on their back.

Lethargy

• Irritability
• Restlessness
• Colic
• Hard to soothe
• Fever
• Changes in breathing
• Changes in appetite and dehydration
• Cold symptoms, like a cough and runny nose

Frequently asked questions