Is it normal for my baby to vomit?

It’s common for babies to vomit frequently in the early weeks as they adjust to feeding and as their bodies develop. You can tell when your baby is vomiting rather than just possetting (bringing up small quantities of milk), because there will be a lot more coming out, not just a few teaspoons trickling down his chin. It can be frightening for your baby, so he’s likely to cry.

Everything from car sickness to indigestion can cause your baby to be sick – even a prolonged bout of crying or coughing can trigger this reflex. So you may see quite a lot of vomiting in your baby’s first few years.

An attack of vomiting will generally subside six to 24 hours after it starts, without any particular treatment apart from a change in diet (see below, about how to deal with vomiting). As long as your baby seems otherwise healthy and continues to gain weight, there’s usually no need to worry.

When should I worry?

During your baby’s first few months, vomiting is probably caused by mild feeding problems, such as his tummy being too full. After the first few months, a sudden onset of vomiting is more likely to be caused by a stomach virus, such as gastroenteritis, which is often accompanied by diarrhoea.

Your baby may also be sick when he has:

• a cold
• a urine infection
• an ear infection

Once your child is a little older, it can sometimes be a symptom of more serious illnesses. Call your doctor if you notice any of the following warning signs in your baby:

• Signs of dehydration, including a dry mouth, lack of tears, sunken fontanelle, and fewer wet nappies than usual (less than six nappies a day).
• A fever, with a temperature of 38 degrees C or higher if he is younger than three months, or 39 degrees C or higher if three months or older.
• Refusal to breastfeed or drink his formula milk.
• Vomiting for more than eight hours, or vomiting with great force.
• A non-blanching rash, which is a rash that doesn’t fade when the skin is pressed.
• Sleepiness or severe irritability.
• A bulging fontanelle.
• Shortness of breath.
• A swollen abdomen.
• Blood or bile (a green substance) in the vomit (see below).
• Persistent forceful vomiting in a newborn within half an hour of eating (see below).

Blood or bile in the vomit: This is usually nothing to worry about. It may happen when the force of regurgitation causes tiny tears in the blood vessels lining the food pipe (oesophagus). Your baby’s vomit may also be tinged with red if he has swallowed blood from a cut in his mouth or has had a nosebleed in the past six hours.

However, call your doctor if your baby continues to have blood in his vomit or if the amount is increasing. The doctor will probably want to see a sample of the vomit if it contains blood or bile, so, although it may be an unpleasant task, try to save some. Green bile can indicate that the intestines are blocked, a condition that needs immediate attention.

Persistent or forceful vomiting in a newborn within half an hour of eating: This may be due to pyloric stenosis, a rare condition that is most likely to begin when your baby is a few weeks old, but could show up at any time before he reaches four months.

The baby vomits when a muscle controlling the valve leading from the stomach into the intestines has thickened so much that it won’t open up enough to let food through. The problem is simple to remedy with minor surgery, but it does require immediate medical attention.

How should I deal with vomiting?

Every child is going to be sick sooner or later, and usually it’s nothing to worry about. Like every other part of parenthood, it’s something you’ll soon get used to, and there are steps you can take to help him get better:

• Keep him hydrated: When your baby vomits, he’s losing precious fluids. It’s important to replace them so he won’t get dehydrated. To do this, give him sips of oral rehydration solution (ORS), such as Dioralyte, a few times an hour, alongside his usual breastmilk or full-strength formula, and water. Don’t give your baby fruit juices or carbonated drinks.
• Ease him back into his routine: If your baby hasn’t vomited for 12 to 24 hours, you can begin moving back to his usual diet, but keep giving him plenty of fluids. Start with easy-to-digest foods such as cereal or yoghurt. You can also try using frozen clear liquids, such as ice lollies, if your child is over 12 months.
• Help him rest: Going to sleep may also help settle your baby. The stomach often empties into the intestines during sleep, relieving his need to vomit.

Don’t give your child anti-nausea medicines (prescription or over-the-counter), unless your GP has prescribed them.

If your baby attends childcare or nursery, keep him at home until at least 48 hours after his last episode of vomiting.

One of the saddest things for a new parent is watching their baby suffer through his first cold. Your baby will be uncomfortable, snuffling, and probably will have trouble feeding. It’s hard to watch, but there’s a lot you can do to alleviate the discomfort. And you can be assured that it’s called the common cold for a reason, and it’s usually not serious. Experts estimate that your baby will get between eight and 10 colds in his first two years alone. That’s a lot of tissues and long nights.

What causes colds?

Colds are upper respiratory tract infections caused by one of many different viruses. They’re most commonly spread when someone with a cold sneezes or coughs and unleashes a cold virus into the air to be inhaled by someone else. They can also commonly be transmitted through hand-to-hand contact, so always wash your hands after blowing your nose. Babies tend to get a lot of colds because they’re born with immune systems which function at about 60% of capacity.

How do colds affect babies?

Few things are more frustrating than a baby with a cold. A sick baby will probably have a fever (up to 101 degrees F / 38 degrees C), cough, reddened eyes, a sore throat, and runny nose. Your child may also be irritable and lose his appetite. Babies under six months old can’t breathe through their noses when they’re all stuffed up, so they have trouble breathing and eating. Children aren’t usually developmentally ready to blow their own noses until about the age of four, so you’ll have to help younger children clear the mucus.

If your baby has been sleeping through the night, you’ll be reminded of those first few weeks of life. He’ll probably wake up several times during the night due to his discomfort and difficulty breathing. Expect to be up with your baby, comforting him and wiping his nose.

How long do colds generally last?

Symptoms generally abate after three to 10 days, though in very young babies they may last up to two weeks. Most babies who have some exposure to older children will experience six to 10 colds during their first year; it may seem as if his nose is runny all winter long.

Can I help prevent my child from getting colds?

Breastfeeding is one of the best ways to protect your baby’s health, since as long as he’s breastfeeding, he’s getting your antibodies and your natural immunities. This isn’t a foolproof way to protect your baby’s health, but when breastfed babies do become ill, their cold symptoms are generally mild.

You can also try to protect your child by keeping him away from those who are ill and by asking all sick family members to wash their hands thoroughly before handling your baby or his things.

If you or your partner smoke, give it up, and refrain from taking your baby to areas where someone has been smoking. Children who live with cigarette smokers have more colds and their colds last longer than their peers who aren’t exposed to smoke.

When should I consult the doctor?

Do so at the first sign of illness if your child is less than three months old. In an older baby, call your doctor if a cold persists for more than five days; if your child’s temperature climbs above 102 degrees F / 39 degrees C; or if he has an earache, breathing problems, wheezing, a persistent cough, or a persistent, thick, green mucus running from his nose.

How do I treat a cold?

There’s little you can do except ride it out, and help your child get plenty of rest and liquids (increase the amount of vitamin C-rich fruit juices). If he’s feverish, you can give him paracetamol suspension under a doctor’s direction. Don’t give him any cold remedies without consulting your GP or local pharmacist. In children under one year old, over-the-counter cold medications often do more harm than good, and cough medicines have been shown to be no better than a non-medicated syrup for easing symptoms. Nonetheless, there are some remedies to ease his discomfort:

• If your baby is congested, elevate the head of the mattress with an old towel or two. Sleeping at an incline may help relieve your baby’s postnasal drip. (Do not use pillows to prop your baby up — they can pose a suffocation hazard — or pillows under the mattress.)

• Because babies are too young to blow their noses, the best way to help them breathe more easily is to wipe their noses. You can also apply petroleum jelly to the outside of your baby’s nostrils to reduce irritation. If your child is having trouble breastfeeding with a stuffy nose, you may like to ask your GP to prescribe saline drops to apply to each nostril 15 minutes before a feed. Some parents then use a suction bulb to clear the nose of salt water and mucus.

• Try a cool mist vaporiser to moisten the air. Or take your baby into the bathroom with you, turn on the hot water or shower, close the door, and sit in the steamy room for about 15 minutes. Remember to change your baby into dry clothes after the steam bath.

• If your child has a stuffy nose without any other symptoms, check his nostrils for foreign objects. You never know: even little ones are capable of putting things up there.

Colds are a fact of life. Once you’ve survived your baby’s first one, you’ll know what to expect with the next.

It can be heartbreaking looking after a baby who is not well. Our baby health articles will help you to deal with concerns such as colds and fevers, to recognise common childhood illnesses and decide when to call the doctor. We also answer your queries about immunisations.