Babies and toddlers get sick quite a bit during the first few years of life. While it might seem startling to see your baby throw up for the first time, it’s actually quite common and often nothing to worry about.
In many cases, baby vomiting goes away on its own with a little TLC from you. But sometimes a toddler or baby throwing up can be a sign of something more serious that warrants a check-in with your pediatrician.
If your baby or toddler is vomiting, read on for the potential causes and when your child might need treatment.
Vomiting vs. spit up: What’s the difference?
During the first year of life, it’s usually very normal for babies to spit up frequently. Newborns have an immature sphincter between the esophagus and stomach, which allows food to easily come back up. In older babies, a little milk can make its way out when burping. Vomiting, on the other hand, is more forceful and may be caused by an underlying infection or condition that may require medical attention.
If your baby has no other symptoms and the discharge looks cheesy, it’s probably ordinary spit up. Spitting up should decrease with age. Be sure to talk to your doctor if your baby spits up every time she eats and isn’t gaining weight.
If your baby or toddler is vomiting and has other symptoms, such as fussiness after feedings, rashes or diarrhea, let your doctor know.
Why do babies and toddlers throw up?
Babies and toddlers may throw up for a number of reasons.
In the first few months of life, vomiting could be due to GERD (gastroesophageal reflux disease). Projectile vomiting in infants may be due to hypertrophic pyloric stenosis, which requires immediate medical attention. Later on, baby vomiting may be linked to motion sickness, food allergies, a gastrointestinal virus or food poisoning. Rarely, vomiting may be due to appendicitis, which is an emergency.
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Read on to narrow down the potential cause for your toddler or baby’s vomiting:
Reflux (GERD)
All babies spit up to some extent, but a baby repeatedly coughing and vomiting is a common sign of GERD. In babies with GERD, food backs up from the stomach into the esophagus because the esophageal muscle isn’t strong enough to keep it down, causing complications from acid reflux.
If your baby’s spit up gets worse with time and she has other symptoms, your doctor may diagnose GERD.
In addition to baby vomiting, other common GERD symptoms include:
- Refusal to eat
- Crying or arching the back during feedings, which may mean your baby is in pain
- Fussiness after feedings
- Blood or green color in the spit up
- Wheezing
- Coughing
See your pediatrician if you think your baby has GERD. A few strategies may help your baby feel better, including feeding smaller amounts of food more frequently, switching formula or bottles, and keeping baby upright for 20 to 30 minutes after feedings. Your doctor may also recommend medications that safely treat the symptoms of GERD.
Motion sickness
Motion sickness happens when you’re moving and the signals from your inner ears, eyes, muscles and joints don’t match up with how your brain processes movement. Your child might vomit when she’s in a car or boat or after she going on a playground swing or theme-park ride. Motion sickness tends to be more common in children and usually comes on suddenly.
Other symptoms of motion sickness beyond vomiting in children may include:
- Queasiness
- Yawning
- Sweating
- Pale or blue skin or mucous membranes
- Lack of interest in food
There’s no need to call your doctor if your child has occasional motion sickness; try to avoid giving your child a heavy meal just before car rides and offer the window seat. If motion sickness becomes a problem, consult your doctor for advice.
Food allergies or intolerance
Your baby may have food allergies or a food intolerance if she vomits almost immediately after eating. About 90 percent of all food allergies are caused by peanuts, tree nuts, milk, eggs, soy and wheat. (Keep in mind, that doesn’t mean you shouldn’t feed your baby these foods; in fact, doctors usually recommend starting them sooner to prevent food allergies.)
Other symptoms of a food allergy or intolerance in babies and toddlers may include:
- Skin rashes
- Hives
- Swelling of the lips or tongue
- Watery eyes
- Sneezing
- Wheezing
More serious symptoms of a food allergy include pale or blue skin, difficulty breathing or loss of consciousness. If you spot any of these symptoms, call 911 immediately.
Otherwise, schedule an appointment with your pediatrician if you notice these symptoms after your child eats. Your child’s doctor will diagnose a food allergy with a blood test or a skin-prick test.
A gastrointestinal virus
Gastrointestinal viruses, like rotavirus, are common and spread quickly among children in day care and other group settings. Your baby or toddler may have a gastrointestinal virus if she’s vomiting, and has other symptoms such as:
- Diarrhea
- Fever
- Stomach pain
Doctors usually recommend carefully watching your child and giving her bland foods (if your baby is eating solids) and plenty to drink. But be sure to call your doctor right away if your baby or toddler has signs of dehydration (more on that below).
Food poisoning
Foodborne bacteria like salmonella or E. coli can cause gastrointestinal symptoms including vomiting. Food poisoning is a prime suspect if the whole family gets sick with similar symptoms around the same time — it’s likely due to something everyone ate. Symptoms caused by the most common food poisoning germs can begin anywhere from six hours to six or seven days after exposure.
Other symptoms of food poisoning may include:
- Diarrhea
- Fever
- Stomach pain
- Nausea
- Headache
- Weakness
Most of the time food poisoning goes away on its own in a few days, although occasionally antibiotics are in order. (See below for food poisoning symptoms that deserve a call to the doctor.) In the meantime, ask your pediatrician how to keep your child comfortable and hydrated, and ask whether your child should drink an oral rehydration solution (like Pedialyte).
Appendicitis
Appendicitis is a relatively common but serious infection that’s most common in kids 10 years and younger but very rare in children under 3. The appendix becomes blocked, allowing bacteria to grow and causing inflammation and abdominal pain. It’s important to get your child checked out immediately, as the appendix can rupture and spill its contents into the abdominal cavity — which is a medical emergency.
In addition to vomiting, symptoms of appendicitis include:
- Stomach pain that’s usually around the belly button and may move to the lower right part of the belly; it might come and go and get increasingly intense
- Loss of appetite
- Low fever
- Diarrhea
- Swollen belly
If you suspect your little one has appendicitis, call her pediatrician immediately or head to the ER. Doctors may run any number of tests, including CT scans or blood tests, to diagnose appendicitis. If your child does have appendicitis, her appendix will need to be removed — usually with a minimally invasive surgery that typically takes less than an hour.
Pyloric stenosis
Pyloric stenosis is a narrowing of the pyloric sphincter muscle (a muscle located between the stomach and small intestine) that keeps food from passing into the small intestine. The condition usually begins when your infant is between 2 weeks and 2 months old; your doctor may suspect pyloric stenosis if your baby forcefully vomits after feeding. The following symptoms warrant a check-in with your doctor:
- Baby projectile vomiting (very forceful vomiting) within 30 minutes of feeding
- Bloody vomit
- Constant hunger (because your baby isn’t digesting enough food)
- Dehydration
- Constipation
- Weight loss
- Wave-like contractions (known as peristalsis) across your baby’s tummy after eating
A stomach ultrasound, X-rays and a blood test are used to diagnose the condition; it’s cured with surgery.
How to help your baby or toddler after they throw up
If your baby or toddler is vomiting, trust your instincts and don’t hesitate to call the doctor if something feels off. Fortunately, vomiting often goes away on its own, and there’s usually no need to worry if your child seems to be her usual self and is well enough to eat and play.
If you suspect a stomach bug, it’s a good idea to keep your child out of day care for at least 48 hours after the last time she vomited or had diarrhea.
Since vomiting can cause dehydration, your goal is to keep your baby or toddler hydrated. Give your child small sips of water or broth (avoid sugary drinks like juice until your child is feeling better). If you’re worried your baby or toddler might be dehydrated, ask your doctor about giving her an oral rehydration solution like Pedialyte. If she’s eating solids and still has an appetite, feed her the same foods she usually enjoys.
When should you seek treatment for a baby or toddler who is vomiting?
Vomiting can sometimes be serious. If you’re concerned about your baby’s vomiting, it’s always a good idea to check in with your doctor.
Call your doctor or head to the ER if your child:
- Vomits repeatedly and can’t keep down fluids
- Continues vomiting for more than 24 hours
- Has signs of dehydration, including fewer diapers (or less frequent trips to the potty), darker urine, sunken eyes or fontanel, tearless crying or listlessness
- Has vomit that’s green or bloody
- Is floppy or seems less responsive
- Is extremely irritable
- Has severe abdominal pain
- Is forcefully or strenuously vomiting
- Has a hard or bloated belly
- Has swelling or pain in the scrotum (in boys)
- Has pale or blue skin, difficulty breathing or loss of consciousness after eating (which may signal a food allergy)
You should also call the pediatrician’s office right away if you suspect food poisoning and your child has:
- Been vomiting for more than 12 hours
- Diarrhea that doesn’t get better in two days
- A fever of 100.4° F
- Feces that are bloody or black
- Bloody vomit
- Severe stomach pain
- Signs of dehydration
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