SYMPTOMS

What is infant vomiting?

Infants refer to children under 1 year old. Infant vomiting is a common symptom during infancy, manifesting as vomiting shortly after birth, spitting up, or regurgitating stomach contents containing bile.
Vomiting may be physiological and harmless, or it may indicate a serious condition requiring immediate medical attention.
Accompanying symptoms of vomiting often include nausea, a feeling of wanting to vomit. Vomiting may cause some discomfort, and the vomitus can consist of food, digestive fluids, bile, fresh blood, or coffee-ground-like material.
If vomiting is caused by an illness, it is often accompanied by other symptoms of the disease, such as fever and diarrhea in acute gastroenteritis, abdominal distension, crying due to pain, and lethargy in intestinal obstruction, or fever, bulging fontanelle, lethargy, and even seizures in encephalitis, etc.

Where does infant vomiting commonly occur?

Vomiting is a gastrointestinal symptom. The "trigger points" that cause vomiting are usually located in the upper digestive tract, including the mouth, throat, esophagus, stomach, duodenum, etc.

What is the mechanism of infant vomiting?

Vomiting occurs due to increased pressure in the stomach, forcing stomach contents to reflux through the esophagus and exit the mouth. The mechanism of vomiting involves complex neural reflexes. Causes of vomiting include not only gastrointestinal diseases but also metabolic and infectious diseases, such as acidosis and meningitis.

When does infant vomiting typically occur?

Vomiting in children of different ages may indicate different conditions. For example, vomiting in healthy infants after feeding may indicate spitting up, while vomiting in newborns may suggest swallowing syndrome. Vomiting lasting over 12 hours in newborns or over 24 hours in other infants is considered "prolonged" and requires immediate medical attention.

What is the difference between infant vomiting and spitting up or regurgitation?

Broadly speaking, vomiting includes spitting up and regurgitation.

In a narrow sense, infant vomiting usually refers to pathological reflexes or symptoms. Spitting up or regurgitation typically describes a physiological phenomenon in infants, where milk reflux occurs due to immature development of the lower esophagus, often accompanied by burping. Spitting up or regurgitation is usually mild, does not cause discomfort to the infant, and improves with development.

Does infant vomiting affect vaccination?

After evaluation by a professional, vomiting caused by non-severe conditions, such as mild gastroenteritis or spitting up, usually does not affect vaccination.

TREATMENT

What to Do When a Baby Vomits?

1. If a baby vomits without other abnormal symptoms, you can temporarily stop feeding for 1–4 hours to reduce digestive burden and avoid further vomiting or choking. Refer to the section below on "What Can Be Eaten?"
2. When a baby vomits, close supervision is needed. Turn the baby on their side promptly to prevent choking or aspiration.
3. To reduce spitting up or reflux, burp the baby after feeding.

What Tests Are Needed for Infant Vomiting?

The most important steps are a thorough medical history and physical examination. If related illnesses are suspected, tests may include abdominal X-rays, complete blood count, blood gas analysis, electrolytes, biochemical tests, vomit analysis, urinalysis, etc.

What Can a Baby Eat While Vomiting?

Method 1:

• After acute vomiting with no other discomfort, stop feeding for 4–6 hours to let the digestive tract rest before resuming.
• During fasting, fluids are allowed. Offer small, frequent sips of oral rehydration solution (ORS III) to prevent/treat dehydration—e.g., no more than 5 mL per spoonful every 1–2 minutes. Total fluid intake should be 50–100 mL/kg over 4 hours, adjusted based on vomiting volume.
• If no vomiting occurs within 4–6 hours, try liquids like breast milk or formula.

Method 2:

• After acute vomiting with no other discomfort, stop food and water for 1 hour. If no vomiting occurs, try small amounts of breast milk, formula, or other easily digestible liquids, gradually increasing (e.g., 30, 60, then 90 mL hourly).
• If feeding isn’t tolerated, fast for another hour before retrying or switch to Method 1.
  Once liquids are tolerated, transition slowly from fluids to semi-solids, then to normal diet within a day.

Note: If vomiting persists/worsens despite these measures, seek medical attention promptly.

What Should a Baby Avoid After Vomiting?

Avoid feeding immediately after vomiting, especially solid foods requiring chewing.

Medication for vomiting is rarely needed, so parents should avoid self-administering drugs.

DIAGNOSIS

When should you seek medical attention for infant vomiting?

Seek immediate medical attention if an infant's vomiting is accompanied by the following symptoms or conditions:

• Frequent vomiting that interferes with feeding.
• Weakness, lethargy, or irritability after vomiting.
• Signs of dehydration, such as reduced urination, dry mouth, or altered mental state.
• Presence of bile, blood, or coffee-ground-like material in vomit.
• Prolonged vomiting (>12 hours for newborns, >24 hours for infants under 1 year).
• Accompanying symptoms like abdominal pain, bloating, bulging fontanelle, fever, seizures, or jaundice.

Is it normal for a baby to be drowsy after vomiting?

While brief fatigue and paleness after vomiting may occur, excessive drowsiness is abnormal and requires immediate medical evaluation.

POTENTIAL DISEASES

What are the possible causes of vomiting in infants?

Infant vomiting may be associated with the following conditions:

1. Swallowing Syndrome: Characterized by vomiting mucus or blood within hours after birth, often related to the newborn swallowing amniotic fluid during delivery. If vomiting affects feeding, gastric lavage with warm saline may be used for treatment.
2. Intestinal Obstruction: Various causes, such as intussusception or developmental abnormalities, can lead to intestinal obstruction. It may cause bilious vomiting, which is a medical emergency in infants requiring immediate attention.
3. Acute Gastroenteritis: Mostly caused by viral infections, such as rotavirus or norovirus. Often accompanied by fever and diarrhea.
4. Food Allergy: Typically occurs after ingesting allergenic foods like cow's milk protein or eggs. IgE-mediated food allergies can trigger vomiting within minutes, along with other allergic symptoms like rashes.
5. Inherited Metabolic Disorders: A rare cause of vomiting in infants, but early identification can be life-saving. Examples include organic acidemia, which may present as lethargy, feeding difficulties, and acidosis in newborns.
6. Meningitis: Caused by increased intracranial pressure. Symptoms may include fever, altered consciousness (e.g., lethargy or coma), and a bulging fontanelle upon examination.
7. Gastrointestinal Malformations: Vomiting and drooling appear shortly after birth. Esophageal atresia is often associated with polyhydramnios.
8. Hirschsprung's Disease: Gradual onset of abdominal distension, reduced bowel movements, and possible vomiting after birth.
9. Improper Feeding: The infant is otherwise healthy with normal growth, but history reveals overfeeding.