When adults vomit it is usually a sign of illness. For this reason, vomiting in a small baby may cause great concern that there is something seriously wrong. However, this is not necessarily so.
Many small babies have what is known as reflux. This occurs when the contents of the stomach flow back up the oesophagus, the passage between the mouth and stomach. In adults there is a type of valve mechanism preventing this happening, but this valve is often not developed in tiny babies. This can result in quite large amounts of milk coming out of the mouth, and even the nose, shortly after a feed or when the baby is ‘burped’.
Provided the baby seems happy, generally thriving and gaining weight, this regurgitation, called possetting, is quite harmless. It usually stops soon after solids are introduced into the diet and is reduced if the baby can be kept upright for a while after feeds. Some medicines are available to reduce the reflux and, in bottle-fed babies, thickening the feeds may help.
If a baby is vomiting at times other than shortly after feeding, appears distressed and is not gaining weight, medical advice should be sought. Infections of any sort and a range of other conditions may cause vomiting and need to be excluded.
A condition called pyloric stenosis, in which the opening at the lower end of the stomach is partly blocked, is present in about 2 per cent of babies. This causes projectile vomiting, in which large amounts of vomit can shoot out of the mouth, travelling quite a distance. The baby will fail to gain weight and a small operation may be necessary to relieve the obstruction.
As with many other symptoms in babies, such as fever, it is important to look at your baby as a whole. If the vomiting is mild and your baby looks well, there is unlikely to be a serious problem. But if your baby looks unwell, even if the vomiting is mild, or if the vomiting itself is very severe, you should take your child to be assessed by your doctor.
Last Reviewed: 30 November 2009