Is it normal for newborn to vomit after feeding?
Vomiting can be part of many illnesses in children and babies. This is usually not a major concern as long as your child seems to behave differently.
Vomiting is frequent in infants and young children. Vomiting occurs when food is returned from the stomach. The amount of vomit can often seem more significant than it is.
Types of vomiting
It is important to pay attention and know the difference between real vomiting and just spitting up. Vomiting is the forceful throwing up of stomach contents through the mouth. However, spitting up is the easy flow of stomach contents out of the mouth, which is a natural thing that happens to newborns and babies under 6 months old.
There are different types of vomiting, including:
Possession – this is when your baby vomits small amounts after a meal.
Reflux – these vomitings are common in babies. This is due to the accidental opening of the valve at the top of the stomach. The content of the stomach slowly rises in the feeding tube (esophagus). Reflux is not harmful to babies. They usually come out when they walk.
Vomiting of projectiles – this is when your baby strengthens the contents of his stomach. The amount of milk or food may seem right on the floor, but usually only represents the amount of the last food. Babies may occasionally vomit, but if this happens after every meal, you should immediately consult your doctor. This may be due to blockage due to muscle thickening at the exit of the stomach.
Common causes of a baby vomiting
The most common cause of vomiting in the baby during the first few days is that the remnants of the amniotic fluid that was swallowed in the womb, mixed with mucous produced by the lining of the baby’s stomach, in preparation for absorbing milk feeds.
Then the vomiting accrues after feeding. Meaning that the baby is taking larger volumes of milk (breast milk of formula) while his digestive system is not yet fully used, which is normal, and that is the main reason for the vomiting/spitting up.
When the milk comes shortly after a meal, it looks (and feels) about as it fell: a milky liquid. If the milk comes a moment after the meal, it is usually partially digested and often contains pieces of curd. Partially digested breast milk does not tend to have a strong odor, but the formula will usually have it.
Another reason why babies often vomit is that the muscle valve at the top of their stomach (between the esophagus and the stomach) is weak and immature. In adults, this valve closes after ingestion of food to keep it to a minimum. It takes a lot of effort to open this valve to allow an adult to surrender. For babies, the valve closes, but not so tightly. It can easily be forced with a slight pressure behind.
During the normal process of digestion of milk (and food), and then to guide the stomach contents in the intestine, it exercises a “contraction”. The pressure of these contractions can force the milk to stand up in the esophagus of the baby, to vomit. This can also happen if the baby’s belly is overcrowded or gently squeezed. For example, placing the baby too far over your shoulder, or if your baby is lying down while sitting or having a “tummy”.
Most babies who often vomit are happy, healthy and become more burdensome. They will eventually “live” by the time they are a year old (or even earlier for some). This can improve somewhat after about six months when your baby is finally sitting and spending more time in an upright position because gravity often helps to keep things low.
Other possible causes of newborn vomiting include:
- Motion sickness
- Excessive crying
- A cough
- Being hugged
- Ear infection
- Food allergy
- Urinary infection
When do I have to worry about my baby vomiting?
Although newborns usually vomit, according to NUH, if your child has any of the following symptoms, you should immediately take him to the doctor:
- Eyes cast
- Less than five wet diapers per day
- Dry skin, mouth, and tongue
- Fontanelle casting (the weak point on his head)
- I do not want to drink
- Vomiting without stopping for more than four to six hours
- Diarrhea more than six times a day
- Fast breathing
- Fever above 39 ° C for more than 12 hours
- Fresh or grayish skin
- The vomit is green
When does my doctor need to be involved?
Call your doctor if your baby’s vomiting is persistent or uncontrollable. This includes a baby who continues to vomit despite an empty stomach (called dry heaving) or who continues to vomit over several hours, unable to tolerate any liquids.
Call if the color of the vomit is red, dark brown, or black. These are all colors associated with blood. Green vomit contains bile and is also worrisome – a doctor should evaluate any child who has it.
Anytime you think that the vomiting is becoming projectile, your baby should be evaluated for pyloric stenosis.
What tests need to be done, and what do the results mean?
Vomiting rarely requires medical tests. In the case of bloody or green vomit, however, an X-ray may be helpful to look at the bowels. X-rays can show poor functioning in the intestines.
If there is blood in the vomit, then a complete blood count may be done to make sure that the baby is not losing too much blood. In extreme cases, if there is a significant amount of bleeding associated with the vomiting, then a small camera can be inserted through the mouth into the esophagus, stomach, and intestine in order to look for the source of the blood. This is called endoscopy.
If pyloric stenosis is suspected, then a physical exam may reveal a small round lump where the outlet of the stomach is. This lump, which feels like an olive, represents the actual thick and tight pyloric sphincter. To confirm the diagnosis, your doctor will do an ultrasound. Sometimes babies must drink some milk during the ultrasound so that the liquid can be followed down to the stomach and the outline of the enlarged pyloric sphincter can see.
What are the treatments for baby vomiting?
The primary treatment for most types of vomiting is time. If an infection (such as a virus or bacteria) is the cause, then the infection will typically pass, and the vomiting will subside. Some infections – such as parasites – require treatment with specific medications.
There are medications available to stop acute vomiting. These medications, called antiemetics, are rarely used in infants but may be recommended by your doctor if a child is becoming dehydrated. The most common of these is promethazine (also called Phenergan), given in the form of a rectal suppository since the oral form usually will not stay down in a vomiting child.
If pyloric stenosis is the cause of the vomiting, then the treatment is surgery. The surgery is a relatively simple procedure whereby the thickened, tight pylorus is cut to release the pressure on the outlet of the stomach. Children are often drinking within hours of the surgery, and the forceful spitting up resolves completely.
Bottom line, if any unusual situation or any of the above symptoms occur, you must see a doctor. Consult a doctor before giving any medication to your baby, especially the first time.