Vomiting in newborns

Vomiting in newborns: How to distinguish from spitting up

Vomiting in newborns is a symptom that always causes concern. Unlike the normal, safe spitting up, vomiting is an active, forceful expulsion of a significant portion or all of the stomach contents. It can be a sign of simple overfeeding or a signal of serious diseases, so it is important to be able to differentiate them and know when to consult a doctor.

Key differences between vomiting and spitting up

The main difference is the mechanism. Spitting up is a passive process when milk simply flows out. Vomiting is a forceful reflex act accompanied by contraction of the abdominal muscles and diaphragm. Often the baby becomes restless and cries before vomiting.

Possible causes of vomiting

• Overfeeding. The simplest and most common cause. A newborn's stomach is very small, and if the baby has taken too much, the excess will come out.
• Severe reflux (GERD). With pathological reflux, spitting up can be so strong that it resembles a "vomiting fountain".
• Gastroenteritis (intestinal infection). Usually accompanied by diarrhea, fever, and feeling unwell.
• Pyloric stenosis. This is a congenital narrowing of the stomach outlet that hinders food passage. A characteristic sign is forceful "fountain" vomiting 15-30 minutes after each feeding. This condition requires surgical treatment.
• Elevated intracranial pressure and other neurological problems.

When is vomiting dangerous?

A single episode of vomiting in a child who feels well is usually not a cause for panic. However, seek medical attention immediately if:

• Vomiting recurs and is a "fountain".
• Vomitus has a green, yellow, or bloody color.
• Vomiting is accompanied by fever, diarrhea, lethargy, or signs of dehydration.

Read about feeding basics and how to avoid overfeeding in our articles.