Spitting up? Baby vomiting? Projectile vomiting? Although these aren’t the best topics for dinner-table discussion, it’s helpful for parents to know what they’re dealing with when it comes to their baby’s peculiar spitting habits. Babies spit up frequently, so hang in there!
In making your assessment about whether your baby is spitting up or vomiting, consider force and distance, says Dr. Dina Kulik, a pediatric emergency medicine specialist at The Hospital for Sick Kids in Toronto. “If vomit is traveling a distance and with force, I would suggest seeing your doctor,” she says. Spit up, on the other hand, usually dribbles out of the mouth. Even if there’s a lot of it, it’s easily recognizable as it exits the mouth with less force than vomit.
How to Recognize Projectile Vomiting (Pyloric Stenosis)
Usually a baby vomiting means he’s simply caught a stomach bug, says Dr. Amy Halanski, a pediatrician with Doctor on Demand. Your baby may give a little cough and then vomit forcefully. Although your baby can’t tell you that his stomach hurts, he will act fussier than usual due to stomach discomfort. However, in very rare instances, the vomit can be a sign of something more. If your child is projectile vomiting, meaning that the vomit is actually shooting out from her mouth and traveling several feet, you should call your doctor immediately. This can be a sign of pyloric stenosis — the narrowing of the opening between the stomach and intestines. Halanski notes this usually occurs in babies ages of 3 to 5 weeks but may occur slightly earlier or later.
Many parents worry about projectile vomiting without realizing how rare and specific it is, notes Halanski. “It’s like something out of ‘The Exorcist’,” she says, “not just regular vomiting that travels a couple of inches.” She commonly finds that parents and grandparents are nervous about anything that leaves a child’s mouth — whether spit up or vomit — but she emphasizes that pyloric stenosis is rarely seen in children older than 6 months.
When to Seek Medical Care
Baby vomiting can be scary, but it usually doesn’t require medical attention. Instead, make sure your child is staying well-hydrated — nursing or bottle-feeding regularly — and give her plenty of attention. When your child vomits, pick her up or tilt her head to the side to move the vomit away from the mouth, says Kulik.
The following are red flags, according to Halanski, and if you see them, seek you should seek medical attention:
- A child less than 12 months old vomiting for more than a day
. - A child showing signs of dehydration, such as a sunken fontanelle (soft spot), tearless crying, dry gums and fewer wet diapers than usual.
- Blood-tinged vomit. While this can often be explained (for example, by mom’s cracked nipples), it shouldn’t be ignored.
- Bright green vomit. Halanski emphasizes that the vomit needs to be “the color of green grass or greenish-yellow” to be a cause for alarm.
- A child who seems lethargic or severely not himself. “I tell parents to trust their instincts,” says Halanski. If your child seems uninterested in his caregivers, much more spaced out than usual or uninterested in normal play, voice your concern to your doctor.
- If you suspect pyloric stenosis (projectile vomiting).
While the amount of fluid that comes out of a baby’s mouth can be alarming, being able to recognize harmless spit up and normal vomiting while ruling out pyloric stenosis, can help keep you calm — even when you’re covered in regurgitated food.
Keren Perles is a freelance writer and mother of three young boys — all of whom were happy spitters. She has written hundreds of articles on child health and development and is the founder of Heart and Mind Parenting.
