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Discharge Instructions: When Your Baby Spits Up or Vomits

Closeup of diaphragm with large opening allowing top of stomach and sphincter to move up into chest cavity. Stomach contents flow up into esophagus.
In babies, it’s common for a little bit of fluid to travel out of the stomach and up the esophagus.

At the top of the stomach is a muscle called the sphincter. When you eat, the sphincter opens to let food into the stomach. When you’re not eating, the sphincter stays closed to keep food inside the stomach. The sphincter is very relaxed in babies. It's easy for a little bit of the baby’s stomach contents to leave the stomach. The food travels up the food pipe (esophagus) and comes out through the mouth. This is called spitting up, and it’s normal. It usually doesn't need to be treated as long as your baby is gaining weight. Talk with your baby's healthcare provider if you are concerned about their weight gain. Spitting up is not the same as vomiting. Vomiting can sometimes be a sign of a serious problem. This sheet will help you know the difference.

What is spitting up?

Spitting up is sometimes called a wet burp. It usually happens during or right after feeding. Often only a small amount of liquid comes up. Many parents worry that a baby is spitting up most of the feeding. But usually it only looks that way. So you don't need to worry if your baby is having wet diapers and growing well. If your baby spits up, gently wipe the baby’s face and lips clean. Talk with your baby's healthcare provider about what to do if your child starts to choke on their spit-up.

What is vomiting?

Vomiting is more serious than spitting up. It’s more forceful. A larger amount of liquid or food comes up from the stomach. It may occur with fever or diarrhea. Vomiting can happen during or after a feeding. It can also happen when the baby isn’t eating. Vomiting can be a sign that the baby is sick (see the box below).

Signs of a problem

Call your baby's healthcare provider right away if your baby has:

  • Vomit that is green-tinged or red-tinged, even if the baby vomits only once

  • Vomiting that continues, no matter what the vomit looks like, if it seems more severe than normal spitting up

  • Very strong vomiting that happens again and again

  • Signs of dehydration. These include dry mouth, sunken soft spot (fontanelle), listless or sleepy appearance, or no wet diapers for several hours.

  • No weight gain or loss of weight

Online Medical Reviewer: Donna Freeborn PhD CNM FNP
Online Medical Reviewer: Heather Trevino
Online Medical Reviewer: Liora C Adler MD
Date Last Reviewed: 3/1/2020
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