Babies and toddlers get sick quite a bit during the first few years of life. While it can be startling to see your baby throw up, especially if it’s the first time, vomiting is common in young children and very often nothing to worry about.
In many cases, baby vomiting goes away on its own with a little TLC from you. But sometimes throwing up can be a sign of something more serious that warrants a check-in with your child’s pediatrician.
If your baby or toddler is vomiting, read on for potential causes to consider, as well as additional symptoms that indicate you should take your child to the doctor.
Why is my baby or toddler throwing up?
Vomiting in babies and toddlers is very common, and your little one may throw up for a number of different reasons.
In the first few months of life, many babies spit up after feedings, which isn’t cause for concern. Frequent and forceful vomiting soon after mealtime that’s accompanied by general discomfort may also be due to a condition called GERD (gastroesophageal reflux disease), while projectile vomiting in infants could be caused by hypertrophic pyloric stenosis, a less common condition which requires medical attention.
After the first few months of life, baby and toddler vomiting is usually caused by a gastrointestinal virus, but it can also be linked to other mild infections, food allergies, food poisoning or motion sickness.[1]
Other relatively uncommon causes for vomiting include conditions such as asthma, intussusception, accidental poisoning, and Hirschsprung disease. In rarer cases, vomiting could be due to a more serious infection that requires immediate treatment.
All of these conditions have specific symptoms beyond vomiting to watch out for. Here's how to narrow down the potential cause of your toddler or baby’s vomiting, and remember to always reach out to your child’s pediatrician if you have any concerns.
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Common causes for vomiting in babies and toddlers
Though there can be many possible reasons for vomiting in babies and toddlers, a few causes are much more common than others. Most likely, your little one has one of the following:
A common infection
After the newborn phase, the most common reason for vomiting is an infection — usually an intestinal virus, although rare bacteria and parasites can also cause vomiting.
Some of the more common infections that can cause vomiting include:
- Gastrointestinal viruses like rotavirus are among the most common infections among young children. They’re usually quite contagious and spread quickly among children in day care and other group settings. Your child will usually have other symptoms such as fever or diarrhea in addition to vomiting.
- The flu can sometimes cause vomiting in young children. With the flu, kids usually also have fever, dry cough and other symptoms.
- Urinary tract infections are usually accompanied by a frequent need to use the toilet, along with urine that looks cloudy and may have a strong odor. Your child may also complain that it hurts to urinate, and show other signs of illness such as diarrhea, fever and fatigue, as well as vomiting.
- Otitis media is a common type of ear infection that often develops with a cold. Children usually also tug one or both ears, may have difficulty eating and sleeping, and may throw up too.
Food poisoning
Foodborne bacteria like salmonella or E. coli can cause gastrointestinal symptoms such as nausea, diarrhea and vomiting. Food poisoning is a prime suspect if the whole family gets sick with similar symptoms around the same time — it’s likely due to something everyone ate.[2]
Symptoms caused by the most common food poisoning germs often begin within two to six hours of eating a contaminated food, although they can appear sooner or up to several weeks after exposure, depending on the cause. In addition to vomiting, nausea and diarrhea, your baby may have a headache or fever, among other symptoms.[3]
Call the pediatrician’s office right away if you suspect food poisoning and your child has:
- Been vomiting for more than 12 hours
- Diarrhea with a fever of 101 degrees Fahrenheit or higher
- Bloody vomit or feces
- Black or maroon feces
- Severe stomach pain that doesn’t go away after bowel movements
- Signs of dehydration
Motion sickness
If your toddler seems fine but vomits suddenly during a car ride, you’ll likely suspect motion sickness. Motion sickness can occur when you’re moving and the signals from your inner ears, eyes, muscles and joints don’t match up with how your brain processes movement. Your child might vomit when she’s in a car or boat, or after going on a playground swing. Motion sickness is rare in babies but common in children ages 2 to 12.
There’s no need to call the doctor if your child has occasional motion sickness. But if motion sickness becomes a problem, consult her pediatrician for advice.
Less common causes of vomiting in children
Vomiting in babies and toddlers can usually be linked to one of the common causes above. However, sometimes vomiting accompanied by other symptoms signals a more serious or chronic condition.
Reflux (GERD)
All babies spit up to some extent, but a little one who repeatedly coughs and vomits after mealtime may have GERD. In babies with GERD, food backs up from the stomach into the esophagus because the esophageal muscle isn’t strong enough to keep it down, causing complications from acid reflux.
If your baby’s spit-up gets worse with time and she has other symptoms too, your doctor may diagnose GERD. In addition to baby vomiting, other signs of GERD may include:[4]
- Refusal to eat, or eating constantly
- Crying or arching her back during feedings, which may mean your baby is in pain
- Gurgling or wheezing sounds during feeding
- Irritability and fussiness, especially with spit-up
- Blood in her spit-up
- Coughing
See your pediatrician if you think your baby might have GERD to diagnose her symptoms and discuss potential treatments.
Food allergies or intolerance
Your baby may have food allergies or a food intolerance if she vomits almost immediately after eating. About 8% of children in the U.S. are affected by a food allergy, according to the American Academy of Pediatrics (AAP), and around 90% of food allergies are caused by peanuts, tree nuts, milk, eggs, soy, sesame, fish, shellfish and wheat. (Keep in mind, that doesn’t mean you shouldn’t feed your baby these foods; in fact, doctors usually recommend starting them as early as 4 to 6 months of age to prevent food allergies. Talk to your pediatrician for guidance.)
Symptoms of a food allergy or intolerance usually occur within one to two hours of eating a food; in addition to vomiting, other symptoms in babies and toddlers may include:
- Skin rashes
- Hives
- Swelling of the lips or tongue
- Watery eyes
- Sneezing
- Wheezing
Serious symptoms of a food allergy include pale or blue skin, difficulty breathing or loss of consciousness. If you spot any of these symptoms, call 911 immediately.
Otherwise, schedule an appointment with your pediatrician if you notice symptoms like rashes after your child eats. Your child’s doctor will diagnose a food allergy with a blood test or refer you to an allergist for testing.
Asthma
Asthma is the most common chronic disease in children. Sometimes a hacking, forceful asthma cough can lead to vomiting, frequently with activity or at night. Other common asthma symptoms include:
- Shortness of breath
- Tightness in the chest
- Wheezing
You’ll often notice these symptoms are linked to a specific trigger, such as allergens (like dust, pollen and pet dander); irritants (like pollution or secondhand smoke); infections like the flu; cold air; exercise; or even emotional outbursts.
It’s important to take good notes about your child’s symptoms and triggers, as your doctor will rely on this information to make a diagnosis.
Pyloric stenosis
Pyloric stenosis is a narrowing of the pyloric sphincter muscle (a muscle located between the stomach and small intestine) that keeps food from passing into the intestines. This uncommon condition usually begins when an infant is between 2 weeks and 6 months old.
The following symptoms warrant a check-in with your doctor:[5]
- Baby projectile vomiting (very forceful vomiting) within 30 minutes of feeding; the vomit may sometimes contain blood
- Constant hunger — including wanting to eat soon after vomiting (because your baby isn’t digesting enough food)
- Dehydration
- Constipation
- Weight loss
- Wave-like contractions (known as peristalsis) across your baby’s tummy after eating
A stomach ultrasound, X-rays and a blood test are used to diagnose the condition.
Other infections
Although they’re less common, it’s helpful to know about more serious infections that can also cause vomiting. These can include:
- Appendicitis is very rare in children under 3[6] and most common in kids ages 5 to 20 years of age. It causes strong pain around the belly button or on the lower right part of the abdomen.[7]
- Meningitis occurs when fluid collects around the brain and spinal cord, usually due to a viral infection but sometimes from bacteria, fungi or parasites. While viral meningitis usually goes away on its own without treatment, bacterial meningitis is a medical emergency. The Hib vaccine, which children get starting at 2 months, protects kids from contracting a common type of bacterial meningitis.
- Hepatitis A is a bacterial infection that’s rare in the U.S. but more common in other areas of the world. It can lead to liver disease.
Some of these conditions require immediate treatment, so trust your gut and contact your doctor right away if your child’s symptoms concern you.
Hirschsprung's disease
In about 1 in 5,000 births, babies experience green or brown vomit with constipation and other symptoms due to a birth defect called Hirschsprung's disease. Children with this condition are missing nerve cells in the intestine, which causes stool to become blocked.
Severe cases are usually caught because a newborn doesn’t poop within the first 48 hours of birth. Less severe cases may be caught later in a child’s life and accompanied by symptoms including chronic constipation or diarrhea and trouble gaining weight.
It’s important to get your child checked out if these symptoms persist, as Hirschsprung's disease can cause slow growth due to an impaired ability to absorb nutrients. To diagnose the condition, your doctor may order tests including imaging tests, anorectal manometry and rectal biopsies.[8]
Intussusception
When a piece of the bowel slides into the next, fluids and solids can get blocked, resulting in a condition called intussusception. This is the most common abdominal-related medical emergency in children under 2 but can occur at any age, and it’s important to seek medical care immediately if you think your little one may have it, as blood flow can get cut off to the blocked area and lead to more serious complications.[9]
Symptoms tend to come on suddenly. Beyond vomiting, watch for the red flag signs outlined below. Doctors may perform an X-ray or abdominal ultrasound to check for blockage in the intestines.
Accidental poisoning
Swallowing something poisonous can cause vomiting. If your otherwise healthy child suddenly starts vomiting and you suspect she may have swallowed something hazardous, especially if she has any red-flag symptoms, head to the ER right away.
What’s the difference between spitting up and throwing up?
During the first year of life, many babies spit up frequently. Newborns have still-developing digestive systems, which makes it easy for food they’ve just eaten to come back up. Your newborn may also spit up when she drools, coughs or cries, and in older babies, a little milk can sometimes make its way out when burping.
Vomiting, on the other hand, is more forceful than spit-up. It could be caused by an underlying infection or a condition that may require medical attention.
If your little one has no other symptoms and the discharge looks cheesy, it’s probably ordinary spit-up. Most babies spit up less often as they approach their first birthdays, but be sure to talk to your doctor if your baby spits up every time she eats and isn’t gaining weight.
If your baby or toddler is vomiting and has other symptoms, too — such as fussiness after feedings, rashes or diarrhea — let your doctor know.
Treatments for a baby or toddler who is throwing up
Vomiting often goes away on its own, and there’s usually no need to worry if your child seems to be her usual self and is well enough to eat and play. But always trust your instincts and don’t hesitate to call the doctor if anything feels off.
Since vomiting can cause dehydration, your goal is to keep your baby or toddler hydrated. Give your child small sips of a pediatrician-approved electrolyte solution like Pedialyte, water or broth (avoid sugary drinks like juice until your child is feeling better). If your baby is eating solids and still has an appetite, it’s okay to feed her bland foods — but never force your child to eat, even if she hasn’t eaten all day.
Other specific treatments for vomiting depend on the cause, and may include:
- Mild infections (flu, stomach bug, UTI and otitis media): Your child’s pediatrician may recommend treatments such as antivirals or antibiotics depending on the cause of the infection and your child’s symptoms and risk for complications.
- Food poisoning: Most of the time, food poisoning goes away on its own in a few days, although occasionally antibiotics and IV fluids are in order for more serious cases.
- GERD: Discuss recommendations to tackle GERD with your child’s pediatrician, which may include switching formula (if your child is formula-fed), feeding your baby smaller amounts of food more frequently, and keeping her upright for 20 to 30 minutes after feedings. If these tactics don’t work, your doctor may recommend medication.
- Serious infections (appendicitis, meningitis): Prompt evaluation and treatment is critical. If your child has appendicitis, her appendix will need to be removed — usually with a minimally invasive surgery. Depending on the cause, meningitis may require antibiotics or other medications.[10]
- Food allergies: The only way to “treat” food allergies is with avoidance: Avoid any foods that cause an allergic reaction in your child.
- Asthma: Depending on your child’s symptoms, her doctor may prescribe medications such as a bronchodilator or an anti-inflammatory corticosteroid to treat and prevent asthma attacks.
- Pyloric stenosis: This condition can be treated with a minimally invasive surgery called a pyloromyotomy. If your little one is diagnosed with pyloric stenosis, the doctor will likely schedule this procedure right away.
- Hirschsprung's disease: For most children with this condition, symptoms are improved with surgery.[11]
- Accidental poisoning: Your child’s blood may be tested for certain chemicals, and she may receive activated charcoal, antidotes or other treatments.
- Intussusception: Most children can be treated with an enema to fix the blockage — especially if the condition is diagnosed and treated promptly. Occasionally, kids may need surgery if the intestine is torn or there are other complications.
How to prevent throwing up in your baby or toddler
Most young children vomit from time to time, and it’s impossible to completely avoid many of the conditions above. However, there are some preventative steps you can take to lower your baby or toddler’s risk of vomiting:
- To prevent vomiting from motion sickness: Try to avoid giving your child a heavy meal just before car rides. Your doctor may also suggest an over-the-counter medication before road trips if your child is over 2 years old. Always ask for your practitioner’s advice before giving your child any medicine.
- To prevent vomiting from infections, including the flu, rotavirus and meningitis: Teach your toddler to wash her hands often and do your best to limit contact with sick people. Be sure that your baby receives all of her recommended vaccinations on time, and insist that everyone in your family — including caregivers and your child, starting at 6 months of age — gets the flu shot.
The more serious and chronic conditions — such as asthma, appendicitis, Hirschsprung's disease and intussusception — can’t be prevented, but they can be effectively treated as long as they’re diagnosed. Food allergies can only be prevented by avoiding problematic foods.
When to call the doctor about your baby or toddler throwing up
Vomiting can sometimes be serious. If you’re concerned about your child’s vomiting, it’s always a good idea to check in with her pediatrician. And if any of the red-flag symptoms below accompany vomiting, call your practitioner right away or take your little one to the emergency room:
- Vomit that’s green, yellow or orange in color, or bloody
- Severe abdominal pain (a baby experiencing this may cry very loudly and pull her knees toward her chest)
- Repeated vomiting and an inability to keep down fluids
- Vomiting that continues for more than 24 hours
- Signs of dehydration, including fewer than six wet diapers in 24 hours (or less frequent trips to the potty), darker urine, tearless crying, listlessness, and dry mucus membranes (you may notice your child has cracked lips)
- Appearing floppy or less responsive
- Extreme irritability
- Forceful or strenuous vomiting
- A hard or bloated belly
- Convulsions
- Fever, especially if your baby is under 6 months old or if your older child has a fever of 102 degrees F or higher
- Swelling, redness or pain in the scrotum in boys
- Seizures
Try to carefully note your child’s symptoms so you can describe them to your doctor in as much detail as possible. For vomiting, this might include:
- How long your child has been vomiting and how often
- Whether there’s a lot of material, or if it’s mostly dry heaves
- What the vomit looks like (for example, clear, mucus-streaked, greenish, pinkish, bloody, like curdled milk, or like coffee grounds)
- If the vomit projects long distances
- Triggers for vomiting (such as eating or coughing)
- Other symptoms, such as difficulty swallowing, change in saliva, drooling, etc.
Know that vomiting in babies and toddlers is often an unpleasant rite of passage that will likely improve on its own. More serious causes for vomiting are also usually very manageable, as long as your doctor promptly diagnoses the condition that’s causing your child to throw up.
But while vomiting usually resolves quickly with a little home care, never hesitate to reach out to your practitioner for guidance and reassurance. You know your child best: If you feel that something just isn’t right, get in touch with a medical professional right away.
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