Vomiting in Babies & Toddlers
Content reviewed against published AAP, NICE, AAP guidelines
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Vomiting in babies is the forceful expulsion of stomach contents. It is different from spit-up (reflux), which is effortless and common in young babies. Most vomiting in babies and toddlers is caused by viral gastroenteritis and resolves in 1-3 days. However, certain patterns of vomiting — particularly projectile vomiting in young infants, green (bilious) vomiting, or persistent vomiting with dehydration — require urgent evaluation.
Key takeaways
- Vomiting in babies is the forceful expulsion of stomach contents.
- Most common cause: Viral gastroenteritis (stomach flu)
- Emergency: Green (bile-stained) vomiting at any age — possible bowel obstruction
- Home care: Wait 30-60 minutes after vomiting before offering fluids
Possible Causes
When to Seek Help
Emergency — Call 911 or go to ER:
- Green (bile-stained) vomiting at any age — possible bowel obstruction
- Projectile vomiting in infant 2-8 weeks old (possible pyloric stenosis)
- Vomiting blood or coffee-ground material
- Vomiting with severe abdominal distension
- Vomiting with bulging fontanelle, stiff neck, or altered consciousness
- Vomiting after significant head injury
- Baby is lethargic and difficult to rouse between vomiting episodes
Urgent — See doctor today:
- Vomiting with signs of dehydration (no wet diapers 6+ hours, dry mouth, no tears)
- Intermittent screaming with vomiting and bloody/jelly-like stools (possible intussusception)
- Vomiting with fever in infant under 3 months
- Persistent vomiting (unable to keep any fluids down for 8+ hours)
- Vomiting with abdominal pain that is getting worse
Same-day appointment:
- Vomiting lasting more than 24 hours but child keeping some fluids down
- Vomiting with low-grade fever in baby over 6 months who is mildly dehydrated but still making some wet diapers
- Recurrent vomiting episodes (cyclical) without clear cause
Monitor at home:
- Viral gastroenteritis with vomiting less than 24 hours and child maintaining hydration
- Occasional spit-up in infant who is growing well
- Single vomiting episode with no other symptoms and child returns to normal
By Age
0-2 months
Normal: Spit-up (effortless milk return) is extremely common and usually normal. Most babies spit up several times a day, peaking around 3-4 months.
Worry if: Forceful/projectile vomiting that shoots across the room (pyloric stenosis typically presents at 2-6 weeks). Green (bile-stained) vomiting at any age is urgent. Poor weight gain with frequent vomiting.
2-6 months
Normal: Reflux-related spitting up peaks around 4 months. Small amounts after feeds with happy, growing baby is normal.
Worry if: Projectile vomiting, vomiting blood or coffee-ground material, green/bilious vomiting, vomiting with distended abdomen, or baby losing weight or becoming dehydrated.
6-12 months
Normal: Occasional vomiting with viral illnesses (1-2 days) is common. Some babies vomit with forceful coughing or gagging on new foods.
Worry if: Vomiting with severe abdominal pain (drawing legs up, screaming in episodes), bloody stools (jelly-like), or persistent vomiting lasting more than 24 hours with signs of dehydration.
1-3 years
Normal: Stomach bugs (gastroenteritis) are frequent in toddlers, especially in daycare. Vomiting that resolves within 12-24 hours with oral rehydration is typical.
Worry if: Vomiting lasting more than 24-48 hours, signs of dehydration (no wet diapers 6-8 hours, no tears, dry mouth), vomiting with headache and altered consciousness, or vomiting after head injury.
Home Care
- Wait 30-60 minutes after vomiting before offering fluids
- Start with small sips of oral rehydration solution (Pedialyte) — 1-2 teaspoons every 5 minutes
- For breastfed babies: nurse frequently but for shorter periods
- Gradually increase amounts as tolerated over several hours
- Avoid juice, soda, or full-strength sports drinks
- Once keeping clear fluids down for 6-8 hours, introduce bland foods (bananas, rice, toast)
- Do NOT give anti-vomiting medications to young children without doctor guidance
- Track wet diapers and signs of dehydration carefully
- Keep baby positioned on side or upright (not flat on back) during active vomiting
Need help deciding what to do?
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Sources
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Symptoms
Bottom line
Most cases of vomiting in babies are not emergencies. However, seek immediate care if green (bile-stained) vomiting at any age — possible bowel obstruction.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.