When to Seek Medical Care

When to call the doctor

• If your baby shows signs of dehydration (which may be difficult to recognize in infants)
  
  
  • A decrease in the number of wet diapers
    
    
  • A sunken soft spot (fontanelle) on the top of the head
    
    
  • Lack of tears when crying
    
    
  • Lethargic behavior
  
  
• If weight loss is a concern - Normal infant spitting up should not cause a loss of weight. If this is a concern, the doctor should be contacted to check the child's weight and compare this to prior weights.
  
  
• If the spitting up is forceful and shoots out of the mouth
  
  
  • This type of vomiting can be a sign of a condition called pyloric stenosis.
    
    
  • This condition usually appears in the first several weeks of life and is caused by an abnormal narrowing of the valve leading from the stomach to the intestine.
    
    
  • This causes gradually worsening projectile vomiting after every feeding that usually develops over several days.
    
    
  • Affected children seem hungry between feedings and may lose weight or become dehydrated.
    
    
  • Pyloric stenosis is diagnosed based on an ultrasound or x-ray that shows the narrowing of the valve to the intestines.
    
    
  • Pyloric stenosis is treated with a minor surgical procedure.
  
  
• If other worrisome signs of illness appear, including fever, diarrhea, difficulty breathing, or abnormal fussiness

Normal infant spitting up does not require emergency treatment. The following situations may signal a different, more serious cause for the vomiting, and the child should be taken to the hospital's emergency department.

• If the infant stops breathing, becomes limp, or has any blue color change during a spitting up episode: With normal spitting up, the child may choke or gag briefly but should not stop breathing or turn blue.
  
  
• If the spit up appears green or brown: A green or brown color of the spit up may be a sign of a blockage in the intestine. Gentle patting on the infant’s back should be all that is required during a spitting up episode.
  
  
• If for any reason the child appears to be seriously ill and in your judgment cannot wait to be seen at the doctor’s office