It is entirely normal for infants to bring up a bit of milk after a feed. You may want to have a wash cloth or kitchen roll handy during feeds. However, if your baby seems to be vomiting, rather than just bringing up milk, and has fever or diarrhoea, it may mean your baby is poorly.
The amount brought back up may seem a lot, but don't worry, it's not really. As long as your baby seems contented and is putting on weight, there's no cause for concern. However, if baby is throwing up violently, it may be a sign of illness.
Reflux in babies
If baby drinks more than her stomach can take, then she is likely to bring the milk back up. It's not uncommon for the swallowed milk to be regurgitated when a baby burps or hiccups. And if you ever tried boisterous play with your baby or just lifting her up after a feed you're probably wiser now!
However, one thing to know is that regurgitation can actually happen because your baby is not getting enough to eat. If your baby is very hungry, she might be over-eager at the next feed. If she's ravenous, she might gulp down a lot of air and get hiccups. As she hiccups or burps, some of the milk she swallowed will come back up too. This is why babies often bring up milk when they belch or are burped.
Burping your baby.
There are two things you can try as a way of reducing baby's reflux:
• Take little breathers during feeds, to give baby a chance to burp.
• Avoid getting baby all over-excited with hectic movements after a feed.
Vomiting caused by illness
If baby actually sicks up rather than regurgitates milk, she might have an infection or sensitivity to certain foods. Seek medical advice if your baby is losing weight, is less active or doesn't fill her nappy as much as before.
One virus infection that typically causes explosive vomiting is gastric flu. With this type of infection, children often have diarrhoea as well.
An ordinary cold with a runny nose can also cause vomiting in babies. The vomit may contain mucus, and your child will be generally unwell and distressed.
Other infections such as an ear infection or urinary tract infection can also cause vomiting.
Cow's milk allergy and gluten intolerance
If your baby starts bringing up more milk than usual when you introduce infant formula or a goodnight milk (formula with added cereal), it may be due to allergy to cow's milk protein. Around two per cent of all infants have this allergy, and vomiting is one of the commonest symptoms. Most children grow out of cow's milk allergy between the age of two and four, but some individuals still have the allergy in adulthood.
If a child has frequent stomach ache and is losing weight even after being weaned onto solids, your doctor will probably want to check for gluten intolerance. Gluten is present in foods such as goodnight milks (formula with added cereal), porridge and bread.
Further reading: food allergy and food intolerance in infants.