What is spitting up?

Spitting up is sometimes called a “wet burp.” It often 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 there is no need to worry, especially 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 doctor 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 also comes up from the stomach. It may occur with other symptoms, such as 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

Contact your baby's doctor right away if your baby has:

• Vomit that has bile in it (looks green) or blood (looks red, brown, or black or like it has coffee grounds in it), even if the baby vomits only once.

• Vomiting that continues, no matter what the vomit looks like.

• Forceful vomiting.

• Signs of dehydration. These include dry mouth, sunken soft spot (fontanelle), no tears when crying, listless or sleepy appearance, no wet diapers for several hours, and dark-colored urine.

• Baby refuses to eat or drink anything for more than a few hours.

• Bloody bowel movements.

• Fever (see below).

Fever and children

• Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal.For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal).This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.

  • Ear (tympanic).Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary).This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.

  • Mouth (oral).Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

  Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the doctor what type to use instead. When you talk with any health care provider about your child’s fever, tell them which type you used.

  Below is when to call the doctor if your child has a fever. Your child’s doctor may give you different numbers. Follow their instructions.

  When to call a doctor about your child’s fever

  For a baby under 3 months old:

  • First, ask your child’s doctor how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

  • A fever of ___________as advised by the doctor

  For a child age 3 months to 36 months (3 years):

  • Rectal or forehead: 102°F (38.9°C) or higher

  • Ear (only for use over age 6 months): 102°F (38.9°C) or higher

  • A fever of ___________ as advised by the doctor