Vomit: What if My Baby Vomits when Eating?

Katie Ferraro (0s):

So when parents see vomit, they sometimes think, gosh, is that a sign that my baby can't tolerate the particular food that I just fed them? I say no more often than not, that's not what it's saying. It may be that the baby's belly is too full of milk or perhaps there's an underlying illness. So a little bit of vomiting is okay, but vomiting every time your baby eats, that's definitely not typical. Hey there, I'm Katie Ferraro, registered dietitian, college nutrition professor, and mom of seven specializing in Baby-Led Weaning. Here on the Baby-Led Weaning Made Easy podcast I help you strip out all of the noise and nonsense about feeding, leaving you with the competence and knowledge you need to give your baby a safe start to solid foods using Baby-Led Weaning.

Katie Ferraro (49s):

Hey guys, welcome back to another episode of the Baby-Led Weaning Made Easy podcast. This is your host, Katie Ferraro. I'm a registered dietitian and mom of seven specializing in Baby-Led Weaning. and today we're talking about vomiting. It just feels weird to say that, but what do I do if my baby vomits, when eating now I know on other podcasts, vomit might be a taboo topic, but you guys clean up dirty diapers and vomit all the time. So I know you're fine with it. Maybe you don't clean up vomit all the time, but there might be a little bit of vomiting when you start solid foods, especially if you're doing Baby-Led Weaning., but we're going to talk about when it's a problem, but how more often than not, it's usually not a problem.

Katie Ferraro (1m 30s):

So I like to start each episode with a Baby-Led Weaning tip of the day. Today's tip, a little bit of vomiting is to be expected when you start solid foods. Okay? But if your baby is vomiting, every time you offer solids, please know that that is not typical. And it is something that you should alert your pediatrician to the baby is vomiting. Every single time they're trying to eat your baby. Six months of age, plus exhibiting the other signs of readiness to feed. We need your pediatrician to put you in touch with either a speech language pathologist or an occupational therapist who specializes in infant feeding. And so sometimes in a few short feeding therapy sessions with a qualified and trained professional, they can identify if there really is a problem with your baby.

Katie Ferraro (2m 12s):

And if so, help you develop a plan exercises, interventions to help your baby get beyond that. So a little bit of vomiting is normal, but when parents write to me and say, my baby's vomiting, every single feeding, that's certainly not typical. And I think you should know that. Okay? So hang tight because we're going to cover when your baby does vomit on food. Let's look at situation when it's nothing to worry about. And then when it is problematic. So why do babies vomit? We're talking about vomit related to food intake. This is not, oh, because your baby has a bug and is sick. Parents will often ask, you know, if my baby is actively sick, should I stop solid foods? When your baby is sick, you need to, you know, your baby best.

Katie Ferraro (2m 53s):

I wouldn't encourage you to stop solid foods entirely for days and weeks on end because your baby does need this very valuable, crucial period to learn how to eat. I generally don't offer new allergenic foods when a baby is actively sick. Okay? Because if they're immunocompromised to begin with they're immune barriers and defenses are down, potentially allergenic foods may have more of a likelihood to cause a reaction, not necessarily a full-blown anaphylactic allergic reaction, but your baby's going to be prone to having reactions. That might not be typical if they were to try that food under a healthy situation. So parents sometimes wonder is vomiting, a sign that my baby can't tolerate the food.

Katie Ferraro (3m 33s):

And you're likely aware that when you start solid foods, your baby will gag on foods. Okay? Gagging is a natural and necessary part of learning how to eat. If you're not familiar with gagging, or you're confused about the difference between gagging and choking, please make sure to go listen to episode number four, which is called gagging versus choking. What is the difference? And so for some babies, when they gag a particularly involved gag, I hate to use the word violent because that has a negative connotation and involved gag, but read violent will induce vomiting in some babies. Okay. That, and I would say, I'll just say in my own experience, having done Baby-Led Weaning with six of my seven kids.

Katie Ferraro (4m 15s):

Each kid might vomit three or four times in the six month period when we're trying new foods from six to 12 months of age, and some parents are like, oh, my baby's vomiting like three or four times a day. That's not typical. Okay. Now a few caveats there. If the baby's belly is full of milk, and then they have even a slight gag for some babies, with the most sensitive gag reflexes reflexes, rather that will cause the baby to empty the contents of the stomach and vomit. And some babies don't care. They'll just play with it, continue eating. You and I care cause we're the ones that have to clean it up. But if the baby is repeatedly getting to the point of vomiting, then they're going to start off negative, starting to have negative associations related to feeding.

Katie Ferraro (4m 56s):

And we don't want that. So I would encourage you to wait an hour between milk feeds and solid food feeds, knowing that some babies may need longer in order for their stomach to empty to an appropriate level where they could then gag on a little bit of food, which is good. It's a good part of learning how to eat, but we don't want to have them excessively gagging and their bellies full and then unnecessarily vomiting. So no vomiting is not a sign that your baby can't tolerate food. When should you be concerned about vomiting again, if it's every time you feed or more frequently than what you would expect, either what you've seen in other children of yours or in speaking to friends or colleagues, certainly let your pediatrician know and document, okay.

Katie Ferraro (5m 38s):

And then document what it looks like. I know that sounds so weird, but that you're differentiating between whether it's spit up or it's vomit. I was working with a mom the other day, who the baby was actively teething and you know, our babies, aren't trying these new foods in a bubble, right? There are other things going on in parallel with starting solid foods, including teething. So this baby was like having a rough go of it with teething, but totally fine. Trying foods. We don't stop solid foods just because the baby's teething. I hate to break it to you. Teething is a three-year process. You don't stop eating food for three years. You either make some little modifications and we'll cover that in a separate episode for the food tweaks that you do for teething. However, this baby had all a lot of drool going on and a lot of spit-up.

Katie Ferraro (6m 20s):

And then as they were eating the food, we were eating, we were doing watermelons. It was like a nine month old baby. So watermelons a food I wait a little bit longer on because it has it's watery and that's a thin liquid and babies can gag more on that food than other thicker liquids. So, you know, your baby can drink breast milk or formula, which is a thicker liquid, but I don't do water for babies until they're much older because it is more challenging for babies to swallow. Also, babies don't need extra water. They get enough water from the formula and breast milk that you're feeding them. Plus the foods, if you live in a really hot environment, that's different. But for the most part, I don't add water until the baby is closer to age one, but we were doing watermelon. It is a food that babies, historically gag on, and this baby had a lot of saliva, a lot of drool.

Katie Ferraro (7m 4s):

And the mom keeps saying, oh, the babies he's throwing up, he's throwing up. And I kept saying, that's not, that's not throw up. That's spit up. And that's drool from teething. Like there's a distinct difference between the opaque contents of one stomach, which is vomit versus the translucent drool or mucus. Maybe also had a little bit of a cold too. So just differentiate, you know, not everything that comes out of your baby's mouth that looks gross is necessarily vomit, but you should be concerned if your baby is vomiting every time they eat, if it's happening alongside the other signs of an allergic reaction. So let's say you introduced shellfish. All of a sudden your baby has patchy red hives and get, I don't want to freak you out. This is very unlikely to happen.

Katie Ferraro (7m 44s):

But if your baby did have red raised itchy hives all over their body, difficulty breathing and then started vomiting. That's those things in conjunction would give me an indicator that the baby's having an allergic reaction. Now, if your baby tried blueberries and a few days later got sick and was vomiting and there's no other signs associated that it was coming from the food. No, no skin stuff, no difficulty breathing, no fussiness vomiting in an isolated situation like that is very unlikely to be related to an allergic reaction. Okay. We're also concerned about vomiting if, and when it leads to dehydration, because of course prolonged loss of fluid, it will be problematic, right. And will require electrolyte replacement. But that doesn't happen as a typical side effect of eating.

Katie Ferraro (8m 26s):

And sometimes parents are confused because they'll write and say things like I'm freaking out my baby's constipated and I'll say, Hey, constipated, constipation rather is a totally typical and to be expected side effect of starting solid foods. If they write to me and say, Hey, my baby's vomiting all the time. I say, whoa, that's atypical. That's not something that we generally see now how close to feeding solid food did you feed the milk? Wait, at least an hour do longer than that for some babies. Okay. So quick wind for you. Wait an hour between milk and solid food feeding, some babies will need a little bit longer, but a little bit of vomiting is to be expected. If your baby is vomiting more frequently than what I've described, that certainly is something that you would want to contact your pediatrician and talk about.

Katie Ferraro (9m 10s):

If you guys have more questions about very fascinating topics like constipation and vomiting. I teach a weekly online workshop called Baby-Led Weaning for Beginners. It's how to get your baby to try 100 foods before turning one, without you having to spoonfeed purees or buy pouches. I give everyone on that workshop, a copy of my 100 First Foods list. So if you're looking for some new foods to work your baby through, come check out the free workshop. I also host a Q and A session at the end of the workshop, where I make a point to answer everybody's questions. As in-depth, as you want to get about your baby's vomit, I'll answer it to the best of my ability. You can sign up for the free online workshop. Baby-Led Weaning for Beginners, by going to the show notes page for this podcast episode, that's blwpodcast.com/20.

Katie Ferraro (9m 57s):

That'll take you to episode 20, which is vomiting. What do I do with my baby vomits when eating, click the link and get signed up for this week's workshop times, and I'll answer all your questions about vomiting or whatever else you're curious about when it comes to giving your baby a safe start to solid foods using Baby-Led Weaning. Bye now!