Vomit: What if My Baby Vomits when Eating?

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<v SPEAKER_1>My kids are getting ready to go back to school, which means I'm going to be going back to work.

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<v SPEAKER_1>This podcast is sponsored in part by Stokka USA.

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<v SPEAKER_1>Have you seen the new enhanced trip trap from Stokka high chair?

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<v SPEAKER_1>So I've used this chair for my own seven kids, plus the babies that I work with in my infant feeding practice.

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<v SPEAKER_1>This baby vomits the entire contents of his stomach all over my table.

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<v SPEAKER_1>And I asked my sister and they're like, Cece, when did this baby last have a bottle?

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<v SPEAKER_1>And she's like, oh, I just fed a bottle out in the van.

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<v SPEAKER_1>Like, oh my gosh, no, we cannot pump a baby full of six ounces of breast milk or formula, have them sit down to a food like pork, which they're going to gag on as they're learning how to eat.

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<v SPEAKER_1>And gagging is a good thing.

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<v SPEAKER_1>It's how they learn to eat.

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<v SPEAKER_1>But if their belly is full of milk, that really involved gag can elicit a vomit.

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<v SPEAKER_1>And so a little bit of vomiting is to be expected.

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<v SPEAKER_1>But there are some things we can do to lower the risk of vomiting when your baby starts solid foods.

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<v SPEAKER_1>Hey there, I'm Katie Ferraro, registered dietitian, college nutrition professor and mom of seven, specializing in baby-led weaning.

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<v SPEAKER_1>Here on the Baby-Led Weaning with Katie Ferraro podcast, I help you strip out all of the noise and nonsense about feeding, giving you the confidence and knowledge you need to give your baby a safe start to solid foods using baby-led weaning.

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<v SPEAKER_1>There are so many disgusting things that happen when you become a parent, and they gross all of us out to different degrees.

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<v SPEAKER_1>I have a cousin who cannot change a dirty diaper to save our life.

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<v SPEAKER_1>And I was like, what do you think you are going to do when you have a baby?

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<v SPEAKER_1>My nephew, she threw up on him the first time she had to change his dirty diaper.

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<v SPEAKER_1>Sorry, we're talking about vomit today.

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<v SPEAKER_1>So I know you guys are here for some of the disgusting stories.

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<v SPEAKER_1>Vomit does not gross me out, but it grosses some of you out.

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<v SPEAKER_1>And this episode, we're going to be talking about vomiting.

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<v SPEAKER_1>And what if my baby vomits when eating?

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<v SPEAKER_1>It's going to happen.

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<v SPEAKER_1>What's typical?

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<v SPEAKER_1>When should you be worried?

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<v SPEAKER_1>How can we lower the risk of vomiting?

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<v SPEAKER_1>And what sort of timing do we need to put in place to help make sure our babies aren't vomiting all the time?

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<v SPEAKER_1>Because, heads up, a little bit of vomiting is to be expected when you start solid foods.

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<v SPEAKER_1>We know that, but if your baby is vomiting every day or every meal, that's not typical.

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<v SPEAKER_1>And I like to start these mini training episodes with a Baby-Led Weaning tip of the day.

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<v SPEAKER_1>And today's tip is a little bit of vomiting is to be expected when your baby starts solid foods.

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<v SPEAKER_1>But, if your baby is vomiting every time, every meal, every day, please know that is not typical.

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<v SPEAKER_1>And that's something that we either need to tweak the feeding schedule.

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<v SPEAKER_1>And hang tight, because I'm going to show you how you can lower the risk of vomiting, especially for bottle-fed babies.

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<v SPEAKER_1>But in other cases, you may need a referral to a speech-language pathologist who can help take a look and see what's going on.

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<v SPEAKER_1>Or an occupational therapist who specializes in infant feeding and feeding therapy, because maybe something is going on.

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<v SPEAKER_1>Quick story, this is one of my favorites about babies vomiting when they're starting solid foods.

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<v SPEAKER_1>And I have a lot to choose from.

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<v SPEAKER_1>So I'm the oldest of six kids, and my youngest brother has four kids.

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<v SPEAKER_1>And we had our first babies within a week of each other, which is so weird.

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<v SPEAKER_1>I'm like, you're not old enough to have a baby.

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<v SPEAKER_1>But anyway, he's on his third baby.

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<v SPEAKER_1>My sister-in-law, she's down to do baby-led weaning.

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<v SPEAKER_1>She'd done it with her other two kids.

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<v SPEAKER_1>She was getting more confident.

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<v SPEAKER_1>She's like, I can do the fruits and vegetables by myself, but I really want your help for the meat.

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<v SPEAKER_1>So I said, all right, come over.

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<v SPEAKER_1>The first meat that we did together was pork.

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<v SPEAKER_1>So one of my favorite recipes from our Baby-Led Weaning program is pork carnitas.

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<v SPEAKER_1>It's so fun to make for babies.

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<v SPEAKER_1>It's so cheap.

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<v SPEAKER_1>It's so easy.

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<v SPEAKER_1>So I made baby Frankie some pork carnitas, and I did my purees for a few days approach.

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<v SPEAKER_1>So we did a thin puree of the pork, a chunkier puree of the pork, and then some soft strips of shreddable pork with a lot of extra low-sodium broth.

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<v SPEAKER_1>This is like standard operating procedure for my approach to baby-led weaning.

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<v SPEAKER_1>Baby Frankie picked up the strips of pork and like went to town on it.

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<v SPEAKER_1>Like he was putting it everywhere and he started gagging pretty heavily as babies will do when food gets to the back of their mouth and they're not comfortable with it.

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<v SPEAKER_1>Again, very typical.

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<v SPEAKER_1>And he vomited the entire contents of his stomach all over my table.

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<v SPEAKER_1>And my sister-in-law was kind of freaking out and I was like, it's not a big deal.

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<v SPEAKER_1>And then he picked the meat up from the varf and ate it.

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<v SPEAKER_1>I have it on video.

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<v SPEAKER_1>It was fantastic.

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<v SPEAKER_1>So I asked my sister-in-law, Cece, like, when did this baby last have a bottle?

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<v SPEAKER_1>She's like, oh, I just fed him a bottle out in the van before I came into your house.

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<v SPEAKER_1>And she's like, what?

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<v SPEAKER_1>And I get so mad at myself because I always forget to tell parents, especially parents of bottle-fed babies, and when we're doing meat for the first time, your baby's going to gag.

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<v SPEAKER_1>And a particularly involved gag can elicit the vomit response.

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<v SPEAKER_1>And if that baby's belly is full of milk, like baby Frankie, I mean, he probably had like six or seven ounces on board, right?

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<v SPEAKER_1>Like minutes before he goes to learn how to eat pork.

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<v SPEAKER_1>And the big gag, it was so involved that it did cause him to vomit.

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<v SPEAKER_1>And so the suggestion for bottle-fed babies is try to wait an hour between the end of the milk feed and the start of the solid food feed that gives your baby's stomach a little bit of time to empty so that they're not so full of milk, so that when they do inevitably gag, they're not going to vomit the entire contents of their stomach all over the table.

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<v SPEAKER_1>I mentioned at the outset of this episode that a little bit of vomiting is to be expected, but we don't want your baby vomiting every day or every meal.

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<v SPEAKER_1>If we're causing them, quote unquote, causing them to vomit, because we're feeding them right after they drink a huge bottle, if they do vomit frequently, they can start to have negative associations with food and feeding.

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<v SPEAKER_1>So in that case, in the story of baby Frankie, who just picked the pork up out of the vomit and started eating it again, he wasn't traumatized by this.

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<v SPEAKER_1>But if every day that was happening, he's probably not going to want to eat.

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<v SPEAKER_1>So we started building in an hour-ish between the end of that bottle feed and the start of the solid food feed.

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<v SPEAKER_1>For the exclusively breastfed babies, this is almost never a concern because your breastfed baby is snacking.

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<v SPEAKER_1>They're not drinking six ounces of breast milk and then sitting down at the table.

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<v SPEAKER_1>It tends to be more the bottle-fed baby.

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<v SPEAKER_1>So regardless of what's in your bottle, if they drink a high volume of it, we got to give them some time to let that stomach empty.

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<v SPEAKER_1>That's also a reminder is that especially early on in starting solid foods, you don't bring a hungry baby to the table.

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<v SPEAKER_1>That's another mistake I always make when families come over.

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<v SPEAKER_1>I literally now have it in my pre-feeding checklist is to talk and teach to families who are going to come over and learn about starting solid foods.

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<v SPEAKER_1>I tell them, listen, just stick to your regular milk schedule, breastfeed your baby, give your bottle feed.

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<v SPEAKER_1>Like for the first eight weeks in phase one of baby-led weaning, we do not alter the milk schedule and we do not alter the nap schedule.

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<v SPEAKER_1>Because your baby does not know how to use food to make that feeling of hunger go away.

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<v SPEAKER_1>And so many babies come over and be like, oh, I'm like starving him out, so he's hungry here at the table with you.

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<v SPEAKER_1>Like, no, no, no, no, no, no, no, no, we don't want that.

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<v SPEAKER_1>Because a starving baby is going to start freaking out and a freaking out baby can't eat solid food because they're throwing their head back, opening their airway, drastically increasing the risk of choking.

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<v SPEAKER_1>So stick to your regular milk schedule in phase one, which is the first eight weeks of Baby-Led Weaning.

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<v SPEAKER_1>If you're a schedules person and you like feeding schedules, I have all of the schedules for phases one, two, and three of Baby-Led Weaning.

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<v SPEAKER_1>They're all inside of my program.

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<v SPEAKER_1>It's called Baby-Led Weaning with Katie Ferraro.

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<v SPEAKER_1>You can check it out at babyledweaning.co/program.

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<v SPEAKER_1>I also have a hundred first foods daily meal plan in there.

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<v SPEAKER_1>If you're like, I don't want to figure out which foods to feed my baby.

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<v SPEAKER_1>Don't worry, I did it for you.

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<v SPEAKER_1>All the recipes and videos and instructions on how to make the hundred foods from my hundred first foods list, it's all inside of that program.

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<v SPEAKER_1>Again, that's at babyledweaning.co/program.

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<v SPEAKER_1>Hey, we're going to take a quick break, but I'll be right back.

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<v SPEAKER_1>This episode is sponsored in part by Ritual Prenatal Vitamins.

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<v SPEAKER_1>Are you still taking your prenatal vitamin?

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<v SPEAKER_1>In fact, the World Health Organization recommends continuing your prenatal until you start weaning.

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<v SPEAKER_1>Again, that website is ritual.com/weaning for 25% off.

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<v SPEAKER_1>Another question that parents have about vomiting is, if my baby vomits, is that a sign that they can't tolerate the food?

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<v SPEAKER_1>And the answer can go both ways, yes and no here.

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<v SPEAKER_1>In most cases, as I mentioned, a little bit of vomiting is typical.

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<v SPEAKER_1>And we're very quick to blame solid foods.

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<v SPEAKER_1>Oh, the baby vomited.

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<v SPEAKER_1>It must be the food that I fed them.

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<v SPEAKER_1>And that's not always the case, of course, with lots of different underlying illnesses or situations, something else could be causing the vomiting.

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<v SPEAKER_1>But vomiting can be a side effect of an allergic reaction.

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<v SPEAKER_1>Now, it's not an independent sign, because sometimes babies will vomit, and parents are like, they're allergic to strawberries, because that was the new food I gave them today.

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<v SPEAKER_1>It's very unlikely that your baby is going to be allergic to strawberries.

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<v SPEAKER_1>But if your baby has, let's say, a potentially allergenic food, one of the top nine allergenic foods, those are the nine foods that account for about 90% of food allergy.

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<v SPEAKER_1>Say, egg, for example.

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<v SPEAKER_1>If you feed your baby egg and they break out in hives, so there's some skin reaction, red, raised patches around their face, or their chest, or their whole body, and then they start vomiting, yeah, red flag, probably a food allergy.

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<v SPEAKER_1>Contact your pediatrician.

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<v SPEAKER_1>But if there's no skin involvement in no hives and just a little bit of random vomiting, that is not necessarily a sign of an allergic reaction.

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<v SPEAKER_1>Now, there is a very rare type of food allergy that is characterized by delayed onset vomiting.

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<v SPEAKER_1>I almost don't even like talking about it because it's so rare.

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<v SPEAKER_1>It's called FPIES, and that stands for food protein-induced enterocolitis syndrome.

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<v SPEAKER_1>And FPIES, again, is very rare.

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<v SPEAKER_1>And whenever you talk about it, parents are like, oh, my baby vomited.

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<v SPEAKER_1>They look it up online like my baby has FPIES.

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<v SPEAKER_1>Your baby very likely does not have FPIES.

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<v SPEAKER_1>But I did interview the world's leading expert on FPIES just so that we could learn about it.

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<v SPEAKER_1>That's in episode 230.

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<v SPEAKER_1>If you think your baby has FPIES, go listen to this episode first.

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<v SPEAKER_1>But what FPIES is characterized by is delayed onset vomiting, meaning that more than two hours following ingestion, your baby starts having profuse vomiting, like the type that you're like, oh my gosh, this baby needs to go to the hospital.

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<v SPEAKER_1>Okay, that could potentially be FPIES.

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<v SPEAKER_1>So check that episode out if you think that pertains to you.

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<v SPEAKER_1>But throwing up a little bit, okay?

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<v SPEAKER_1>And a lot of times what parents say is throw up.

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<v SPEAKER_1>I'm like, that's not throw up, that's just spit up, okay?

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<v SPEAKER_1>Also, if your baby is drooling, there's a lot of liquids happening in the mouth and we're offering very fluid foods, right?

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<v SPEAKER_1>We want lots of liquid because the extra broth, the sauces, all of these things help lower the risk of choking.

00:13:35.614 --> 00:13:40.894

<v SPEAKER_1>That sometimes, especially as your baby's learning how to eat, they might spit up some of that, they might vomit.

00:13:40.894 --> 00:13:43.294

<v SPEAKER_1>And parents always say, well, how much vomiting is typical?

00:13:43.294 --> 00:13:46.934

<v SPEAKER_1>Just so you know, there's like no peer-reviewed guideline on like, this is a normal amount of vomiting.

00:13:46.934 --> 00:13:49.434

<v SPEAKER_1>And if after your baby vomits more than that, it's not normal.

00:13:49.434 --> 00:13:57.734

<v SPEAKER_1>But in my experience, in a six-month weaning period from six to 12 months of age, most babies may vomit two or three times in that six-month period.

00:13:58.234 --> 00:14:03.814

<v SPEAKER_1>If you're like, whoa, my baby vomits two or three times a day or two or three times a week, again, that's not typical.

00:14:03.814 --> 00:14:14.634

<v SPEAKER_1>And in that case, you would want to consider asking your pediatrician for a referral to a speech-language pathologist or an occupational therapist who specializes in infant feeding and feeding therapy, and they can help you out.

00:14:14.634 --> 00:14:17.594

<v SPEAKER_1>So quick win to round out the vomiting business.

00:14:17.594 --> 00:14:22.674

<v SPEAKER_1>If your baby is bottle-fed, wait an hour between the end of the milk feed and the solid food feed.

00:14:22.674 --> 00:14:29.054

<v SPEAKER_1>That's in order to allow the baby's stomach time to empty so that they don't vomit every time that they are eating.

00:14:29.054 --> 00:14:30.494

<v SPEAKER_1>I know the vomiting stuff can get weird.

00:14:30.494 --> 00:14:34.814

<v SPEAKER_1>I know it's hard for some parents to overcome it, but it is one of those areas where you might get stuck.

00:14:34.814 --> 00:14:41.314

<v SPEAKER_1>In every phase of Baby-Led Weaning, there are areas where you might get stuck, and I'm here to help you brainstorm to get out of them.

00:14:41.314 --> 00:14:43.434

<v SPEAKER_1>Check out some of the resources that I mentioned in today's episode.

00:14:43.434 --> 00:14:57.514

<v SPEAKER_1>They're all linked below where you are listening, but you can also go to the show notes page and see the same exact resources on your computer or your phone if you want to, and that's at blwpodcast.com/twozero, a special thank you to our partners at Airwave Media.

00:14:57.514 --> 00:15:02.854

<v SPEAKER_1>If you guys like podcasts that feature food and science and using your brain, check out some of the podcasts from Airwave.

00:15:02.854 --> 00:15:05.454

<v SPEAKER_1>We're online at blwpodcast.com.

00:15:05.454 --> 00:15:07.334

<v SPEAKER_1>Thank you so much for listening, and I'll see you next time.

00:15:16.527 --> 00:15:26.007

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00:15:26.007 --> 00:15:34.427

<v SPEAKER_2>You can learn a lot in just a few minutes with stories about impending hurricanes, winter storms, or even what not to miss in the night sky.

00:15:34.427 --> 00:15:39.487

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00:15:39.487 --> 00:15:42.707

<v SPEAKER_2>That's AccuWeather Daily, wherever you get your podcasts.