Vomiting in the newborn: when is spit-up something to worry about?

July 6, 2012 Robert L. Weinsheimer, MD

a mother tries to calm her crying infant


In this article:

  • It’s normal for babies to spit up.

  • Be wary of dark yellow or green vomit, or projectile vomiting.

  • If you’re concerned about your baby’s spit-up, contact your Swedish physician.

I have never met a baby that didn't on occasion spit up. Many perfectly healthy babies can even spit up quite a bit. Reflux is often the label given to babies who vomit, and this rarely amounts to a significant problem.

However, there are a few things that a parent should watch out for:

The most important thing is the color of what a baby is throwing up. Dark yellow and especially green vomit is never normal in a baby and demands immediate medical evaluation as this could represent a dangerous twisting of the intestines, which is linked to abnormally positioned intestines.

Another consideration is quantity. If a baby is throwing up more than 1/4 of what s/he is taking in, vomiting to the point of possible dehydration (fewer wet diapers), or projectile vomiting, then this may suggest a problem called pyloric stenosis. Pyloric stenosis usually affects babies less than 2 months of age and progresses from a little spit-up to seemingly their entire feeds shooting out of their mouth. This results from the rapid growth of a muscle called the pylorus which surrounds the exit of the stomach. This overgrown muscle squeezes closed the exit, so the only option for milk in the stomach is to go back the way it came. Pyloric stenosis affects about 1 in 400 babies, and it is often diagnosed with the help of ultrasound. Pyloric stenosis is treated very effectively by a surgery that spreads open the muscle to allow passage of food out of the stomach. This can be accomplished by a minimally invasive approach called a laparoscopic pyloromyotomy.

So remember: beware the baby that vomits green, and it is not normal for a baby to projectile vomit!

Find a doctor

If you have questions about your baby’s vomiting, contact the pediatrics department at Swedish. We can accommodate both in-person and virtual visits.

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.

Join our Patient and Family Advisory Council.

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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