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What to Do if Your Baby has Blood in Their Spit Up

Updated on March 16, 2018
kate stroud profile image

Kate is a mother of two boys and also manages a nanny business in the Sacramento area of California.

Medical Disclaimer

I'm not a doctor, I'm a mom who has panicked through every hiccup, head bump and chesty cough. Take this article as parent-to-parent advice but remember that if anything concerns you about your baby, you should call your pediatrician or the after-hours nurse line.

If you feel that your baby is suffering from a life threatening emergency, skip this article and call 911 or head to the ER right now.


While my niece and nephew have been the kind of babies who have these petite, precious little spittles after a feeding, my babies were always on exorcist level, spitting up to the point where I should have just renamed them after volcanoes.

The good thing is that spit up is usually not a huge deal, and after lots of conversation with our pediatrician I realized that as in all things baby-related, each baby is different and there is no true “normal” when it comes to spitting up.

There are things that can be worrisome, however, like when there’s blood in your baby’s spit up which you definitely shouldn’t just brush off as typical baby grossness. But what should you do if your baby has blood in their spit up? Even though it’s counter-intuitive, don’t clean it right up. You’re going to want to call your baby’s pediatrician right away but before you do that you can get some more information to share with the doctor that’ll help you all give your baby the best care possible.

A tried and true tactic to prevent spitting up is to hold your baby upright after a feeding. That underdeveloped digestive system is much happier when gravity isn't working against it.
A tried and true tactic to prevent spitting up is to hold your baby upright after a feeding. That underdeveloped digestive system is much happier when gravity isn't working against it. | Source

Steps to Take if Your Baby Has Blood in Their Spit Up

Take A Few Pictures

I know it seems gross but grab your phone and take a few pictures of the spit up. First from far away to give some scale as to how much came out and then some up close shots to get the details. If you tell your doctor that your baby has blood in their spit up, they’re going to want to know what it looks like, how much, if it’s streaking, etc. In the chaos of the moment it’s too easy for details to blur together and for the brain to exaggerate or dismiss important things.

If you have pictures of the mess you’ll be able to give the pedi a better description of what you’re dealing with and, if they want, you’ll even be able to send them the pictures or bring them in for them to see while examining your baby.

Write Down Your Baby's Symptoms

When you call, you’ll probably be put through to the nurse’s line so that the nurse can determine if you should bring your baby in or if they should just send a note into the doctor for a call back. The first thing the nurse is going to want to know is your baby’s current stats like:

  • Does your baby have a fever, what’s their temperature? So make sure you’ve taken your baby’s temp and write it down before making the call.

  • What the blood looks like. Now’s the time to pull out those pictures - is it streaking, is it just flecks?

  • What your baby has eaten recently. Some babies are still nursing or drinking milk while also consuming some solid foods and some babies spit up closer to their first year than others. Both of my babies spit up pretty consistently until near their first birthday, so sometimes some solid food was mixed in and changes the consistency/color of their spit up.

  • How your baby is acting. The nurse is going to want to know if your baby seems lethargic, is experiencing diarrhea, etc. Write down your baby’s behavior and symptoms beforehand so that when you call you have your stuff together and don’t have to sit there in your tired, panicked haze trying to recall pertinent information.

  • How forceful the spit up was and how much came up. Again, those pictures are going to help you.

Call Your Pediatrician

Once you have the pictures taken and the symptom info written down, call your pediatrician’s office and ask to speak to a nurse. The nurse will go over all of the info mentioned above and let you know whether they think the situation needs to be discussed with the doctor or not.

Every office is different, but more often than not, I’ve found that my nurse does suggest that we come in, especially if there’s a fever present.

So be prepared to come in right away if they do think your baby needs to be seen. If not, make sure you still have that pen and paper with you so that you can write down your nurse’s suggestions for observation and any other info they pass along.

If anything about your baby concerns you, even if it seems like a silly thing to bring up, call your pediatrician and ask to be connected to the nurses line.
If anything about your baby concerns you, even if it seems like a silly thing to bring up, call your pediatrician and ask to be connected to the nurses line. | Source

What Could the Blood Mean?

According to Dr. Sears the blood could be a sign that your baby’s esophagus has suffered a small tear from forceful spit up but there’s also a possibility that the blood is actually coming from you. If you’re breastfeeding and you have cracked, bleeding nipples, this could be the source of the blood.

Make sure you discuss these possibilities with your pediatrician before they examine your baby.

How to Help Your Baby Spit Up Less

According to the Mayo Clinic spitting up is result of an under-developed esophageal muscle that helps keep all of your baby's food in their tummy. Until this muscle matures, you're going to deal with spit up. It's not fun, especially if it's happening every day, so here are a few steps you can take to prevent or at least lessen those precious regurgitated milk showers.

  • Take Breaks During Feeding - When my kids were babies I would let them nurse on one side, sit them up to burp and digest, then switch to the other side about ten minutes later. The same can be done with a bottle, just take the break when your little one is halfway through the bottle, making sure to hold them upright so their little tummy is in the right position for digestion.

  • Burp Them Regularly - Every newborn should burp after feedings to release the air in their stomach, otherwise, the buildup can push food out the same way it came in.

  • Limit Activity - Make sure to have the first hour after a feeding be a quiet time for your baby. Just like a soda bottle, too much movement can upset their stomach and make them spit-up.
  • Don't Eat Crazy Stuff (If you're breastfeeding) - Just trust me. Spicy Curried Pad Thai and a newborn baby are almost always a recipe for disaster.

Analyzing my baby's spit up has never been my favorite part of babyhood and I'm sure it's not yours either.

I know it's super freaky, but - welcome to parenthood, where just when you think you have a handle on the most basic stuff, your kid throws bloody spit up in your path and you're starting all over again. Take a deep breath, drink a glass of water, write down a list of questions inspired by this article (but maybe try not to bring up tuberculosis right away) and give your pediatrician a call.

You've got this!

© 2018 Kate Stroud


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