What to Do if Your Baby Is Spitting Up Blood

Most Likely Causes of Blood in Newborn Vomit or Spit-up

Close up of baby spitting saliva
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If you notice that your newborn is spitting up blood, it can be very scary. What could be the cause of this troubling symptom? The good news is that there is no need to jump to alarm on this one unless your baby is showing signs of fever, swollen belly, or lethargy. Consider these likely sources.

If you see some red flecks or pink-tinged newborn spit-up or vomit, the source of the blood is most likely to be swallowed maternal blood.

The blood came from you, either by the baby swallowing blood during the birth process or from your breasts or nipples during breastfeeding.

Cracked, Sore Nipples

In most cases of breastfeeding babies, that blood is coming from you and not your baby. Consider if you are having issues with cracked or sore nipples. Quite likely, you are bleeding and it is mixing with your breastmilk. Here are some resources you can read to help you heal and decrease the blood in your baby's spit up. Learn how to stop breastfeeding pain and bleeding and how to avoid using bottles until breastfeeding is well-established.

Swallowed Blood During Delivery

If your baby spits up blood shortly after delivery, it may also have a simple, unalarming reason. Sometimes during delivery, the baby swallows maternal-fetal blood into his stomach. Be sure to notify the medical staff that it happened and continue to monitor your baby.

Forceful Spit Up Can Cause Bleeding

In some very rare instances, a forceful spit up or vomit can cause a small tear in a tiny blood vessel in your baby's esophagus. Again, no need to worry here. This will heal quickly. Keep breastfeeding, taking steps to help reduce spitting up.

When to Worry About Baby Spitting Up

If these don't seem to explain the blood in your baby's spit up and it continues to persist, then it is definitely time to call the pediatrician.

You may be able to request to talk to an office nurse, detail your baby's symptoms and any related behavior (for example is your baby experiencing colic, constipation, distended stomach, fever, etc.) A doctor may be able to explain the best course of action for you and your baby.

Pursue prompt medical attention should your baby have symptoms of abdominal distention, green vomiting, lethargy, or fever.

Less Likely Reasons for Blood in Baby Spit Up

If you had a home delivery and your baby didn't get a vitamin K injection, he may have a clotting disorder. If your baby had a nasogastric tube or other procedures, there may be trauma or irritation that is continuing to leak blood. Other irritations of the nose, throat, esophagus, and stomach might be the source. Give your doctor an accurate history of when you saw the blood and any other factors so she will know what further tests to perform.

Sources:

Boyle JT. Gastrointestinal bleeding in infants and children. Pediatrics in Review. 2008;29(2):39–52. doi:10.1542/pir.29-2-39.

Mayo Clinic Staff. Vomiting blood causes. Mayoclinic. September 2014. http://www.mayoclinic.org/symptoms/vomiting-blood/basics/causes/sym-20050732.

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