What to Do If Your Baby Is Spitting Up Blood

If there is blood in your baby's spit-up, there may be several reasons why. Learn when not to worry and when you should call a health care provider for advice.

Medically reviewed by Wendy L. Hunter, M.D.Medically reviewed by Wendy L. Hunter, M.D.

If your newborn is spitting up blood, you are likely feeling scared and may want to call a health care provider right away. If you see some red flecks or pink-tinged newborn spit up or vomit, the source of the blood is most likely swallowed maternal blood and is sometimes called rusty pipe syndrome. The blood comes from the birthing parent, either by the baby swallowing blood during the birth process or from the breasts or nipples during breastfeeding.

The good news is that there is usually no reason to be alarmed unless your baby is showing signs of fever, swollen belly, or lethargy. Read on to learn some likely causes of blood in your baby's spit-up.

Reasons a Baby May Spit Up Blood

There are a few reasons there may be blood in a baby's spit-up. The most common cause is cracked nipples, but other common reasons include swallowing blood during birth and forceful spitting up.

Cracked nipples

In most cases of breastfeeding babies, that blood is coming from you and not your baby. Blood in your breastmilk can occur if you are having issues with cracked or sore nipples. Quite likely, you are bleeding, and it is mixing with your breast milk.

Nipple pain and injury is often the result of an improper latch. So, having a health care provider or lactation consultant observe a feeding can sometimes resolve the problem. Early intervention often quickly alleviates the pain and allows the injury to heal.

Other reasons for nipple injury include:

• Breast pump trauma

• Skin lesion

• Infection (nipple thrush, for example)

• Vasospasm (painful blood vessel constriction at the nipples)

• Nerve pain resulting from a health condition (like fibromyalgia or a migraine)

• Oversupply
  

• Plugged ducts

• Newborn tongue-tie

Nipple pain sometimes leads to early and undesired weaning. Talk to a health care provider about how to stop breastfeeding pain and bleeding so you can comfortably achieve your breastfeeding goals.

Ingesting blood during birth

If there is blood in your baby's spit-up shortly after delivery, there is generally no reason to be concerned, as it's likely the baby swallowed maternal-fetal blood during birth. Swallowing maternal-fetal blood during birth can also sometimes show up as bloody stool. Be sure to notify the medical staff that it happened so they can rule out other causes.

Spitting up with too much force

In some very rare instances, a forceful spit-up or vomit can cause a tear in a tiny blood vessel in your baby's esophagus. Again, no need to worry here. This will heal quickly. But it's a good idea to mention it to a health care provider to be sure nothing else is going on. If you are breastfeeding, you'll likely be advised to keep doing so and advised on steps to help reduce spitting up.

Less Likely Causes of Blood in Baby's Spit Up

Less likely causes of blood in a baby's spit-up include:

• Trauma: If your baby had a nasogastric tube or other procedures, there may be trauma or irritation that is continuing to leak blood.

• Irritation: Other irritations of the nose, throat, esophagus, and stomach might be the source.

• Clotting disorder: If your baby didn't receive a vitamin K injection, they may have a clotting disorder.

• Milk protein allergy: Babies fed cow's milk may have a cow's milk protein allergy that contributes to bleeding.

Give the health care provider an accurate history of when you saw the blood and any other factors so they will know what further tests to perform.

When to Worry About Blood in Baby's Spit Up

If the above common causes 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 a health care provider.

You may be able to request to talk to an office nurse and detail your baby's symptoms. Be ready to offer information about the following:

• Is your baby experiencing colic?

• Are they constipated?

• Is their stomach distended?

• Do they have a fever?

Warning Signs

Pursue prompt medical attention should your baby have the following symptoms:

• Abdominal distension

• Green vomiting

• Lethargy

• Fever

Related: Acid Reflux in Babies: Causes, Symptoms, and Remedies

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