Mumsnet Talk

My DD is 11wo and for the past couple of days has been fussier than usual, not feeding as well as usual (she's ebf) and she's been snuffly. Today she's been upset and crying a fair bit and over the last hour has been very sick four times. She soaked through DH's t-shirt twice (he's given up wearing one for now!), then she was sick all over herself. She then got very upset out of hunger and had the best feed she's had in a couple of days, much less fussing. She seemed happy, did a regular sized burp and then about five minutes later threw up all over me. Like, a lot. She's never been a sicky baby at all. I know babies are sick often but this isn't like her at all. I don't want her to get dehydrated and I know she needs to feed but it seems like she can't keep it down. What should I do?

As she is so young I would contact your OOH GP now and ask for advice.

She's just been very sick again and I hadn't fed her since she was sick last time. She's throwing up a lot every time and she really is quite upset. Should I call NHS direct? Or the out of hours doc? I really am quite worried now because she's never been sick like this before. That's five times in an hour and a half.

I would call OOH doctor

I would call now because if they tell you to come in (which I think they will do, because they will not want to take risks with such a young child) it maybe more difficult (snow, ice) the later it gets.

Thank you - I've called and now we're waiting for a doc to call us back.

If the vomitting follows a coughing attack it could be whooping cough. Not all doctors are alert to the fact that it is going round again.

Very glad you have called OOH doctor.
Keep offering her the boob, and make sure she's not getting too hot with the coughing. You might need to drink more yourself to keep up!

Also keeping her up straight (i.e. head against yoru shoulder) might help her breathe better during and after coughing, but once she needs to vomit I would hold her forward to make sure she doesn't swallow anything and gets it all out. Also she may get very distressed so try to reassure her as much as possible. I would get your DH to prepare a bag in case they want her (and you) to stay overnight at hospital for observation.

The first time it followed a cough, not sure about the middle two, but the last two didn't. OOH nurse has made us an appointment at OOH practice at 9.50.

I would still pack a hospital bag for you and for her. Also, take plenty of spare clothes/blankets etc as she maybe throwing up on the way to out of hours. I know this is wrong and illegal but when I was in a similar situation years ago, dh drove and I sat in the back of the car with her on my lap rather than car seat so she could lean forward during vomitting (as she vomitted several times during the journey). I just put a large thick towel on my lap and let it soak it with a large bip or muslin around her neck to try to keep her clothes a little clean. Is your OOH at the local hospital?

It's not at the hospital but it's not too far from there. I will take clothes/blankets/nappies etc with us, thank you because I think I would probably have just picked up her changing bag and only taken that.

Would she still want to feed? Because probably one of the biggest concerns now is that she gets dehydrated (and if they keep her in for observation they can quickly intervene if necessary). Does she have any fever? It is horrible, but it is good to see the OOH and then take it from there.

Oh, and if the OOH gives you the choice to wait and see at home or go to hospital for observation I personally would go for the latter given that it is weekend and given that such a small child can deteriorate really quickly (and also perk up very quickly BTW but then they will just discharge you).

Thank you. They've just said that it's probably a winter vomiting bug and to keep an eye on her over the weekend. She's vomited up everything she has in her and because it's so late has fallen asleep now without another feed. I'm going to let her sleep for a couple of hours and then wake her to feed if she hasn't woken by herself before then. He suggested feeding her half the amount as usual but twice as often to give her the best possible chance to keep the breastmilk down. He also said if she doesn't really improve then to get a urine sample... I have no idea how we will succeed with that if it comes to it.

Thanks for your helpful advice. I'm just resigned to having little sleep and lots of washing to do over the next few days but hopefully it'll clear up quickly and she'll feel better.

Please don't restrict feeds - I can kind of see where he's coming from, but you will make more to compensate, and some of it will be staying down.
All best for a speedy recovery.

Thanks NotYet, I will play it by ear with feeds. She'll be absolutely starving when she wakes up I think so she will probably want to guzzle and will probably protest loudly if I try and stop her before she's finished. She's used to feeding 100% on demand, and often feeds little and often anyway. She's not retched or anything for just over an hour now so it'll be interesting to see how she reacts when food goes in.

When my dd was so little she actually fed in her sleep, she could just latch on and drink, yours may do the same, but sometimes doctors warn against letting them do that because they say they might forget to swallow and then can choke. I always checked she was swallowing (you can feel it by keeping your finger lightly against her throat) and if concerned that she is not swallowing gently open her mouth and let milk just dribble out. Also, if you try this, keep her slightly upright. If she however starts vomitting make sure you support her to get it all out so she doesn't inhale any vomit (can cause pneumonia), so you have to be really on the ball.

If she drinks little and has vomitted a lot then getting an urine sample is much more difficult. I kept dd on thick towel and just waited and waited and waited and when it finally happened quickly put the container in the stream. These are the best samples but can take literally hours of patience (ignoring phones, anything, because that is when it will happen and then you have a several hours wait again). Some people in another thread mentioned putting cottonwool in nappy and squeezing that out in container (our paed did not like that, but clearly some doctors say it is okay).

Also, if it is a winter vomitting bug it is probably quite contagious so you and your DH might get it as well. Better stock up on essentials in case it strikes (or resort to internet deliveries).

Hope she will be feeling a bit better tomorrow.

I really am worried now that she's going to get dehydrated. She cannot keep even the tiniest amount down. She is sick within five minutes of anything entering her belly, if I let her have a longer feed she is sick before she's even finished, if I let her have a teeny tiny minute long feed, not even getting to my let down, she is still sick within five minutes and the sick is yellow. I'm just going in circles, feed, vomit, calm down crying child, wait a while (and change clothing/bedding if necessary!), feed, vomit... How long does she need to be going through this before she gets seriously dehydrated? She can't really be getting anything from any feed, it's simply not in there long enough. I know she's throwing it all up because she can besicj multiple times after a feed until she's just retching and nothings coming out. My mum suggested giving her cooled boiled water instead of breastmilk to see if she can keep that down but I'm sure I've read somewhere before that just breastmilk is best. Should I try it? She's only ever drunk breastmilk.

it wont harm her trying. its awful when they have a bug but your doing the right thing. is she still gettting wet nappies? hows her soft spot?

Soft spot seems very slightly sunken and no wet nappy for a couple of hours now but I'm not surprised because I don't think she's actually managed to drink anything and keep it down since about 4. Will try a small amount of cooled boiled water and see if she can stomach that.

If she falls asleep am I better letting her sleep until she wakes? Or should I be trying to get fluids into her?

This is what the NHS website says about dehydration in babies:
Dehydration in babies

A baby may be dehydrated if they have:

* a sunken soft spot (fontanelle) on their head
* few or no tears when they cry
* dry mouth
* fewer wet nappies
* drowsiness
* fast breathing

I am not a doctor, but she must be getting totally exhausted, so I would let her sleep a few hours and then try another feed/cooled boiled water.

However, if you do think she is dehydrated (i.e. she does have some of the above symptoms I would take her to A&E, because she is still so little and can deteriorate (but also improve) really quickly.

I wouldn't let her sleep until she wakes - I would wake her after 2-3 hours, depending on how often she normally feeds.

We're waiting for the boiled water to cool and she seems much happier now that there's nothing left in her to throw up. She's drifting off to sleep but keeps stirring. Hopefully she'll drop off and I can give her a bit of water in a couple of hours. I changed her nappy when we got in at 10.30 even though the previous one was barely wet so that I could keep tabs on how many wet nappies she has. Thanks for everyone's support so far

Oh poor you. Am currently in hospital with DS2 who had some kind of D&V bug. I ended up calling an ambulance for him yesterday as his legs went purple an I freaked out that he had meningitis. Turned out he was just very dehydrated but a day on fluids and he's quickly getting better. Trust your instincts I say. The GP told me he was probably fine when I phoned him. I knew there was something wrong so trusted my gut.
Hope your DD is ok.

Oh God. Just read that back. Sorry. Was not intended as a scare story!