Baby Spitting Up Blood: Why It’s Happening and What to Do

Updated 27 November 2021

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Reviewed by Anna Klepchukova, Flo chief medical officer, UK

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Spitting up milk or formula is common in newborns; but you might be worried if your baby spits up blood. Keep reading to find out when babies spitting up blood is considered normal, and when it’s cause for concern.

Reasons for spitting up blood

Ingesting blood irritates your baby’s stomach so if you notice blood in their spit-up and you’ve been breastfeeding, don’t panic. In some cases, it has more to do with you than with your baby.

Depending on their age, there a number of explanations for why they’re spitting up blood.

Your newborn baby spits up blood in the first few days of life

In the first few days after birth, it’s natural for your breast milk to be bloodstained. This is due to increased blood flow to the area, a generation of new cells, and growth in your milk ducts. Often referred to as “rusty pipe syndrome,” bloodstained breast milk may be slightly red, pink, orange, or brown in color. Don’t worry – it’s perfectly safe for them to drink this breast milk. Just remember that their spit-up will take on a similar appearance.

Alternatively, your newborn might spit up blood during the first three days if they swallowed blood during delivery. Consult your doctor if you think this is the case.

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Your newborn baby spits up blood in the first few months of life

If your little one is spitting up blood during the first few months, try to determine if the blood is actually coming from you.

Do you have peeling or cracked nipples? If they happen to bleed during breastfeeding, it’s possible for your baby to ingest some of it. As a result, their spit-up is going to have a slightly blood-tinged hue, or contain tiny traces of blood.

Try breastfeeding with a nipple shield to temporarily limit your baby's exposure to your cracked nipples.

Incorrect usage of a breast pump or any type of physical trauma to the breasts could also be underlying factors. Broken capillaries have a tendency to leak blood into your breast milk.

Testing out different breastfeeding positions might help your child latch properly and alleviate some of the related symptoms.

Have you already taken steps to try and heal your nipples? Are you still seeing blood in your breast milk? Then make an appointment with your doctor who should rule out more serious conditions, such as:

• Intraductal papilloma (a benign breast tumor)
• Mastitis (an infection leading to bleeding of the nipples)
• Breast cancer

When to call the doctor if your baby spits up blood 

When your baby spits up blood and you’ve been able to determine that isn’t coming from you, contact your doctor immediately. Possible causes include:

• Clotting disorders, which are more common in babies with a vitamin K deficiency (most newborns receive a vitamin K injection at birth)
• Excessive or forceful vomiting, which may produce small tears in their esophagus
• Trauma or irritation to their nasal pathways, especially if they’ve used a nasogastric tube or undergone nasal suctioning

What does a small amount of blood in the vomit mean?

Spit-up is easily expelled by newborns because the sphincter muscle between their stomach and esophagus hasn’t fully developed. Vomiting, on the other hand, is a forceful action that might be rather uncomfortable and possibly dangerous.

If your baby is throwing up blood, or has a small amount of blood in their vomit after ingesting cow’s milk or formula, it could be an allergic reaction. Note that blood in the vomit usually resembles streaks of coffee grounds.

Vomiting is also a potential symptom of gastroesophagael reflux disease (GERD,) or in more serious cases, gastrointestinal bleeding due to esophageal or stomach tears. Less common reasons include anatomical anomalies, vascular abnormalities, and congenital coagulation disorders.

When to call the doctor if your baby is throwing up blood

Seek medical attention if your baby is throwing up blood that you know isn’t yours. Vomiting blood, or hematemesis, can be an indication of severe illness. Be on the lookout for the following signs and symptoms:

• Green vomit
• Temperature (taken rectally) which is higher than 100.4 degrees Fahrenheit
• Diarrhea, particularly dark or bloody stools
• New skin rashes
• Seizures or severe fussiness and being inconsolably upset

If possible, take a sample of the blood in your baby’s vomit to your doctor for testing. 

When it comes to your child’s health, it’s always better to be safe than sorry. Seek medical assistance immediately if you have any concerns about spotting blood in your baby’s spit-up or vomit.

History of updates

Current version (27 November 2021)

Reviewed by Anna Klepchukova, Flo chief medical officer, UK

Published (14 August 2019)