What to Do If Your Baby Is Spitting up Blood

Most Likely Causes of Blood in Newborn Vomit

baby spitting up blood

Verywell / Emily Roberts

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If you notice that your newborn is spitting up blood, it can be very scary and you may want to call your pediatrician right away. The good news is that there is usually no reason to be alarmed by this symptom unless your baby is showing signs of fever, swollen belly, or lethargy. Consider these likely causes.


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 and is sometimes called rusty pipe syndrome. The blood came from you, either by the baby swallowing blood during the birth process or from your breasts or nipples during breastfeeding.

Cracked 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 breast milk.

If you can heal your problems, there will be less blood in your baby's spit-up. Learn how to stop breastfeeding pain and bleeding so you can comfortably avoid using bottles until breastfeeding is well-established.


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 their stomach. Be sure to notify the medical staff that it happened and continue to monitor your baby.

Forceful Spit

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. Keep breastfeeding, taking steps to help reduce spitting up.

When to Worry

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 Causes

If you had a home delivery and your baby didn't get a vitamin K injection, they 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.

Babies fed cow milk may have a cow milk protein allergy that contributes to bleeding. 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.

2 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Kural B, Sapmaz S. Rusty pipe syndrome and review of literature. Breastfeed Med. 2020 Sep;15(9):595-597. doi:10.1089/bfm.2020.0055 PMID:32493050

  2. Burris AD, Burris J, Järvinen KM. Cow's milk protein allergy in term and preterm infants: Clinical manifestations, immunologic pathophysiology, and management strategies. Neoreviews. 2020 Dec;21(12):e795-e808. doi:10.1542/neo.21-12-e795 PMID:33262206.

Additional Reading

By Jennifer White
Jennifer White has authored parenting books and has worked in childcare and education fields for over 15 years.