Clinical assessment and risk stratification
- Colostrum feeds within the first two days of life can produce bright yellow vomit shortly after feeding.
- The colour will be similar to that of the mother’s milk.
- Obviously this will not occur in bottle-fed infants and the child will remain well.
Image caption: Colostrum-stained vomit
Management
- Reassurance is all that is required.
- Parents should be advised to return if:
- Persistently projectile, haematemesis or bilious vomiting
- New concerns (marked distress, feeding difficulties or faltering growth)
- Persistent, frequent regurgitation beyond the first year of life
- If there are any doubt the patient should be referred for a surgical opinion.