What is the cause of vomiting white frothy emesis, also known as hematemesis (vomiting blood) is not applicable here as the emesis is white and frothy, a possible indication of gastrointestinal (GI) issues?

From the Guidelines

Vomiting white frothy emesis in infants is most likely due to gastroesophageal reflux (GER) and typically resolves on its own with time, but it's crucial to rule out other underlying pathologies such as obstruction along the gastrointestinal tract or infectious etiologies 1. When evaluating an infant with vomiting white frothy emesis, it's essential to consider the clinical differentiation between vomiting and regurgitation, as nonbilious vomiting is often associated with GER, which is common in infants, especially in the first weeks of life 1. Key points to consider in the evaluation of vomiting in infants include:

• The majority of cases are benign and related to GER, which usually has no definitive pathologic cause and is unrelated to a functional defect 1
• Bilious emesis or repeated forceful vomiting should be evaluated for underlying obstruction, and congenital GI tract abnormalities are a primary consideration in neonates presenting with vomiting in the first week of life 1
• A diagnostic workup should start with a thorough clinical evaluation, including history and physical examination, which can lead to the diagnosis in most instances 1
• Viral gastroenteritis, systemic infections, and metabolic disorders may be diagnosed by clinical and laboratory criteria, and conditions like hypertrophic pyloric stenosis (HPS) may be diagnosed by feeling the classic “olive” of hypertrophied muscle 1 In terms of management, while waiting for medical care, it's recommended to avoid eating solid foods, sip clear fluids slowly to prevent dehydration, and not take medications without medical advice 1. It's also important to note that white frothy vomit can occur when stomach contents mix with air and digestive juices, creating a foam-like appearance, and common causes include gastroesophageal reflux disease (GERD), gastritis, peptic ulcers, pancreatitis, or food poisoning 1. Overall, prompt medical attention is necessary to rule out underlying pathologies and provide appropriate management for vomiting white frothy emesis in infants.

From the Research

Vomiting White Frothy Emesis

• Vomiting white frothy emesis can be a symptom of various conditions, including gastrointestinal disorders, infections, and other medical conditions 2, 3.
• The evaluation and treatment of nausea and vomiting depend on the underlying cause, which can be acute or chronic 2, 3.
• Acute nausea and vomiting can be caused by gastroenteritis, foodborne illness, acute migraine headaches, vestibular disturbances, early pregnancy, and adverse effects of medication 2.
• Chronic nausea and vomiting can be caused by gastrointestinal, infectious, metabolic, neurologic, psychiatric, or medication-related factors 2, 3.
• Treatment options for nausea and vomiting include nonpharmacologic management, such as fluid and electrolyte replacement, small frequent meals, and avoidance of trigger foods, as well as pharmacologic therapy with antiemetic drugs 2, 4, 5.
• Antiemetic drugs, such as ondansetron and metoclopramide, can be effective in reducing symptoms of acute nausea and vomiting, but chronic symptoms may require more targeted treatment 4, 5.
• In some cases, vomiting white frothy emesis may be a symptom of a more serious underlying condition, such as gastroparesis or cyclic vomiting syndrome, which requires specialized treatment 3, 6.