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Last updated: September 12, 2025View editorial policy

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Differential Diagnosis for Bright Yellow Spit Up in Newborn

  • Single Most Likely Diagnosis
    • Gastroesophageal Reflux (GER): This is the most common cause of spit up in newborns, and the bright yellow color could be due to the presence of bile. GER is a normal physiological condition in infants, where the lower esophageal sphincter is not fully developed, allowing stomach contents to flow back up into the esophagus.
  • Other Likely Diagnoses
    • Overfeeding or Foremilk Hindmilk Imbalance: Overfeeding or an imbalance between foremilk and hindmilk can cause excessive spit up, which may appear bright yellow due to the high fat content of hindmilk.
    • Lactose Intolerance or Sensitivity: Although rare in newborns, lactose intolerance or sensitivity can cause gastrointestinal upset, leading to bright yellow spit up.
    • Pyloric Stenosis: This condition, characterized by a narrowing of the pylorus, can cause projectile vomiting, which may appear bright yellow.
  • Do Not Miss Diagnoses
    • Pyloric Stenosis with Gastric Outlet Obstruction: If left untreated, pyloric stenosis can lead to severe dehydration, electrolyte imbalance, and even death.
    • Intestinal Obstruction: Conditions like intestinal atresia or volvulus can cause bright yellow vomit and require immediate surgical intervention to prevent complications.
    • Infectious Gastroenteritis: Bacterial or viral infections can cause severe gastrointestinal symptoms, including bright yellow diarrhea or vomit, and may lead to dehydration and sepsis if not promptly treated.
  • Rare Diagnoses
    • Biliary Atresia: A rare congenital condition where the bile ducts are blocked, causing bright yellow vomit and requiring prompt surgical intervention.
    • Choledochal Cyst: A congenital anomaly of the bile ducts that can cause bright yellow vomit and may lead to complications like cholangitis or pancreatitis if left untreated.
    • Congenital Hyperbilirubinemia: A group of rare genetic disorders that affect bilirubin metabolism, causing elevated bilirubin levels and potentially leading to bright yellow vomit.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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