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Spit-up, vomit, and stool changes: how to record what you saw

Published August 25, 2026

When you want to discuss spit-up, vomit, or a stool change at an appointment, a direct description is more useful than a label chosen later. Write what you saw, when you saw it, and what else you observed nearby in time.

Use one page or phone note for the day. Give every entry a date and time. If you are making notes after the fact, say that the time is approximate. A record can include uncertainty without trying to smooth it away.

The point of these notes is not to decide what an observation means. Interpretation belongs to the pediatrician.

Begin with the time and setting

For each entry, write the time and where the baby was. You might write “2:15 p.m., held upright after bottle,” “4:40 p.m., changing table,” or “overnight, noticed at diaper change around 1 a.m.”

Add nearby time-stamped observations as separate lines. A feed can have its own start and end time. Sleep can have its own line. If you heard crying, note the sound and duration separately. Keeping details on separate lines preserves the sequence without turning one note into a long story.

The NHS describes keeping a note of feeding and nappy observations when preparing to speak with a health professional. For this purpose, a time-ordered page is enough.

Describe what you saw in ordinary words

For material that came out of the mouth, write where you saw it and how it looked to you. Use words like “on bib,” “on shirt,” “on floor,” “small amount,” “larger patch than earlier,” “thin,” “thick,” or “curdled-looking” only when they match what you saw. If you are comparing size, name the object you used for comparison, such as a coin, washcloth corner, or palm.

For stool, write the time, color, texture, and anything you noticed on the diaper or clothing. You can use color words, such as yellow, green, brown, black, red, or another word that describes what was in front of you. For texture, write loose, watery, pasty, seedy, formed, or another everyday description. Do not substitute a conclusion for the description.

If you are not sure how to describe an entry, write “not sure how to describe color in this light” or “noticed after changing clothes.” Your uncertainty is part of the observation record.

Keep amounts and counts faithful to what you know

If you measured a quantity, copy the measurement and unit exactly. If you did not measure it, use a comparison you can explain or leave the amount out. Do not add a number because a blank feels incomplete.

When there are repeated entries, write each one with its own time. A line such as “three diaper changes” loses the timing. Three short lines can show when you noticed each change without requiring you to calculate anything.

In a written record, that can mean the feed times and the details you directly saw before, during, or after it.

Label photos clearly if you choose to take them

If you choose to bring a photo, pair it with a written line. Note the date and time, what the photo shows, and the lighting or surface if that helps you remember the image. For example: “Photo at 11:05 a.m., diaper on changing pad, taken near window.”

Keep the written description even when you have a photo. The note puts the file in the sequence of the day and gives you words to use during the appointment. Do not edit the photo into an annotated conclusion; keep it as a labeled record of what you chose to capture.

Read the page in order before you go

Before the visit, review the entries from earliest to latest. Mark the notes you want to show, but leave the original words visible. Bring the page, the matching photos if any, and the nearby feed, diaper, sleep, and sound entries.

If another caregiver made an entry, include their initials or name. You can say which details you saw yourself and which were written by someone else. A clear record makes those handoffs visible.

Keep the page focused on what you observed. The pediatrician can review the timeline and discuss interpretation with you.