<s>[INST] I keep my 6 week old granddaughter. She is on Similac Formula and has been spitting up a lot in the last week. Sometime she projectile vomits. She is not running a fever, has 2 to 3 wet diapers in 6 hours. Her temperature ranges from 97.6 to 99.5. She has been coughing and today has been unusually fussy.. Her mother said she cried almost 3 hours this afternoon. She quiets when held. Do we need to be concerned, does she need to see her doctor. [/INST] Hi...this looks like a viral illness and upper respiratory illness. There are 2 issues -1. Keep checking her temperature and if it crosses 101F she needs to be evaluated for sepsis.2. Other probability is she might be having an ear infection and it could be the reason for her fussiness.She needs to see her doctor.Regards - Dr. Sumanth </s>