What is vomiting?
Vomiting (throwing up) happens when the stomach forcefully pushes its contents up through the mouth. It has many causes. The most common cause is a virus, but also can be caused by strep throat, migraines, appendicitis, urinary tract infections, etc.

What problems can vomiting cause?
The real danger of vomiting is that it may lead to dehydration. Your child may also have a fever or diarrhea (loose, frequent stools). A child with vomiting, fever and diarrhea may become dehydrated more quickly.

What are signs of dehydration?

  • Your child does not make tears when crying
  • Your child has a dry sticky mouth
  • Your child has no urine in over 8 hours or less than 3 urinations in 24 hours
  • Your child refuses to drink fluids, despite encouragement
  • Your child starts to act very sick or looks listless

Moderate to severe dehydration may require a trip to the Emergency Room to obtain IV fluids

What is the treatment for vomiting?

The goal of treatment is to keep your child from getting dehydrated.
General guidelines include:

  • Perform Oral Rehydration Therapy for 3-4 hours.
  • Use an oral rehydration solution (unflavored Pedialyte, half strength sports drink or Liquid IV).
  • Syringe feed 5mL every few minutes for several hours.
  • You are only asking your child to swallow the small amount you are putting in their mouth, not to drink a large glass/bottle of fluid.
  • It will get easier the more you keep trying.
  • Your child may vomit, but it is usually less than what they were ingesting.
  • After your child is able to keep down oral rehydration solution for 3-4 hours, you may begin to resume a regular diet.
  • Do not dilute breast milk or formula.
  • If your child has problems keeping the fluids down or vomits more than 8 times in less than 8 hours, he or she should be evaluated.

What are oral rehydration solutions?

  • Give babies less than 12 months old unflavored Pedialyte or a less costly store brand.
  • Give babies over 12 months old half strength Gatorade (half water, half Gatorade) to drink if they will not take the fluid listed above. Use regular, not diet, but it may be any flavor except those that are red in color.
  • Do not use plain water for babies less than 12 months of age.
  • For all other children, use half-strength Gatorade or less costly sports drinks.

What do I do if my baby is breast fed?
If your baby has vomited only once or twice:

  • Continue breast feeding
  • Limit total nursing time or nurse on only one breast each feeding
  • After 4 hours without vomiting, nurse as usual

If vomiting occurs three or more times:

  • Nurse for 2-3 minutes every 15-30 minutes
  • Or, put your baby on oral rehydration therapy as directed above
  • After 4 hours without vomiting, return to your regular nursing schedule

Warning Signs of Vomiting

Some conditions that cause vomiting require immediate medical treatment, so be alert for the following trouble signs, whatever your child’s age, and call your pediatrician if they occur.

  • Blood or bile (a green-colored material) in the vomitus
  • Severe abdominal pain
  • Strenuous, repeated vomiting
  • Swollen abdomen
  • Lethargy or severe irritability
  • Convulsions/seizures
  • Signs or symptoms of dehydration, including listless appearance, dry mouth, absent tears, depression of the “soft spot” and decreased urination
  • Inability to drink adequate amounts of fluid
  • Vomiting continuing beyond twenty-four hours

Final note
One final comment is that children often look worse when they have a fever, so if your child has a fever, give them acetaminophen or ibuprofen. Remember that there is a suppository form of acetaminophen if your child is vomiting and unable to tolerate oral medications.