Vomiting

Vomiting is the forceful emptying of a large amount of the stomach's contents. Nausea and abdominal pain usually occur before each episode of vomiting. the main cause is viral gastroenteritis usually starting with vomiting and diarrhea to follow in 12-24 hours. In viral gastritis the vomiting usually stops in 12-24 hours. If diarrhea is present it may last for several days. If vomiting lasts for more than 24 hours without associated diarrhea your child needs to be seen. 

Reasons to Have Your Child Seen

We would want your child to be seen immediately if skin is gray or cold, very weak, difficult to awaken, has a stiff neck, bulging fontanel or could have been poisoned by a plant, chemical or medicine. Depending upon the situation we may want you to call 911. Reasons to seek medical assistance:

• Signs of dehydration.
• Blood (red or coffe-ground color) in the vomit that is not from a nose bleed
• Yellow or green vomit in the vomit for a child less than 12 weeks of age
• Abdominal pain that lasts over 2 hours
• Less than 12 months of age who vomits Oral Rehydration Solution (ORS) three or more times and has watery diarrhea
• Receiving ORS and continues to vomit everything for 8 hours
• Recent head or abdominal injury
• Fever greater than 105° F (40.5° C) if child is over 12 weeks of age
• Fever greater than 100.4 F (38° C) if child is under 12 weeks of age
• Hernia in the groin that looks like it is stuck
• Any concerns you may have for your child

Home Care for Your Child with Vomiting

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Formula-fed Infants

• For vomiting one or two times offer1/2 strength formula for two feedings, then switch back to full strength formula if tolerated.
• For vomiting more than two times use ORS for 8 hours. ORS= Pedialyte or in children greater than 1 year of age Pedialtye or 1/2 strength Gatorade.
• Spoon or syringe feed small amounts 1-2 teaspoons (5-10 ml) every 5 minutes. After 4 hours without vomiting, double the amount. After 8 hours without vomiting return to formula. For infants greater thatn 4 months of age, return to cereal and bananas. Normal diet is okay in 24 -48 hours. 

Breast-fed Infants

• If vomits twice, nurse one side every 1-2 hours
• If vomits more than 2 times, nurse for 4-5 minutes every 30-60 minutes.
• If continues to vomit, switch to ORS for 4 hours. Spoon or syringe feed small amounts 1-2 teaspoons (5-10 ml) every 5 minutes. After 4 hours without vomiting return to breastfeeding for 5 minutes every 30 minutes.

Older Children (>1 year old)

• Water or ice chips is best for vomiting alone. Give 1 tablespoon every 5 minutes.
• If diarrhea is also present, use ORS with 1/2 strength Gatorade, 1/2 strength lemon-lime soda, popsicles, or ORS frozen pops. After 4 hours without vomiting, double the amount. 
• After 8 hours without vomiting, add solids. Limit solids to bland foods low in fat and sugar and higher in starch for 24 hours. Start with saltine crackers, white bread, rice and dried cereals. Normal diet is okay in 24-48 hours. 
• Avoid Medicine: Discontinue all nonessential medications for 8 hours. 

Severe or continuous Vomiting, but Well Hydrated

Sometimes children will vomit almost everything for 3-4 hours even in small amounts. Some fluid is being absorbed and this will help prevent dehydration. Sleeping for a few hours may help your child to stop vomiting, but awaken if more than 3 hours pass without fluids. Do not give anti-emetic or anti-diarrheal medications to children without doctor's order. 

If you have any concerns about your baby's health, please call. This Webiste is menat to be a guideline, not a substitue for the care of a competent helath care provider. Please do not give any medications without talking to your doctor first. We are happy to help you in any way we can. 

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