Unfortunately, vomiting is a common but typically short-lived problem in children. Most of the time it is caused by a virus that infects the lining of the stomach. It can also occur if your child has eaten something that doesn’t agree with him/her. Much less often, it can be associated with something more serious; but as stated, this is the exception rather than the rule. (See the section below “Contact Our Office if…)

Typically, vomiting will last less than 1 or 2 days. Many viruses that infect the stomach (colloquially called “the stomach flu”) may start with a day or two of vomiting followed by several days of diarrhea.

Vomiting vs spitting up
Vomiting occurs when there is a forceful emptying of much of the contents of the stomach through the mouth. Spitting up, on the other hand, occurs in primarily young infants and results in the child regurgitating one or two mouthfuls.

How to help your child
When an infant or child is vomiting, our goals are to make the child as comfortable as possible, minimize vomiting, and maintain hydration. In general our goal is to “fool the stomach” into thinking that nothing is in it because a “sick” stomach that is quickly filled will likely revolt by expelling its contents i.e. more vomiting. A child will vomit less if he or she is given fluids in small but very frequent amounts. Think of it as “dripping it into the stomach”. Small amounts are absorbed by an ill stomach much more easily. Remember, you want to still give about the same, if not more fluids, than usual, it just needs to be done over an extended period of time. It is labor intensive and will require you to be actively involved in your child’s recovery.

If your child is less than 6 months old and is breastfeeding 
Most infants can continue breastfeeding and do not necessarily need to switch to an oral electrolyte solution (i.e Pedialyte) The key is to nurse for shorter periods but more frequently. You can also consider giving your baby pumped breastmilk with a bottle or a medication syringe, so you control how much your baby is taking at a time.

Older infants and children 
Once again, fluids in small frequent amounts are recommended. If infants are unable to tolerate their formula in even small amounts (1/2-1 oz at a time), an oral electroyte rehydrating solution such as Pedialyte or Kao-electrolyte can be given. Once again, small frequent amounts are the key. Some children with severe vomiting may tolerate only a teaspoon or two every few minutes.

Because oral electrolyte solutions have a slight salty taste to them, you will want to give your child only a teaspoon or two initially. This seems to make the saltiness less noticeable. Also, the flavored versions are more acceptable to children, You can also use Pedialyte popsicles (they can be purchased or you can freeze your own). Children seem to accept these more readily as well--- and it also fits the bill of giving small amounts at a time as it slowly melts.

Toddlers and older children can also be given water or ice chips, which are easily absorbed across the stomach lining. Although juice and other sugary fluids are not generally recommended, if that is the only fluid you can get your child to take, it is better than no fluids at all.

Once your child is tolerating small amounts of fluids you can slowly advance the amount and type of fluids you give your child. If you push it too far too quickly and your child vomits again, just back off to the last step and advance again as tolerated.

Once fluids are going well, you can start back to some easily digestible foods such as toast, bread, crackers, rice, bananas, and applesauce. Once again, offer foods in small amounts and advance to a regular diet as tolerated.

If your child refuses food initially, don’t panic! Remember he or she has an upset stomach and doesn’t want to experience further discomfort (tell me, how much do YOU want to eat when you get the “stomach flu”). Concentrate on fluids, as this is most important, and your child’s appetite will gradually come back as he/she is feeling better.

Common Misconceptions
Don’t let your vomiting child drink as much as they want to at a time. Yes, they may be thirsty, but if the stomach senses a relatively large volume in it, vomiting is likely to occur. As repeatedly taking a bottle away from your infant so he doesn’t drink too much at a time is likely to be upsetting to him, consider using a medication syringe to administer a teaspoon to a tablespoon every few minutes, until they can tolerate more at a time.

Remember Pedialyte is a rehydrating solution that is more easily tolerated and is for temporary use until your child is able to handle a more regular diet. It is a not a medicine and will not “cure” vomiting.

If able, try and avoid medicines taken by mouth as this may upset the stomach further. If your child has a fever and is uncomfortable from it, consider acetaminophen (i.e Tylenol) suppositories. Because NSAIDS (anti-inflammatory medications such as ibuprofen or motrin) are also a little hard on the stomach, it is best to avoid NSAIDS when a child is vomiting. If your child is on a prescription medicine, call our office for advice.

Call our office immediately if:
Your child is less than 3 months old and also has a temp >100.4 R

Your child is less than 3 months old and has vomited (not just spitting up) more than 3 times in a day.

Your child has severe abdominal pain (other than the expected nausea and stomachache just prior to a vomiting episode)

Your child vomits up blood or bright green (the color of freshly mowed grass)--- (vomit that is yellow in color is ok) 

Your child begins to manifest signs of dehydration (no urination in 8 hrs, very dry mouth or no tears when crying)

Your child is acting very sick and very weak (difficult to awaken or is confused when awake)

You are concerned that the vomiting could be a result of a poisoning/ingestion

Your child has a serious chronic illness, such as diabetes

Call our office during regular office hours if:
Vomiting continues for more than 24 hrs in a child less than one year or more than 48 hrs if older than 2.

You have other concerns or questions