Parent Information about Vomiting

* This information is general and may not fit your particular situation. It should be used in addition to what you learn from your doctor.

Symptom Definition

  • Vomiting is the forceful emptying (throwing up) of a large portion of the stomach's contents through the mouth.
  • Nausea and abdominal discomfort usually precede each bout of vomiting.

Cause

  • The main cause is viral gastroenteritis. The illness starts with vomiting, but diarrhea follows within 12-24 hours. If vomiting persists as an isolated symptom (without diarrhea) beyond 24 hours, it often has another more serious cause.

Call 911 IMMEDIATELY if your child has the following signs of dehydration:

  • very dry mouth
  • no tears
  • no urination in more than 12 hours
  • gray skin color
  • is very weak, and
  • is difficult to awaken

Go to the Emergency Room IMMEDIATELY if:

  • Your child has neurological symptoms (stiff neck, bulging soft spot).
  • Your child was possibly poisoned with a plant, medicine, or other chemical.

Call the Office NOW if your child has:

  • Signs of dehydration (very dry mouth, no tears, and no urine in more than12 hours).
  • Red or coffee-grounds colored blood in the vomit that is not from a nosebleed.
  • Bile (yellow or green) in the vomit and the child is less than three months.
  • Continuous stomach pain or crying for more than 2 hours (especially if the stomach is swollen).
  • Sounds serious if attacks of severe abdominal pain/crying suddenly switching to 2- to 10- minute periods of quiet (age usually less than 3 years).
  • Age less than 12 months who has vomited clear liquids 3 or more times in a 12 hour period; in addition, the diarrhea is watery.
  • Drinking clear liquids, such as Pedialyte, and vomits continuously for more than 8 hours
  • Recent abdominal injury.
  • Fever more than 105degrees.
  • Age less than 12 weeks with fever greater than 100.4 degrees rectally.
  • Unusual bulging in the groin that looks like it is not going away.
  • Severe headache persists for more than 2 hours.
  • Age less than 12 weeks with vomiting 2 or more time within an 8 hour period

Home Care Advice for Vomiting

Here are some suggestions for handling your child who is vomiting:

Simple vomiting usually stops within 12 to 24 hours. Help your child go to sleep for a few hours (Reason: sleep often empties the stomach and relieves the need to vomit).

For Bottle-fed Infants Offer Pedialyte or Liquilyte Solution for 8 hours

  • For vomiting 1 or 2 times, weaken the amount of formula for 2 feedings. Then resume regular formula.
  • For vomiting more than 2 or more times, offer Pedialyte or Liquilyte.
  • Spoon or syringe feed small amounts: 1-2 teaspoons (5-10mL) every 5 minutes).
  • After 4 hours without vomiting, double the amount of Pedialyte or Liquilyte.
  • After 8 hours without vomiting, return to regular formula. For infants older than 4 months old, also return to cereal, strained bananas, etc. Normal diet is ok in 24-48 hours.

For Breastfed Infants, Shorten the Nursing Time

  • If vomits twice, nurse 1 side every 1-2 hours.
  • If vomits more than 2 times in an 8 hour period, nurse 4-5 minutes every 30-60 minutes.
  • If baby continues to vomit, switch to Pedialyte or Liquilyte for 4 hours.
  • Spoor or syringe feed small amounts: 1-2 teaspoons (5-10mL) every 5 minutes.
  • After 4 hours without vomiting, return to breastfeeding.

For Older Children (older than 1 Year Old) Small Amounts of Clear Fluids for 8 Hours

  • Water or ice chips are best for vomiting without diarrhea. (Reason: water is directly absorbed across the stomach wall).
  • Give small amounts (1 tablespoon) every 5 minutes.
  • Other options: Diluted flat lemon lime soda, Popsicles, or Pedia pops.
  • After 4 hours without vomiting double the amount of clear liquids.
  • After 8 hours without vomiting add solids.
    • Limit solids to bland foods for 24 hours.
    • Start with saltine crackers, white bread, rice, dried cereals, etc.
    • Normal diet ok in 24-48 hours.

Avoid Medicines: Discontinue all unnecessary medicines for 8 hours. (Reason: usually make vomiting worse. Avoid Ibuprofen, Advil, Motrin).

For Severe or Continuous Vomiting but well hydrated: Sometime children vomit almost everything for 3-4 hours, even if given small amounts. However, some fluid is being absorbed and this will help prevent dehydration. Continue offering clear fluids. Sleeping for a few hours may also help your child stop vomiting.

Expected Course: Vomiting from a stomach virus usually stops within 12-24 hours. If diarrhea is present, it will continue for several days.

Call the office if:

  • Vomiting becomes severe (vomits everything) for more than 8 hours.
  • Vomiting persists for more than 24 hours for a child 2 or younger.
  • Vomiting persists for more than 48 hours for a child older than 2.
  • Signs of dehydration (very dry mouth, no tears, and no urine in more than12 hours).
  • Your child becomes worse.