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Nausea and Vomiting, Age 11 and Younger
Topic Overview
Vomiting occurs when a child's stomach
contents are forced up the
esophagus and out of the mouth. Although nausea may
accompany vomiting in adults and older children, children younger than age 3
are usually not able to tell you if they are having nausea. Most of the time
vomiting is not serious. Home treatment will often ease your child's
discomfort.
Vomiting in a baby should not be confused with spitting
up. Vomiting is forceful and repeated. Spitting up may seem forceful but it
usually occurs shortly after feeding, is effortless, and causes no discomfort.
Causes of vomiting
A baby may spit up for no reason
at all.
Overfeeding, not burping your baby after feeding,
intolerance to milk or formula, and exposure to tobacco smoke are other reasons
why your baby may spit up.
Most vomiting in children is caused by a viral stomach illness (gastroenteritis). A child with a stomach illness also
may have other symptoms, such as diarrhea, fever, and stomach cramps. With home
treatment, the vomiting usually will stop within 12 hours. Diarrhea may last
for a few days or more.
Rotavirus is a virus that can cause
severe vomiting and diarrhea.
Rotavirus vaccine(What is a PDF document?) helps protect against
rotavirus disease.
Vomiting can also be
caused by an infection in another part of the body, such as
strep throat,
pneumonia, and
urinary tract infections. In rare cases, vomiting can
be a symptom of a serious condition, such as a blockage of the digestive tract
(pyloric stenosis), an infection (meningitis) of the fluid (cerebrospinal fluid) and
tissues (meninges) that surround the brain and spinal cord, or
Reye syndrome.
When a toddler vomits,
it is important to make sure he or she has not swallowed medicines, household
liquids, or other poisons. Look around the house for empty containers and
spills. There may be pills in your child's vomit, or the vomit may have an
unusual appearance, color, or odor. For more information, see the topic
Poisoning.
A child who falls down and
forcefully hits his or her head or belly may vomit because of an injury to
those areas. Check your child's body for bruises and other injuries.
Treatment
Babies and children younger than 1 year old
need special attention if they continue to vomit. They can quickly become
dehydrated. It is important to replace lost fluids
when your child is vomiting. Watch your child carefully, and pay close
attention to the amount of fluid he or she is able to drink. Look for early
symptoms of dehydration:
- The mouth and eyes may be drier than usual.
- The urine may be darker than usual.
- He or she may feel cranky, tired, or dizzy.
Also, be sure to notice the color of the vomit, and count
the number of times your child vomits. If your child vomits so frequently that
you can't get him or her to drink or vomits every time he or she takes a
drink, the risk of dehydration is greater.
Check your child's symptoms to decide if and when
your child should see a doctor.
Check Your Symptoms
Home Treatment
Newborns and babies through age 6 months
- Do not feed your baby for about 30 to 60
minutes after he or she has vomited. Be sure to watch your baby carefully for
dehydration. Signs include your baby being thirstier than usual and having darker urine than usual.
- If your baby is breast-fed,
continue breast-feeding. Offer each breast to your baby for 1 to 2 minutes
every 10 minutes.
- Do not give your baby plain water.
- If
your baby is formula-fed, switch to an
oral rehydration solution (ORS).
- Offer
0.5 fl oz (15 mL) of the drink
every 10 minutes for the first hour.
- After the first hour,
gradually increase the amount of ORS that you offer your baby.
- When
6 hours have passed without vomiting, you may resume your child's regular
formula feedings.
- Do not give your child any medicine—prescription,
nonprescription, herbal, or home remedies—without your doctor specifically
telling you to do so.
Children 7 months to 12 months
- When there has been no vomiting for 1 hour,
give 0.5 fl oz (15 mL) of
oral rehydration solution (ORS) every 10 minutes. Be sure to watch your child
carefully for
dehydration.
Signs include your child being thirstier than usual and having darker urine than usual.
- After the first hour, gradually increase
the amount of ORS that you offer your baby.
- When 6 hours have
passed without vomiting, you may slowly resume your child's regular formula
feedings.
- Offer bananas, cereals, crackers, or other mild baby
foods to your baby.
- You can also offer ORS frozen pops to your
child.
- Do not give your child plain water, fruit juice, or soda pop. Fruit juice and soda pop contain too much sugar and
not enough of the essential minerals (electrolytes) that are being lost. Plain
water and diet soda pop lack calories that your child needs.
- Do
not give your child any medicine—prescription, nonprescription, herbal, or home
remedies—without your doctor specifically telling you to do so.
Children over 1 year
- When there has been no vomiting for 1 hour,
give 1 fl oz (30 mL) of a clear
liquid every 20 minutes for 1 hour. Be sure to watch your child carefully for
dehydration. Signs include your child being thirstier than usual and having darker urine than usual. Increase the volume of clear liquids that
you give by 3 fl oz (90 mL) an
hour for each hour that your child does not vomit. For example, give your
child:
- 2 fl oz (60 mL) of fluid every 20 minutes during the second hour for a
total of 6 ounces (180 mL) in the second hour.
- 3 fl oz (90 mL) of fluid every 20 minutes during the
third hour for a total of 9 ounces (270 mL) in the third hour.
- Clear liquids include oral rehydration solution (ORS), clear broth, and gelatin
dessert.
- You can also offer ORS frozen pops to your child.
- Do not give your child plain water, fruit juice, or soda
pop unless you do not have any other rehydration fluids available. Fruit juice and soda pop contain too much sugar and not enough of the
essential minerals (electrolytes) that are being lost. Plain water and diet soda
pop lack calories that your child needs.
- Gradually start to offer
your child regular foods after 6 hours with no vomiting.
- Offer your child solid foods if he or she
was eating solids before. Offer crackers, toast, broths, mild soups, mashed
potatoes, rice, and breads to your older child.
- Allow your child
to eat what he or she prefers—the type of food is not
important.
- Avoid high-fiber foods, such as beans, and foods with a
lot of sugar, such as candy or ice cream.
- You may give your older child an over-the-counter antinausea medicine, such as meclizine (Antivert or Bonine) or dimenhydrinate (Dramamine). Follow the package instructions carefully. If you give medicine to your baby, follow your doctor's advice about what amount to give.
If your child also has diarrhea, try home treatment for diarrhea.
Symptoms to watch for during home treatment
Call your child's doctor if any of the following occur during home
treatment:
-
Dehydration
develops. Signs include your child being thirstier than usual and having darker urine than usual.
- Your child's vomiting
returns or becomes
severe.
- Blood or yellow or green liquid
(bile) is present in your child's vomit.
- Your child's vomiting does
not get better.
-
Intermittent vomiting occurs more frequently with home treatment or lasts longer than 4 days.
- Your child's
symptoms become more severe or frequent.
Prevention
Babies
You may be able to prevent spitting up and
vomiting.
- Feed your baby smaller amounts at each
feeding.
- Feed your baby slowly.
- Hold your baby during
feedings.
- Do not prop your baby's
bottle.
- Do not hold your baby in an extreme upright
position.
- Do not place your baby in an infant seat during
feedings.
- Try a new type of bottle or use a nipple with a
smaller opening to reduce air intake.
- Limit active and rough play
after feedings.
- Try putting your baby in different positions during
and after feeding.
- Burp your baby frequently during
feedings.
- Consider talking to your doctor about starting your baby
on hypoallergenic formula. About 1% of babies who spit up are allergic to milk
protein.
- Do not add cereal to formula without first consulting
your child's doctor.
- Do not smoke when you are feeding your baby. Children
who are exposed to tobacco smoke are more likely to develop illnesses that
cause vomiting. If you smoke, quit. If you can't quit, do not smoke when you
are holding or feeding your baby or when you are in the house or the car. For
more information, see the topic
Quitting Smoking.
- Consider getting your
child the
rotavirus vaccine.(What is a PDF document?)
Toddlers
- Limit active and rough play after
feedings.
- Teach your children how to
wash their hands well, especially if there is an illness in the house.
If you use child care, talk to the caregivers about their
program or policies for sick children.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your
doctor diagnose and treat your child's condition by being prepared to answer
the following questions:
- Did you have problems during your pregnancy or
with the delivery of this child?
- What do you think might be causing
your baby's vomiting?
- Has your child been exposed to someone with a
similar illness?
- How long has the vomiting been going
on?
- Does your child have any other symptoms, such as fever, belly
pain, or diarrhea?
- Has your child had a recent fall or
injury?
- How many times has your child vomited? How much fluid is
lost each time?
- Is your child able to hold down
fluids?
- What does the vomit look like?
- Is there any blood or yellow or green liquid
(bile) in the vomit?
- Did you find any unusual liquids or pills in
the vomit?
- What does the vomit smell like?
- What
prescription or nonprescription medicines are in your home?
- Did
your child's symptoms start after eating at a restaurant? Has anyone else who
ate there with you become ill?
- Has your child recently eaten raw or
undercooked seafood?
- Do you think your child may have eaten any
contaminated food?
- Has your child recently visited a foreign
country?
- Has your child recently drunk water from a lake, stream,
or private well?
- Has your child had any known exposure to toxic
materials, chemicals, or fumes?
- Do you or any other members of your
household smoke?
- Does your child have any
health risks?
Credits
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By
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Healthwise Staff |
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Primary Medical Reviewer
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William H. Blahd, Jr., MD, FACEP - Emergency Medicine |
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Specialist Medical Reviewer
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H. Michael O'Connor, MD - Emergency Medicine |
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Last Revised
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August 14, 2012 |
Last Revised:
August 14, 2012
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