What is vomiting?
Vomiting (throwing up) happens when very strong stomach contractions force a large part of the stomach contents back up the swallowing tube (esophagus) and out through the mouth or nose. It is usually caused by a minor illness.
Vomiting is not the same as regurgitation. Regurgitation is the effortless spitting up of a small amount of food or liquid. Food goes up the swallowing tube and into the mouth. Regurgitation is very common in babies. It is not harmful.
Vomiting could become serious if your child loses too much fluid. Too little fluid in the body causes dehydration.
For more information, please read Dehydration.
Causes of vomiting
Most often vomiting is caused by a viral infection known as gastroenteritis (stomach virus). The infection irritates the stomach and digestive system. Children with vomiting from gastroenteritis may also have diarrhea.
Other causes of vomiting include headaches or head injury, urinary tract infections, blocks in the intestinal tract, coughing, food allergies, and food poisoning. Medications or other substances such as alcohol can also irritate the stomach and cause vomiting.
If your child has severe vomiting or vomiting that does not go away, visit a health care professional.
How long will the vomiting last?
A viral gastroenteritis infection usually begins with vomiting and sometimes fever. The vomiting often lasts only 1 or 2 days, but may last longer.
A child will often have diarrhea at the same time or after the vomiting. The vomiting and diarrhea do not usually last longer than 1 week.
Taking care of your child at home
Give your child clear fluids. Your child will need to replace the water and salt they have lost from vomiting.
If your baby is breastfeeding, continue to breastfeed or give expressed breast milk from a bottle.
For babies and children who are not breastfeeding, offer clear fluids until an hour has passed since the last time they vomited. You can also give your child oral rehydration solution. This will give your child the water, sugar, and salt that he needs.
If your child is not dehydrated and it has been at least an hour since your child last vomited, he can have whatever he likes to drink. This includes milk. Gradually offer more solid foods.
If your child is dehydrated, give oral rehydration solution.
Breast milk for breastfed babies
Breastfed babies with gastroenteritis should continue to drink breast milk. They can drink breast milk either from the breast or by taking expressed breast milk. If your baby vomits after feeding or is vomiting very often, keep breastfeeding. Feed your baby smaller amounts more often.
If you are breastfeeding and your baby is not drinking as much as usual, you may need to pump your milk.
If your breastfeeding baby is still thirsty after drinking breast milk, or if she keeps vomiting, you may offer oral rehydration solution. Offer oral rehydration as described below. Continue to either breastfeed or pump your breast milk.
If your baby is urinating (peeing) less often and you are not sure if you are making enough milk, offer your baby oral rehydration solution in between feedings. Do not give tea or plain water to babies who may be dehydrated.
See a doctor if you think that your baby is becoming dehydrated.
Oral rehydration solutions
If your child seems dehydrated (dry mouth, less active, peeing less often) give your child oral rehydration solution. This solution will give your child the water, sugar and salt that he needs.
Examples of oral rehydration solutions are Pedialyte, Enfalyte, or Pediatric Electrolyte. Generic brands are available and equally effective. You can buy oral rehydration solutions in most drug stores or grocery stores. Home-made solutions are not recommended, because having too much or too little salt can cause serious problems.
Use a teaspoon, syringe, or medicine dropper. You can also use a bottle or cup.
Give your child a small amount of solution (5 mL or 1 teaspoon to start) every 2 to 3 minutes. If your child accepts and drinks the solution, gradually increase the amount. Increase the amount you give up to at most 1 ounce (30 mL) every 5 minutes. Do not give more than 1 ounce at a time. Encourage your child to drink slowly. Drinking quickly can cause vomiting.
If your child is still vomiting, continue giving the oral rehydration solution 1 teaspoon (5 mL) at a time. If your child is still vomiting it does not mean that the oral rehydration solution is not working. The sugar, salt, and liquid in the solution are still being absorbed.
Alternatives to regular oral rehydration solution
Some children may not like the salty taste of oral rehydration solution.
If your child does not want to take the oral rehydration solution, try serving the solution cold. Frozen oral rehydration solution (freezie) and popsicles are available. You can also try to change the brand or flavour of the oral rehydration solution. If your child is still refusing, try the following:
- Mix juice with the oral rehydration solution. Use the ratio 1 part juice with 2 parts oral rehydration solution.
- Give your child an electrolyte sports drink like Gatorade or Powerade. You can buy these at the grocery store. These drinks are not the same as oral rehydration solutions, but they have more electrolytes than plain juice or soda pop.
Avoid sugary drinks
Many juices contain a lot of sugar, which may make diarrhea worse. If your child is having a lot of diarrhea, do not give juice or other sugary drinks.
Offer food
Your child should try to eat a normal diet even when she has gastroenteritis. Good nutrition is important to help her feel better. Unless vomiting is very frequent, offer your child a food that she is familiar with. Many children prefer simple foods when they have been vomiting. It is important to be flexible and give your child something that she wants to eat. Give foods like crackers, cereals, bread, rice, soup, fruits, vegetables, and meat. Avoid giving your child very sugary foods if he has diarrhea.
Milk provides good nutrients. Most children who are vomiting are still able to drink milk. If you feel that your child has more vomiting or diarrhea when drinking milk, try giving him lactose-free milk. If you are not giving your child milk, make sure that he has other healthy options.
Medications
If your child has a fever and feels uncomfortable, give acetaminophen (Tylenol, Tempra, or other brands) or ibuprofen (Advil, Motrin, or other brands).
Contact your doctor if your child takes prescription medications and is having a hard time taking them during this illness.
Medications available over the counter (such as Gravol or other brands) are not always helpful. Sometimes they can cause sleepiness which makes it hard to give oral rehydration. In some cases of persistent vomiting, your doctor may prescribe an anti-vomiting medication such as ondansetron. Ondanestron is given as a single dose.
How to keep the rest of your family healthy
Make to sure to wash your hands and your child’s hands well. This is very important after using the toilet or putting a diaper on your child. This will help stop the illness from spreading to your family.
When to get medical help
Take your child to the nearest Emergency Department, or call 911, if:
- your child has a head injury or may have been exposed to something poisonous
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your child seems very dehydrated (no urine in 8 hours, very dry mouth, no tears, low energy)
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your child’s vomit is green, bloody, or dark brown (coffee colour)
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your child has severe or worsening tummy pain
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your child has trouble breathing
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your child has a very bad headache or sore neck
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your child’s skin is cold or not its usual colour
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your child is very tired or difficult to wake up
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your child appears to be very sick
Call your child’s regular doctor if:
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you think your child may be starting to get dehydrated
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the vomiting lasts longer than 24 hours if your child is under 2 years old
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the vomiting lasts longer than 48 hours if your child is older than 2 years old
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your child's fever lasts more than 3 days
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vomiting happens more than once a month or happens mostly at night or early morning
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you have other concerns or questions
Key points
- Vomiting is caused by irritation of the stomach and digestive system from a viral infection known as gastroenteritis (stomach virus).
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Vomiting usually lasts only 1 or 2 days, but may last longer.
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Breastfed babies with gastroenteritis should continue to drink breast milk.
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Give your child oral rehydration solution and other clear fluids. Avoid giving your child sugary drinks.
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Wash your hands and your child’s hands well.
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Talk to your doctor if your child seems very dehydrated.