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Vomiting
Vomiting is the forceful throwing up of stomach contents through the mouth.
Spitting up (most commonly seen in infants under 1 year of age) is the easy flow of stomach contents out of the mouth, frequently with a burp.
What can cause vomiting in children?
There are many different causes of vomiting in children and vary depending on the age. The following is only a partial list of the causes of vomiting in children. - Viral or bacterial infection of the intestines ("stomach bug" or gastroenteritis) often accompanied by diarrhea and fever.
- Food poisoning
- usually no fever
- usually occurs within 1 - 6 hours after eating something bad
- Infections outside of the intestines
4. Vomiting from forceful coughing
5. Poisonings - Iron
- Lead
- Aspirin
- Certain wild mushrooms
6. An obstruction or blockage of the intestines
- vomitus typically dark green (bile)
7. Gastroesophageal reflux
8. Head injury
What signs and symptoms may suggest a serious cause for the vomiting and require immediate medical treatment?
- Vomiting bile (a yellow-green or green-colored material)
- Vomiting bright red blood or resembles coffee grounds
- Severe abdominal pain
- Continuous, repeated vomiting
- Vomiting that is projectile or very forceful
- this may be a sign of pyloric stenosis that occurs in
infants around 4 to 6 weeks of age because of an
obstruction from the muscle at the outlet of the stomach.
- the baby will have projectile vomiting during or shortly
after feeding. 6. Swollen belly that feels hard or tender
7. Lethargy (i.e. extreme sleepiness) or irritability
8. Pain on urination or foul-smelling urine
9. High fever and a stiff neck
10. Signs of a head injury (e.g., scalp swelling)
What can I do for my child if he/she is vomiting due to gastroenteritis?
- The most common error is giving a child too much to drink too soon, which causes them to continue vomiting.
- At first, if the vomiting is continuous do not attempt to give your child any food or liquids because they will just come right back up.
- Avoid giving plain water to a young infant unless your pediatrician specifies an amount.
Fluids - Once the vomiting has slowed down, the key in treatment for your child is to give small amounts of clear fluids often.
- Start with 1 teaspoon of an oral rehydration solution (e.g., Pedialyte, Infalyte) every 1 - 2 minutes.
o These solutions have the right mix of sugar and electrolytes to
best help your child. o You can slowly increase the amount of fluid you give every five
to ten minutes. o Children can usually be successfully rehydrated in this way
because the small frequent sips get absorbed in between
the vomiting episodes. o After keeping these small amounts of oral rehydration
solution down you can give 60 to 120 mL (2 to 4 ounces)
oral rehydration solution for each episode of vomiting to
a child weighing less than 10 kg (or 22 pounds), and 120
to 240 mL (4 to 8 ounces) to a child weighing more than
10 kg (or 22 pounds). - Breastfed infants should continue to be breastfed while receiving oral rehydration solutions.
- Once the vomiting improves and your child is tolerating the larger amount of fluids you can then try to restart their usual diet.
- If your child has persistent vomiting and isnt keeping anything down, check him for signs of dehydration (i.e. less frequent urination, dry mouth, no tears).
o If he/she is not dehydrated, then you can give him a break
from drinking for a short period of time (30 – 60 minutes)
and then slowly begin to give her/him fluids again as
described above. o If he/she does look dehydrated, call your pediatrician and
prepare to bring your child in for evaluation. Food - With regard to food, as long as your child’s vomiting is minimal withholding food or giving a special diet such as the BRAT diet (bananas, rice, apple sauce, and toast) is no longer recommended.
- It is best to do the following:
- continue to breastfeed
- continue to formula feed your infant, using full strength
formula, once they are rehydrated
- get back to an age appropriate unrestricted diet as soon as
possible
- avoid restricting milk (lactose) in your older child or making
changes to your infants formula
- avoid foods with a lot of added sugars, like juice and
carbonated soft drinks
- dont be alarmed if your child throws up some of this food. It
may be too soon to start feeding again. Just take a step back
to small frequent sips of fluids until the vomiting calms down
again.
Fever - For fever, if your child is unable to keep down acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) by mouth, you may try acetaminophen (Tylenol) suppositories.
Medication - Your doctor may prescribe medication for nausea and vomiting in an older child but should only be used when absolutely necessary.
A 2006 study published in the New England Journal of Medicine evaluated 215 kids bettween 6 months and 10 years of age with gastroenteritis (i.e. vomiting and diarrhea) and dehydration. One half of the kids were given a single tablet of a medication called ondansetron (Zofran), used to treat nausea and vomiting, and the other half a placebo (a pill without any medication in it). The group of kids who received Zofran vomited less, spent less time in the ER and was 3 times less likely to require intravenous fluids than the children who received only the placebo. Also, the Zofran group did not develop any dangerous side effects. This is further evidence that Zofran is safe and effective in young children who are vomiting with dehydration. It can also be given intravenously if needed.
When should I call my pediatrician concerning vomiting in my child? - You should call your doctor anytime your child’s vomiting is not improving or worsening, including not drinking well and any signs of dehydration.
- Call immediately for any signs or symptoms that may suggest a serious cause for the vomiting as listed above.
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