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 age 3 and younger 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's 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 abdomen 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, including:

  • Less frequent and more concentrated urine or fewer diaper changes needed. Your child's urine will have a stronger odor or darker yellow color.
  • Fussiness.
  • Acting hungry most of the time.

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 cannot get him or her to drink or vomits every time he or she takes a drink, the risk of dehydration is greater.

Use the Check Your Symptoms section 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.
  • 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 (14.8 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.
    • 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, undiluted fruit juice, or soda pop. Fruit juice or soda pop contains too much sugar and not enough of the essential minerals (electrolytes) that are being lost. Plain water or diet soda pop lacks 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. Increase the volume of clear liquids that you give by 3 fl oz (89 mL) an hour for each hour that your child does not vomit. For example, give your child:
    • 2 fl oz (59 mL) of fluid every 20 minutes during the second hour for a total of 6 ounces in the second hour.
    • 3 fl oz (89 mL) of fluid every 20 minutes during the third hour for a total of 9 ounces in the third hour.
    Clear liquids include fruit juice mixed to half strength with water, 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, undiluted fruit juice, or soda pop. Fruit juice or soda pop contains too much sugar and not enough of the essential minerals (electrolytes) that are being lost. Plain water or diet soda pop lacks 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, see home treatment for diarrhea.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your child's symptoms if any of the following occur during home treatment.

  • Dehydration develops.
  • Symptoms of a serious illness develop.
  • New or increasing belly pain develops.
  • 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 with home treatment or lasts longer than 4 days.
  • Intermittent vomiting occurs more frequently or longer than 1 week.
  • Your child is losing weight.
  • 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 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 cannot 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

Author Jan Nissl, RN, BS
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Tracy Landauer
Primary Medical Reviewer Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
Last Updated July 1, 2009

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