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
Main Cause: stomach infection (gastritis) from a stomach virus (e.g., Rotavirus). The illness starts with vomiting but diarrhea usually follows within 12-24 hours.
See More Appropriate Topic (instead of this one) If
Vomiting only occurs while coughing, see COUGH.
Child younger than 1 year old spits up a small amount, see SPITTING UP.
Diarrhea is the main symptom, see DIARRHEA.
(To go directly to these topics, click on the links following this document.)
WHEN TO CALL YOUR DOCTOR FOR VOMITING
Call 911 Now (your child may need an ambulance)
Unresponsive or difficult to awaken
Not moving or too weak to stand
Call Your Doctor Now (night or day) If
Your child looks or acts very sick.
You suspect poisoning with a plant, medicine, or other chemical.
Signs of dehydration (e.g., very dry mouth, no tears and no urine in more than 8 hours).
Blood in the vomit that's not from a nosebleed.
Bile (yellow or green) in the vomit.
Abdominal pain is also present (EXCEPTION: abdominal pain or crying just before and relieved by vomiting is quite common and need not be seen).
Fever above 104°F (40°C).
Age less than 12 weeks old with fever above 100.4°F (38°C) rectally.
Age less than 12 weeks with vomiting 2 or more times (EXCEPTION: spitting up).
Age less than 12 months old who has vomited clear fluids 3 or more times and also has watery diarrhea.
Call Your Doctor Within 24 Hours (between 9am and 4pm) If
You think your child needs to be seen.
Has vomited for more than 24 hours.
Fever present for more than 3 days.
Call Your Doctor During Weekday Office Hours If
You have other questions or concerns.
Vomiting is a recurrent problem.
Parent Care at Home If
Mild vomiting (probably viral gastritis) and you don't think your child needs to be seen.
HOME CARE ADVICE FOR VOMITING
1. Sleep: Help your child go to sleep for a few hours (Reason: sleep often empties the stomach and relieves the need to vomit).
2. For Bottlefed Infants Offer Oral Rehydration Solution (ORS) for 8 Hours:
For vomiting 1-2 times, offer ½ strength formula for 2 feedings, then regular formula.
For vomiting more than 2 times, offer ORS (Infalyte, KaoLectrolyte or Pedialyte).
If ORS not available, use formula.
- Spoon or syringe feed small amounts: 1-2 teaspoons (5-10 ml) every 5 minutes.
After 4 hours without vomiting, double the amount.
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 OK in 24-48 hours.
3. For Breastfed Infants, Reduce the Amount Per Feeding:
If vomits twice, nurse 1 side every 1 to 2 hours.
If vomits more than 2 times, nurse for 4 to 5 minutes every 30 to 60 minutes.
If continues to vomit, switch to ORS for 4 hours.
Spoon or syringe feed small amounts: 1-2 teaspoons (5-10 ml) every 5 minutes.
After 8 hours without vomiting, return to regular breastfeeding.
4. For Older Children (older than 1 Year Old) Small Amounts of Clear Fluids For 8 Hours:
Water or ice chips are best for vomiting in older children. (Reason: water is directly absorbed across the stomach wall.) (Exception: vomiting with watery diarrhea needs ORS. If refuses ORS, use 1/2-strength Gatorade.)
Give small amounts; 2-3 teaspoons (10-15 ml) every 5 minutes.
Other options: ½ strength flat lemon-lime soda, Popsicles or ORS frozen pops.
After 4 hours without vomiting, double the amount.
After 8 hours without vomiting, add solids:
- Limit solids to bland foods for 24 hours.
- Start with saltine crackers, white bread, cereals, rice, mashed potatoes, etc.
- Normal diet OK in 24-48 hours.
5. Avoid Medicines: Discontinue all nonessential medicines for 8 hours (reason: usually make vomiting worse). Call if vomiting an essential medicine.
6. Contagiousness: Your child can return to day care or school after vomiting and fever are gone.
7. Expected Course: Vomiting from viral gastritis usually stops in 12 to 24 hours. If diarrhea is present, it usually continues for several days.
8. Call Your Doctor If:
Vomiting becomes severe (vomits everything) > 8 hours
Vomiting persists for more than 24 hours.
Signs of dehydration.
Your child becomes worse or develops any of the "Call Your Doctor" symptoms.
Lucile Packard Children's Hospital is located in Palo Alto, adjacent to Stanford University Hospital, approximately 20 miles north of San Jose, CA and 40 miles south of San Francisco.
