Vomiting In Children

GENERAL INFORMATION:

What is it? Vomiting (throwing up) is very common in children. Vomiting causes food and liquid to come up from the stomach and out of the mouth or nose. Vomiting is often a way that your child's body keeps itself safe from harmful germs or substances. Vomiting can be harmful because your child may lose too much fluid and salt from his body. This is called dehydration (dee-heye-DRAY-shen). Dehydration can be a dangerous condition for your child. When a child is dehydrated, his body and organs such as the heart may not work normally. You can help prevent your child from becoming dehydrated by giving him enough liquids to replace fluid lost from vomiting. It is important to call your child's caregiver if you think your child is becoming dehydrated.

What causes vomiting? There are many causes of vomiting. The following are some causes for vomiting in children:

• Gastroenteritis. Gastroenteritis is the most common cause of vomiting in children over one year old. It is also called the "stomach flu". When your child has gastroenteritis, a germ irritates and infects the lining of his stomach or bowel. Gastroenteritis may be caused by germs such as viruses, bacteria or parasites.
  
  
• Food poisoning. Your child may get food poisoning if he eats food that has harmful bacteria (germ) in it.
  
  
• Problems in other body organs. For example, your child may vomit because he has an ear, lung, or bladder infection. The bladder is the body organ that holds your child's urine. Your child may have vomiting if he has a head injury or appendicitis. Appendicitis occurs when your child's appendix (body organ in the belly) becomes inflamed (red, swollen, and painful).
  
  
• Unknown. You may not know why your child has vomiting.
  
  
• Problems with the esophagus, stomach, or intestines in children less than one year old:
  
  
  • GERD: The esophagus is the tube that connects the mouth to the stomach. Your baby may spit up often after feedings because he has a problem called gastroesophageal reflux disease (GERD). There is a muscle that normally opens to let food into the stomach and closes to keep food and stomach acid in. With GERD, this muscle does not work properly, and causes food and stomach acid to leak back up the esophagus.
    
    
  • Pyloric stenosis: Pyloric stenosis is a problem that is most likely to occur in babies up to four months old. This is caused when a muscle between your baby's stomach and intestines grows too large and thick. With pyloric stenosis, your baby may have projectile (very forceful) vomiting.

What are the signs and symptoms of vomiting? Food that is in your child's stomach comes back up through his mouth, nose, or both. Your child may also have other signs or symptoms depending on what caused his vomiting. Your child may have a fever, abdominal (belly) pain, nausea (upset stomach), or diarrhea (loose, watery stools).

How can I take care of my child at home?

• Help your child to rest until he feels better.
  
  
• Call your child's caregiver if your child shows signs of dehydration.
  
  
  • A baby may be dehydrated if he wets five or less diapers during a 24 hour time period. A dehydrated baby may have a dry mouth and cracked lips, and may cry with few or no tears. A baby with worsening dehydration may act sleepier, weaker, or fussier than usual. The baby's eyes and soft spot on top of his head may be sunken if he is dehydrated. He may also have wrinkled skin, and pale hands and feet.
    
    
  • A child may be dehydrated if he has a dry mouth, cracked lips, cries without tears, or is dizzy. A dehydrated child may be sleepier, fussier, and weaker than usual. He may be very thirsty and will urinate less often than usual.
  
  
• Give your child plenty of liquids.
  
  
  • The best way to prevent dehydration is to give your child plenty of fluids, even if he is still occasionally vomiting. The best fluids to give your child contain a mixture of salt, sugar, minerals, and nutrients in water. These are called oral rehydration solutions (ORS). Many brands are available at grocery stores. Ask your child's caregiver which brand you should buy.
    
    
  • Give your baby 1 to 2 teaspoons of ORS every five minutes. Older children can begin with small sips of ORS often. Use a spoon, syringe, cup, or bottle to feed ORS to your child. If your child does not vomit the ORS, slowly give your child more ORS. Encourage but do not force your child to drink.
    
    
  • Continue giving your baby formula or breast milk throughout his illness, or follow his caregiver's instructions. Your child can start eating foods when he is ready. Start slowly with bland food such as cooked cereal, rice, noodles, bananas, crackers, applesauce, or toast. If he does not have problems with soft, bland foods, slowly begin to serve him regular foods.
  
  
• Put your baby or young child on his stomach or side whenever he is lying down. This may stop him from breathing vomit into his airways and lungs.
  
  
• Save your extra breast milk. If you are breast feeding your child, keep offering him breast milk. If your child is drinking less than usual, pump your breasts after feedings. Store the extra milk in the freezer so that your child can drink it later. Ask your child's caregiver for information about pumping, storing, and freezing your breast milk.
  
  
• Wash your and your child's hands often with soap and warm water. Handwashing may help you and your child to prevent spreading germs to others. Wash your hands after changing diapers and before fixing food. Your child and all family members should wash their hands before touching food and eating. Everyone should wash their hands after going to the bathroom.

Call your child's caregiver if:

• Your child has a temperature over ____.
  
  
• Your child's vomiting is getting worse.
  
  
• Your child will not drink the rehydration fluid (ORS) or keeps vomiting up the ORS.
  
  
• Your baby has projectile vomiting (forceful bursts of vomit) after a feeding.
  
  
• You have a baby less than four months old who has vomiting that is different than regular spitting up.
  
  
• You have any questions or concerns about feeding or caring for your child while he is sick.

Seek care immediately if:

• Your child keeps vomiting up all liquids that you give to him.
  
  
• You think your baby or child is dehydrated.
  
  
• Your child's vomit has blood or material that looks like coffee grounds in it.
  
  
• Your child is acting very different than normal or looks very sick.
  
  
• You think your child ate or drank a poisonous food, plant, or substance.
  
  
• Your child is not thinking clearly, has a stiff neck, or very bad headache.
  
  
• Your child has bad abdominal (belly) pain that does not feel better after vomiting.
  
  
• Your child has painful urination.
  
  
• Your child has problems breathing.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

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