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Tips for taking care of your child: vomiting

Thursday, February 25, 2016

When your child is ill, lots of snuggles and rest can work wonders. When that illness takes a turn towards nausea and vomiting, you need to focus on a different level of care. Here are the symptoms to watch for and some helpful treatment tips.

Mother caring for sick child after vomiting

For vomiting children, the main risk is water loss, or dehydration, especially if fever causes them to sweat more or they are also losing fluid through diarrhea. When vomiting is severe or prolonged, a child may lose sodium, potassium, and chloride - critical minerals for many bodily functions.

Vomiting usually stops in 6 to 24 hours. If your child also has diarrhea, the diarrhea will usually continue for several days. If your child has vomiting without diarrhea and it lasts more than 24 hours, your child may have something more serious than a virus or food poisoning and you should call your doctor.

Tips to care for your child while vomiting

Changes in the diet can prevent excessive vomiting and dehydration.

Offer small amounts of clear fluids for 8 hours (no solid food)

While missing a meal or two will cause no harm to an otherwise healthy child, it’s important that a sick child continue to drink clear liquids to take care of normal daily needs, plus extra to make up for fluid loss and prevent dehydration. Young children are especially susceptible to dehydration because they are less efficient at conserving water than older children and adults. In addition, small body size means that it takes less fluid loss to lead to dehydration.
  • Offer clear fluids (not milk) in small amounts until 8 hours have passed without vomiting. For infants less than 1 year old, always use an oral electrolyte solution (such as Pedialyte or the store brand). Spoon or syringe feed your baby 1 teaspoon (5 ml) every 5 minutes. Until you get some Pedialyte, give formula by teaspoonful in the same way.
  • For a child over 1 year old with vomiting (but no diarrhea), the best fluid is water or ice chips because water can be directly absorbed across the stomach wall. If your child is 2 years old or older water is best, but half-strength, flat lemon-lime soda or Popsicles are also okay. Stir the soda until no fizz remains (the bubbles inflate the stomach and increase the chances of continued vomiting).
  • Start with 1 teaspoon (5 ml) to 1 tablespoon (15 ml) of the clear fluid, depending on your child's age, every 5 minutes. After 4 hours without vomiting, double the amount each hour. If your child vomits using this treatment, rest the stomach completely for 1 hour and then start over but with smaller amounts. This one-swallow-at-a-time spoon-fed approach rarely fails.

Offer bland foods after 8 hours without vomiting

After 8 hours without vomiting, your child can gradually return to a normal diet.
  • Infants can start with bland foods such as cereal. If your baby only takes formula, give 1 or 2 ounces less per feeding than usual.
  • Older children can start with such foods as saltine crackers, cereals, white bread, bland soups, rice, and mashed potatoes.
  • Usually your child can be back on a normal diet within 24 hours after recovery from vomiting.

Diet for breast-fed babies

The key to treatment is providing breast milk in smaller amounts than usual.
  • If your baby vomits once, make no changes. If your baby vomits twice, continue breast-feeding but nurse on only one side for 10 minutes every 1 to 2 hours.
  • If your baby vomits 3 or more times, nurse for 5 minutes every 30 to 60 minutes. As soon as 8 hours have passed without vomiting, return to normal nursing on both sides.
  • Pedialyte is rarely needed for breast-fed babies. If vomiting continues, switch to Pedialyte for 4 hours. Spoon or syringe feed 1 tablespoon (15 ml) of Pedialyte every 5 minutes. If your baby is urinating less frequently than normal, you can also offer your baby Pedialyte between breast-feedings for up to 24 hours.

Common mistakes in the treatment of vomiting

A common error is to give as much fluid at one time as your child wants rather than gradually increasing the amount. This almost always leads to continued vomiting. Generally, making the diet changes recommended above will be more effective than any medication for vomiting.

When to call the doctor

Call IMMEDIATELY if:
  • Your child shows any signs of dehydration (such as no urine in over 8 hours, very dry mouth, no tears when crying).
  • Your child vomits up blood or something that looks like coffee grounds.
  • Your child vomits repeatedly AND also has watery diarrhea.
  • Your child has abdominal pain when not vomiting.
  • Your child is confused or difficult to awaken.
  • Your child starts acting very sick.
Call during office hours if:
The vomiting continues for more than 24 hours if your child is under age 2 years or 48 hours if over age 2. You have other concerns or questions.

Is your child sick?

Use our online resources to help guide care for your sick child. From dosage information to guidelines on when to call the doctor, Northpoint Pediatrics is here to help.
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