Most vomiting is caused by gastroenteritis, a viral infection of the gastrointestinal tract. Thankfully, these infections are usually short-lived and are more disruptive than damaging. Your most important intervention may be your bedside manner – vomiting is frightening for young children and exhausting for children of all ages. Supplement the following time-tested routines with plenty of reassurance.
Rest the stomach. This may be easier said than done with a small child, who doesn’t understand what’s happening and is longing for a big drink of water. Try to wait a few hours, then offer small sips (1 tablespoon) of water every 5 minutes. You can also offer ice chips or a cold, wet washcloth to suck.
If sips of water are not tolerated, you may wish to consult your doctor about an over-the-counter nausea medication. If your doctor approves, ask about the correct dose for your child.
If sips of water are tolerated, slowly increase the amount of liquids you give your child by doubling the volume given every 20 minutes. Then you can try other clear liquids. Milk and milk products should be avoided.
Introduce foods gradually. Wait for your child to say she’s hungry, then start with dry toast or crackers.
Your school-age child will probably tell you when she is ready to eat heavier food, and you can generally trust her judgment and give her what she asks for. With a younger child, stick with bland, starchy foods like potatoes and rice until you’re sure she’s out of the woods.
When Should You Call the Doctor?
The greatest risk of vomiting due to gastroenteritis is dehydration. Call your doctor if your child refuses fluids, is not urinating, cries without tears, has a dry mouth, or seems confused. You should also call if vomiting persists more than 24 hours, which increases the risk of dehydration. You should also call if your child vomits for more than half a day but does not have diarrhea accompanying it.
The following symptoms may indicate a condition more serious than gastroenteritis and require immediate medical attention:
- projectile vomiting in an infant
- vomiting accompanied by high fever
- repeated vomiting of green or yellow bile
- stomach feels hard and bloated in between vomiting episodes
- vomit resembles coffee grounds
- vomiting blood
- vomiting follows head injury
- vomiting during recovery from a viral infection
(Adapted from American Medical Association)