Health Essentials from Cleveland Clinic

As parents, we go through many “firsts” with our children, some joyful and others troubling. One new experience that can stand out as particularly unpleasant is the startled or fearful reaction of your child the first time he or she vomits.

We stand by helplessly trying to reassure our kiddos that yes, even though this doesn’t make sense in anybody’s world, food can go up, in the wrong direction. Children just don’t understand what’s happening or why. They just want it to stop — and so do you.

What causes vomiting in kids?

Vomiting itself is not a condition or illness, says family medicine physician Matthew Goldman, MD. It’s a symptom of another problem. Finding the underlying cause is the key to treating it.

Sometimes, episodes of vomiting are mild and short-lived. Other times, they are a sign of something more serious.

Pinpointing what’s behind a bout of vomiting in a child may not be straightforward, Dr. Goldman says.

“Kids, especially younger ones, are sometimes more sensitive to certain bacteria, so they might be more susceptible to viruses or food poisoning,” he says. “They don’t respond the same way adults with a more developed immune system do.”

They may struggle to articulate how they feel. A lot may depend on your child’s age:

Infants and toddlers

Sometimes an anatomical issue (existing from birth) is responsible. In those cases, a doctor can often fix it before your child reaches adulthood, Dr. Goldman says.

In infants, you may see excessive spitting up or acid reflux. With toddlers, it’s usually a stomach virus, he says.

Older children and adolescents

In older children, your doctor may consider other causes, including common ailments (such as a viral infection) to emergency situations (such as toxic substance overdose or appendicitis).

Depending on the range of symptoms, a doctor may probe for stomach or digestive problems, including:

• Peptic ulcers
• Gastric ulcers
• An intestinal block
• Pancreatitis
• Inflammatory bowel disease
• Pyloric stenosis (a condition that prevents food from passing from the stomach to the small intestines)

In other cases, a doctor may see signs of conditions with a strong psychological aspect, such as bulimia or psychiatric cyclic vomiting syndrome (a disorder of unknown cause with frequent vomiting followed by symptom-free periods).

There are also times when a doctor may suspect pregnancy.

When should your child see a doctor?

A short episode of vomiting isn’t usually concerning, Dr. Goldman says. But you should see your healthcare provider if certain other symptoms accompany the vomiting.

Watch for decreased urination in any child who is having trouble with vomiting. For infants, this means no wet diapers within 6 hours. Also, if the infant is experiencing projectile vomiting, call your provider.

In all kids, watch for green color in vomit as well as fever of 102 (or fever of 101 for more than 3 days).

Also, look for these signs of dehydration:

• Lack of tears when crying
• Dry mouth
• Sunken eyes
• Cool, clammy hands and feet
• Lack of energy

If any symptom(s) concern you, call your healthcare provider.

What can you treat your child’s vomiting?

If your child has an illness that’s causing vomiting, Dr. Goldman offers these tips:

Give fluids. Encourage your child to drink water or other rehydration fluids. Jello and Popsicles® may also help. Avoid juices with high sugar content (apple, pear, cherry) and sports drinks.

Don’t push food. “Remember, it’s common for kids to have little or no appetite during the vomiting process,” Dr. Goldman says. “Monitor them for dehydration, but don’t force them to eat.”

Go slow. Once the vomiting stops, you can help your child ease back into his or her regular diet starting with small amounts of complex carbohydrates (rice, potatoes, bread).

Watch your child’s symptoms carefully and, if vomiting continues or resumes, work with your healthcare provider to pinpoint the problem.

If you have a baby who is vomiting, advice varies based on whether he or she is breastfed or bottle-fed:

• Breastfed infants: Go ahead and breastfeed (unless your healthcare provider says otherwise). But, it’s a good idea to breastfeed more frequently for shorter periods, at first. If vomiting improves, resume normal feeding. If not, seek medical care within 24 hours.
• Formula-fed infants: Give your child ½-ounce to 1 ounce of rehydration fluid (such as Pedialyte®) every 15 minutes for two to three hours. If the child vomits again, try again in 30 minutes. Resume normal feeding if your child’s condition improves. Otherwise, seek care within 24 hours.

How can you prevent your child’s vomiting?

Sometimes, children get sick. They go through illnesses as they build a stronger immune system.

Good hand-washing habits can help your child avoid some illnesses that cause vomiting. Encourage your children to wash their hands regularly with soap and warm water for at least 30 seconds. Remind them to scrub fingernails and in between the fingers as well.

Vomiting is one of those symptoms we all dread, especially for our kids. Remember that your provider is there to help.