DEFINITION
Diagnostic Findings
Vomiting is the forceful
ejection of a large portion of the stomach’s contents through the mouth. The mechanism is strong stomach contractions
against a closed stomach outlet. By
contrast, regurgitation is the effortless spitting up of one or two mouthfuls
of stomach contents that is commonly seen in babies under 1 year of age.
Cause
Most vomiting is caused by a
viral infection of the stomach or eating something that disagrees with your
child. Often, the viral type is
associated with diarrhea.
Expected Course
The vomiting usually stops in 6
to 24 hours. Dietary changes usually
speed recovery.
HOME CARE FOR VOMITING
Special Diet for Vomiting-No Solids for 8 Hours
Clear Fluids for 8 Hours. Offer child
clear fluids (not milk) in small amounts until 8 hours have passed without
vomiting. For vomiting without
diarrhea, the best clear fluid at any age is water. For infants you can also use one of the new oral electrolyte
solutions (such as Pedialyte, Resol, or Ricelyte). After this age, soft drinks (cola, lemon-lime, or ginger ale) are
also acceptable. Stir until no fizz
remains (the bubbles inflate the stomach and increase the chances of continued
vomiting).
Start with 1
teaspoon to 1 tablespoon, depending on age every 10 minutes. Double the amount each hour. If your child vomits using this treatment,
rest the stomach completely for 1 hour and then start over with smaller amounts. The one-swallow-at-a-time approach rarely
fails.
Bland foods after 8 Hours without Vomiting.
After 8 hours
without vomiting, your child can gradually return to a normal diet.
For older
children, start with foods such as saltine crackers, honey on white bread,
bland soups (For example, ‘chicken with stars”) rice, and mashed potatoes.
For babies,
start with foods such as applesauce, strained bananas, and rice cereal. If your baby only takes formula, give 1 or 2
ounces less per feeding than usual.
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 has only vomited once or twice,
continue breast-feeding but nurse on only one side each time for 10 minutes. After 8 hours have passed since your baby
last vomited, return to both sides.
If vomiting
occurs three or more times, put your baby on water or an oral electrolyte
solution. As soon as 4 hours elapse
without vomiting, return to nursing, but again with smaller than usual amounts
for 8 hours.
Medicines
Discontinue all
medicines for 8 hours. Oral medicines
can irritate the stomach and make vomiting worse. If your child has a fever over 102 degrees Fahrenheit (38.9
degrees Celsius), use acetaminophen suppositories. Call our office if your child needs to be taking a prescription
medicine.
Common Mistakes in Treatment of Vomiting
A common error
is to give as much clear fluid as your child wants rather than gradually
increasing the amount. This almost
always leads to continued vomiting.
Keep in mind that there is no effective drug or suppository for vomiting
and that diet is therapy is the answer.
Vomiting alone rarely causes dehydration unless you give drugs by mouth,
milk or too much clear fluid. .
CALL OUR OFFICE IMMEDIATELY if:
v
Your child develops diarrhea and vomits clear fluids
three or more times
v
Your child does not urinate in more than 8 hours
v
Crying produces no tears
v
Any blood appears in the vomited material and it’s not
from a recent nose bleed
v
Abdominal pain develops and lasts for more than 4 hours
v
Your child becomes difficult to awaken or confused
v
Poisoning with a plant, bad food, medicine, or other
chemical becomes a possibility
v
Your child starts acting very sick
During regular hours if:
v
The vomiting continues for more than:12 hours in
children under 6 months old, for more than 24 hours in children 6 months to 2
years old, or more than 48 hours in children over 2 years old
v You
have other concerns or questions