Vomiting in children is one of those parenting moments that no one loves.
It’s not uncommon for me to receive hundreds of text messages from parents alerting me to the fact that their child is vomiting. Well, maybe not that many, but is definitely feels like almost every child is my pediatric practice has had the stomach bug in the last few weeks.
Parents often want to know how to care for their vomiting child and when they should be concerned.
In this article, we will look at the common causes of vomiting and diarrhea, foods and beverages to give, medications that can help with vomiting and when to be worried that your child is dehydrated.
Common Causes of Vomiting & Diarrhea
No one makes it all the way through childhood without suffering several episodes of vomiting and diarrhea. There are many causes for these symptoms in childhood.
- Viral gastroenteritis is by far and away the most common cause of vomiting and diarrhea in children. It is caused by a variety of different viruses. Gastroenteritis can also be accompanied by fever and abdominal pain.
- Food poisoning occurs when a child consumes contaminated food. The bacteria in the food causes your child to vomit.
- Traveler’s diarrhea is typically experienced when traveling to foreign countries with different hygiene standards.
- Bacterial GI infections, such as salmonella or E. coli, can also cause vomiting and diarrhea. Often the diarrhea that accompanies a bacterial infection comes with bloody diarrhea.
In most cases, vomiting and diarrhea will resolve on their own within 12-24 hours. Abdominal pain may persist beyond 24 hours after a stomach virus. Often for a couple of days after the vomiting has resolved, your child will have a decreased appetite and possibly stomach pain.
Food Intake With a Stomach Bug
When your child is experiencing a stomach bug, it is difficult to get them to eat. Often, their stomach pain and fear of vomiting again will cause them to refuse food. During the initial couple of days of a stomach virus, fluids and keeping your child hydrated is much more important than getting them to eat.
When your child is ready to start eating again, you don’t have to offer them any special foods. Whatever your child is hungry for, it is okay to give them. Start to re-introduce food slowly to prevent an upset stomach and return of vomiting.
Likely your child will not ask for them, but it is best to avoid foods that are spicy or really greasy when they are first getting over the stomach bug.
What Should You Give Your Child to Drink
When your child is experiencing vomiting, it is important to provide them with appropriate fluids to prevent dehydration. During the acute vomiting phase where all of the stomach contents are coming up regularly, offer small sips of fluid every few minutes. As the vomiting subsides, you can offer larger amounts of regular fluid.
Clear liquids are typically the best choice during this time. These include water, clear broth, and electrolyte solutions like Pedialyte. These fluids help replenish lost fluids and electrolytes.
For infants who are breastfeeding, it is important to continue offering breast milk. Breast milk contains essential nutrients and antibodies that can help boost their immune system and promote a faster recovery. If your child is formula-fed, you can offer smaller, more frequent feeds to prevent overloading their stomach.
Does medicine help?
In cases of vomiting in children, medicine may be an option for managing symptoms. I frequently prescribe ondansetron (Zofran) to my patients who are vomiting. This medication helps them to stop vomiting so that they can keep fluids down and decrease their risk for dehydration.
Typically, it only takes a dose or two of the medication to get the vomiting to stop. Short term use of ondansetron is safe for children.
There are not any over the counter medications that you can or should give your child for vomiting.
What foods can my child eat with diarrhea?
When your child is experiencing diarrhea, it is important to provide them with foods that are gentle on their stomach and can help slow down the episodes of diarrhea. Here are some recommended foods for children with diarrhea:
1. Bananas: Bananas are easy to digest and can help regulate bowel movements. They are also rich in potassium, which can help replenish electrolytes lost during diarrhea.
2. Rice: Plain, cooked rice is another bland food that can help bind stool and reduce the frequency of diarrhea. Opt for white rice instead of brown, as it is easier to digest.
3. Applesauce: Unsweetened applesauce is a good choice because it contains pectin, which can help firm up stools. Be sure to avoid applesauce with added sugar, as it may worsen diarrhea.
4. Toast: Toasted bread can provide some relief to your child’s upset stomach. Stick to plain, white bread without any added spreads or toppings.
5. Yogurt: Yogurt contains beneficial bacteria, known as probiotics, which can help restore the balance of gut flora. Opt for plain and unsweetened yogurt, as added sugars can worsen diarrhea.
Avoid fruit juices or other sugary beverages as they worsen diarrhea.
It is important to remember that every child is different, and their tolerance to foods may vary. Start by introducing small amounts of these foods and gradually increase as your child’s diarrhea improves.
We know you may have to deal with the added challenge of your child being a picky eater.
What About Vomiting without Diarrhea?
Vomiting without diarrhea definitely gives me pause as a pediatrician. When a child is vomiting, there is a long list of possible causes and some of them are very concerning.
Viral gastroenteritis: common things are common and the stomach flu or viral AGE is the most common cause of vomiting in children
Pyloric Stenosis: This condition occurs in young babies where the outlet to their stomach is smaller than it should be. Projectile vomiting is the main symptom of this condition. It typically occurs in babies around the age of 3-5 weeks old. It is rare after 3 months of age
Head Injury: your child can have mild vomiting or severe vomiting with a head injury depending on the mechanism.
Sickle Cell Disease: children with sickle cell disease can have bouts of vomiting with the onset of a pain crisis
Urinary tract infection or kidney infection: Vomiting in a young baby can be a sign of a urinary tract or kidney infection. Older children can vomit with these conditions as well, but often can tell you that they are having painful urination.
Meningitis: If vomiting is accompanied by a stiff neck, your child needs medical attention right away.
Food Allergy: Some children only have bouts of vomiting with a food allergy. Milk protein allergy often causes bloody stools and is not a true allergic reaction.
What are signs and symptoms of dehydration?
Vomiting and diarrhea can quickly lead a child to become dehydrated.
Signs of dehydration can include a decrease in the number of wet diapers, which may be noticeably less than usual. Additionally, sunken eyes can be an indication of dehydration, as well as a dry tongue and mouth. Weight loss may also occur as a result of fluid loss.
Another sign of dehydration is tiredness or lethargy. Babies may appear unusually sleepy or weak compared to their usual energy levels. You can also monitor a baby’s soft spot. If it is sunken in or if they are crying and don’t have tears, your child is at risk for severe dehydration.
Sometimes, it is difficult to tell whether or not your child is fatigued from the viral infection and the vomiting or if they are truly lethargic. Babies who are lethargic don’t interact with you, are difficult to wake up and appear “out of it.”
If you notice any of these symptoms in your child, it is important to seek medical attention. Your pediatrician can assess your kid’s risk of dehydration, the severity of the dehydration and the amounts of fluids to get your child re-hydrated safely.
Remember, when it comes to dehydration and young babies, early intervention is important.
Conclusion
When I was a child, I would always announce to my mom that I needed to vomit and then proceed to vomit all over her.
Sorry mom.
If you hate when your child is vomiting and wish that there was someone that you could call to reassure you that everything is going to be okay, give me a call. You can set up a free meet and greet to find out if 127 Pediatrics is a good fit for your family.
© 127 Pediatrics; October 2023
This article is for informational purposes only and should not be construed as medical advice.
Dr. Andrea Wadley is the owner, pediatrician, and breastfeeding medicine specialist for 127 Pediatrics. She has an established house-calls-only concierge pediatric practice in Colleyville, TX. She is also the owner and operator of the 127 Pediatrics Online Breastfeeding Medicine and Education Center.
