What is vomiting?
Vomiting (throwing up) happens when very strong stomach contractions force a large part of the stomach contents back up the swallowing tube (esophagus) and out through the mouth or nose.
Vomiting is not the same as regurgitation. Regurgitation is the effortless spitting up of a small amount of food or liquid. Food goes up the esophagus and into the mouth. Regurgitation is very common in babies. It is not harmful.
Vomiting is a symptom of many conditions. The timing of the vomiting, the colour of the vomit and other associated symptoms such as abdominal pain, diarrhea, fever and headache or neck pain are all important pieces of information and can help identify the cause.
Vomiting can become serious if your child loses too much fluid and becomes dehydrated.
Causes of vomiting
Vomiting is often caused by a viral infection known as gastroenteritis (stomach virus). The infection irritates the stomach and digestive system. Children with vomiting from gastroenteritis may also have fever and diarrhea.
Other causes of vomiting include headaches or head injury, blockages in the intestinal tract such as pyloric stenosis in infants, appendicitis, severe coughing, food allergies, severe allergic reactions (anaphylaxis) and food poisoning. Medications or other substances such as alcohol can also irritate the stomach and cause vomiting.
How long will the vomiting last?
This depends on the cause of the vomiting. While viral gastroenteritis usually lasts a few days, other causes of vomiting can last longer.
Taking care of your child at home
The goal of caring for vomiting children is to prevent dehydration and to watch for symptoms that would warrant a visit to a health-care provider.
Medications available over the counter (such as Gravol or other brands) are not recommended. Sometimes they can cause sleepiness which makes it hard to continue to drink fluids by mouth. In some cases of persistent vomiting from a viral infection, your child’s health-care provider may prescribe an anti-vomiting medication such as ondansetron. Ondansetron is given as a single dose.
Babies
Breastfed babies can continue to drink breastmilk. If your baby normally takes formula, then you can continue to offer their regular formula, starting with a small amount (5 to 10 mL or 1 to 2 teaspoons every five minutes) by syringe and then gradually increasing the amount offered if there is no vomiting. If the baby refuses, you can try to offer oral rehydration solution the same way and then switch back to formula when your baby is getting better. Do not give tea or plain water to babies. Use a teaspoon, syringe or medicine dropper to give the fluid to your baby if they are refusing to drink at the breast or from their bottle.
Children
If your child is vomiting, give them fluids to drink. You can use your child's preferred clear fluid, diluted apple juice or a commercially available oral rehydration solution. Give smaller amounts of fluid to drink often. Giving your child water on its own is not enough because water lacks sugars and salts, which are needed to treat dehydration. Offer your child 5 to 10 mL or 1 to 2 teaspoons to start every five minutes. Use a teaspoon, syringe or medicine dropper to give the fluid to your child. You can also use a bottle or cup. If your child accepts and drinks the solution, gradually increase the amount. Increase the amount you give up to at most 1 ounce (30 mL) every five minutes.
Once the vomiting has stopped for 4 to 6 hours, you can begin to offer your child their preferred food and drink.
How to keep the rest of your family healthy
If your child’s vomiting is caused by a viral infection, make sure to wash your hands and your child's hands well. This is very important after using the toilet or putting a diaper on your child. This will help stop the illness from spreading in your family.
When to see a health-care provider
If your child has severe vomiting or vomiting that does not go away, visit a health-care provider.
Go to the nearest Emergency Department if:
- your child has a head injury or may have been exposed to something poisonous
- your child seems very dehydrated (low or no urine output, urine appears dark yellow, very dry mouth, no tears, low energy or sunken eyes)
- your child's vomit is green, bloody or dark brown (coffee colour)
- your child has severe or worsening belly pain
- your child has trouble breathing
- your child has a very bad headache or sore neck
- your child's skin is cold or not its usual colour
- your child is very tired or difficult to wake up
- your child appears to be very sick
Make an appointment with your child's regular health-care provider if:
- you think your child may be starting to get dehydrated and they are refusing to drink fluids, even with a syringe
- your child does not appear to be recovering
- vomiting happens more than once a month or happens mostly at night or early morning
Your child may show physical changes when their condition is serious or when their condition gets worse. Parents and caregivers can learn how to spot these signs in order to seek help from a health-care provider.
