Vomiting

Background:

Vomiting can be caused by many things. The most common is a viral gastrointestinal infection.

 

What to Do:

Because vomiting causes fluid loss from the body, our main concern is dehydration.

 

It is important to continue to get fluid into your child to maintain their hydration. However if they drink quickly and the fluid goes splashing in, it is likely to come splashing back out. Drinking small amounts frequently allows for the small amounts of fluid to be absorbed by the stomach before more is put in. This way, Ii your child does throw up, then they won't lose everything.

 

How you get the fluid into your child and what fluids to use depends on their age and their cooperation levels.

 

All children should be given a few millilitres of fluid every few minutes and increase the volume according to their tolerance until they are drinking normally. You can offer fluid in a variety of way: drink from a cup, sip from a straw, be fed with a syringe or medicine cup or drink from a bottle.

 

Children require water, sugar and salt in order to maintain their hydration. Young infants who are still breast/bottle feeding should be given their usual feed. An oral rehydration solution such as Pedialyte can be used in anyone 2 months of age and older. We recommend buying the Pedialyte powder. It may be more expensive as an initial investment but you can mix it as you need it. It comes as small sachets of powder. Each sachet is to be mixed into 250 mL of water. In clinic, we often use one half of the sachet in 125 mL for smaller children who need less fluid. The premixed bottles have to be thrown out after 72 hours. Skim milk is an excellent rehydration fluid for children over one year of age. You may also use water, very dilute juice, popsicle/freezies or clear soups which if you use some of each, provides water, sugar and salt.

If your child is expressing hunger, you may feed them with a similar philosophy of small amounts frequently. Choose something that is easy on the stomach such as rice, soup with noodles, crackers etc. and give them 1 or 2 bites then wait a while to see if it stays in. Continue to advance the amount they are eating as tolerated.

For both liquids and solids, the goal is to work back to a normal eating pattern. However some kids don't need the whole process and will let you know when they are feeling better and able to feed normally.

 

When to Be Concerned:

Your child should be seen if:

 

• vomiting has lasted for one week
• dark green in the vomit – highlighter yellow is fine. Truly green vomit needs to go to the emergency room.
• blood in the vomit – small streaks or spots can be seen in clinic the next day, large amounts of blood needs to go to the emergency room
• signs of dehydration – children who are dehydrated are very droopy, they tend to lie around and are not particularly interested in doing anything. You may notice that their mouth is dry and sticky, their eyes look dull and they are not making much urine. For children still in diapers, they should be passing the equivalent of 3 good wet diapers per day. Once children are toilet trained, it is very easy to assess their hydration by the colour of their urine. We all pass a darker urine first thing in the morning but our urine gets lighter during the day as we drink fluid. If their urine stays dark i.e. apple juice during the day then they need more fluid. As long as your child is peeing lemonade or lighter you are doing a good job maintaining their hydration.

If your child is happy and playing, they are NOT dehydrated enough that you need to take them to the doctor.

 

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