Children and vomiting

Health and Nutrition > Diseases > C Reviewed by Dr Stuart Crisp, paediatric specialist registrar and Dr Stephen Greene, consultant paediatrician

What is vomiting?

Almost all infants vomit once in a while. This applies to both breastfed and bottlefed children. When children become ill their stomach stops working properly.

It does not empty as fast as usual and this causes the food to come up again. Unwell children will vomit easily. It is unpleasant for a child to vomit, but it is seldom dangerous.

What causes vomiting?

Many different things can make children vomit:

- if it is only a small amount and the baby is well, it may be because the child has eaten too much and vomits the surplus.
- vomiting may occur in cases of stomach upset, often together with diarrhoea. It may be due to a viral infection in the stomach.
- if a child gets an ear infection, and infection of the airways, or the urinary system, the appendix, the throat or chest, and runs a temperature at the same time, this often causes vomiting.
- children who are under a lot of stress at school or at home may occasionally vomit. If this happens repeatedly, it would be wise to consult your doctor.

How should vomiting in children be treated?

- After a child has vomited, help them rinse their mouth with water as vomit has a sour taste. Smaller children who cannot rinse their mouths can have a little water to drink.
- A child is often cold, sweaty and tired after they have vomited. Wipe their face with a damp cloth and let them rest. Most children want to go to sleep afterwards and that is fine. Check on them frequently and be prepared to help if they are sick again.
- Breastfeeding can be continued, but if vomiting continues, call the doctor.
- If it is an older child who vomits, it may help to not give them milk or milk products for a couple of days.
- Make sure the child does not become dehydrated by giving them plenty of fluids to drink. Diluted juice or 'flat' cola is recommended.
- They should not drink a lot straight away after vomiting because the fluid may irritate the stomach and cause them to be sick again. If they can't keep the fluid down, let them rest for a couple of hours then start giving them frequent small drinks.
- In the meantime if your child is thirsty, give them small amounts of water using a teaspoon.
- Water is easier for the stomach to handle if it's not ice cold. If the child wants to drink too much, too fast, give them a clean facecloth soaked in cold water to suck, or an ice-cube or ice lolly.

How can dehydration be prevented?

- If vomiting occurs together with diarrhoea, it will result in a lack of fluids. This may not be serious if it only lasts for a couple of days, but if it occurs repeatedly your doctor or health visitor should be consulted.
- They may advise you to buy carbohydrate and electrolyte solution or powder at the chemist.

These rehydration solutions (eg Dioralyte, Rehidrat) are added to water to make sure the child gets enough salts and energy. They are also available on prescription from your GP.
- A less reliable alternative is to make your own solution using weak lemonade or just plain water with a pinch of salt and a little sugar. For one litre of water, use eight teaspoons of sugar and one of salt. If the child does not recover in a day or two, consult your GP or health visitor.
- If your child continues to vomit or have diarrhoea, call the doctor.

How can you tell whether your child needs fluid?

. Keep an eye on how often they go to the toilet. With infants count the nappies they use.

If the child cries without any tears it may be another sign of dehydration. Check their mouth; the mucous membrane should be moist and pink, the tongue wet and there should be saliva. If the child won't drink, they will soon need fluid, so call the doctor.

Is vomiting ever a serious illness?

In rare cases, if a newborn child of three to five weeks suddenly begins to vomit in a recurrent and violent manner, it is possibly pyloric stenosis - the narrowing of the muscular outlet of the stomach. Seek medical help right away.

This may need to be corrected by surgery and recovery will be complete. Vomiting in a child under four can also be due to intussusception where one part of the bowel is telescoped into another.

In the case of infants, they will pull up their legs, go pale and pass blood in their stools.

A doctor should be consulted urgently but an operation isn't always necessary. If your child acts strangely, seems confused or is hard to communicate with, call the doctor.

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