Concerning a child’s unexplained vomiting: A doctor gives advice

Children often complain of vomiting, which can be caused by a number of different illnesses. Most of the time, it goes away on its own, but sometimes it can be a sign of a major health problem.

Many digestive problems can cause vomiting. But at Boston Children’s Hospital, it can also be a sign of problems with other parts of the body, such as the nervous system, the endocrine system, the kidneys, or the mind. When trying to figure out what causes and how to treat childhood sickness, it’s important to look at the child’s age, when it starts and how long it lasts, and any other symptoms that come with it.

What is a child experiencing unexplained vomiting?

When you vomit, you forcefully push stomach contents out of your body through your mouth and/or nose. Often, sickness, or feeling like you’re going to throw up, comes before it.

What makes kids vomit?

Gastroenteritis, which is inflammation of the stomach and intestines most often caused by a virus, is the most common reason for kids to throw up. After vomiting, people usually have diarrhea within 12 to 24 hours, and other people in close touch are usually having the same symptoms.

A second common reason is getting sick from food. Some other things that can make you throw up are

• Feeling sick while moving
• An reaction to food
• Infections of the throat (like strep throat), ears, cough, or urinary tract
• Eating too much
• Headaches from migraines or concussions
• Response from the heart
• Cyclic vomiting syndrome: frequent bouts of vomiting caused by headaches and a history of migraines in the family
• Cannabinoid hyperemesis syndrome is when people who use marijuana constantly puke and feel sick.
• Serious reasons include appendicitis, kidney infection, gallbladder disease, diabetes, a head accident, or a mass inside the skull. This also includes problems with the structure of the GI system, such as bowel obstruction.

Children’s signs of vomiting

Some of these are feeling sick, sweating, having chills, fever, stomach pain or cramps, diarrhea, or feeling dizzy or lightheaded.

Vomiting a lot can make you dehydrated, which happens when your body loses more water than it takes in. This can make it hard for your body to work properly. Keep a close eye out for these signs of dehydration:

• Less wet diapers for babies, older kids peeing less, and urine that is dark.
• Dry mouth and tongue;
• Crying with few or no tears;
• Feeling dizzy or weak when getting up;
• Being confused.
• Capillaries refilling slowly, taking more than 2 seconds. You can tell by touching your child’s fingernail and making it pale. Then
• time how long it takes for the nail to turn pink.

Treatments for vomiting in children

What to do when a kid throws up will depend on what’s making them sick.

Your child’s doctor may give them an antiemetic, which is a drug that can help with puking that won’t stop.

One of the best ways to keep a child from getting dehydrated while they are vomiting is to give them oral rehydration solution (ORS) at home. These are electrolyte-rich solutions that help you get back to normal quickly. You can get them at the store or drugstore under the brand name Pedialyte. Because they have the right amounts of water, salt, and sugars to keep you from getting dehydrated, these solutions are better to use than clear drinks like soda or fruit juices.

Self-care tips for kids who are vomiting

Sometimes it’s hard to get a child to take ORS when they are throwing up or feeling sick. At first, give the juice in small amounts, several times a day. Every few minutes, giving it with a syringe, dropper, or teaspoon might help. Wait 10 to 15 minutes before trying again if the child throws up.

• Aim for 2 ounces of ORS every hour for 4 to 6 hours for kids under 20 pounds.
• Aim for 3 ounces of ORS every hour for 4 to 6 hours for kids over 20 pounds.

If your child can handle oral fluids without throwing up more, you can keep slowly giving them more fluids.

Most of the time, babies should continue to be fed breast milk or formula.
You can start giving your child solid foods when they stop throwing up and get hungry again. At first, it might help to eat boring, healthy foods. Some examples are

• Toasts/breads
• Rice
• Bananas
• Mashed potatoes
• Pasta
• Yogurts
• Lean meats

When starting solids, it can also help to eat smaller meals and stay away from foods that are too dairy, hot, or fatty.

If your child can’t keep eating even after their symptoms have gone away, you should talk to their doctor because this could affect their diet and weight over time.

When you should call a doctor or nurse

You should get in touch with your child’s doctor if:

• They are younger than one year old and keep throwing up.
• Exhibit signs of dehydration as noted above
• Report persistent abdominal pain when not vomiting
• Have complex medical needs or a weakened immune system
• Have a fever that won’t go away
• Are unable to keep necessary medications down
• Keep throwing up for more than eight hours after getting ORS
• If you feel your child is looking or acting very sick

Get medical help right away if:

• Their poop is colored red, green, or brown.
• Vomiting occurs after a head injury.
• They develop a severe headache or neck stiffness
• They show signs of getting more angry or confused.