Vomiting

Vomiting is the forceful ejection of a large portion of the stomach's contents. By contrast, regurgitation is the effortless spitting up of one or two mouthfuls of stomach contents that is commonly seen in babies under 1 year of age. Most infants will spit up small amounts of formula usually within the first hours after being fed. It will occur less often if a child is burped frequently, held upright for 20 - 30 minutes after feedings and if active play is limited, right after meals. This spitting up tends to decrease as the baby becomes older but may persist in a mild form until 10 - 12 months of age. Spitting up is not serious and doesn't interfere with normal weight gain.

Most vomiting is caused by a viral infection or eating something that disagrees with the child. Vomiting usually stops in 12 - 24 hours. Changing your child's diet generally speeds recovery. Occasionally regurgitation may occur during the first few months of life. It it appears repeatedly or is forceful (projectile) after every feeding, call our office as soon as possible.

If your child is vomiting and is less than 1 year old, offer 1 teaspoon of Pedialyte every 10 minutes. Slowly increase the number of teaspoons every hour until the child has gone 8 hours without vomiting. (For example, 2 teaspoons every 10 minutes for 2 hours, 3 teaspooons every 10 minutes for 3 hours.) They can then return to formula, and, if older than 4 months, they can also return to cereal, bananas and applesauce. A normal diet is okay in 24 - 48 hours.

For breastfed infants, provide breast milk in small amounts. Do not fill up their stomach. If your baby vomits twice, nurse on only one side every 1-2 hours. If the child vomits more than twice, nurse for 4-5 minutes every 30-60 minutes. After 8 hours without vomiting, return to regular breast feeding.

For older children, offer clear fluids in small amounts for 8 hours. Offer an electrolyte solution (Gatorade, Pedialyte), Jello, ice pops, and chicken broth. Give 1 tablespoon every 10 minutes. Increase the number of tablespoons every hour until the child has gone 8 hours without vomiting. (See example above.) If vomiting occurs, give the stomach a 1 hour rest and start again. After 8 hours of no vomiting, start a bland diet for the next 24 hours, (saltines, rice, mashed potatoes, etc) A normal diet is OK in 24 - 48 hours.

Discontinue all over the counter medications. If the child is on a prescription medication, call our office.

Call our office for any of these symptoms:

• blood or bile (green colored) vomitus
• severe abdominal pain
• strenuous repeated vomiting
• swollen abdomen
• lethargy or severe irritability
• signs of dehydration including dry mouth, absent tears, depression of the soft spot, or decreased urination
• inability to drink adequate amounts of fluid
• vomiting more than 24 hours or more than 12 hours in a child 6 months or less
• fever develops
• no urine output in 6 hours
• if diarrhea develops

If you suspect poisoning from a plant, bad food, medicine or chemical, call poison control at 404 616-9000.

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