Vomiting

Vomiting is the forceful emptying (throwing up) of a large portion of the stomach’s contents. Nausea and abdominal discomfort usually precede each bout of vomiting. Most vomiting is caused by a viral infection of the stomach or mild food poisoning. Vomiting is the body’s way of protecting the lower GI tract. The main concern with vomiting is dehydration.

Symptom Management

For Formula-Fed Infants, Offer Oral Rehydration Solution (ORS) Such as Pedialyte:

If your child has vomited more than once, offer ORS for 8 hours.
ORS is a special electrolyte solution that can prevent dehydration. It’s readily available in most supermarkets and drugstores.
Spoon or syringe feed 1-2 teaspoons of ORS every 5 minutes.
After 4 hours without vomiting, double the amount.
After 8 hours without vomiting, return to regular formula.

For Breastfed Infants, Reduce the Amount Per Feeding:

If your child vomits only once, nurse 1 side every 1 to 2 hours.
If your child vomits more than once, nurse for 5 minutes every 30 to 60 minutes.
If your child continues to vomit, switch to pumped breastmilk: 1-2 teaspoons every 5 minutes.
After 4 hours without vomiting, return to regular breastfeeding. Start with small feedings of 5 minutes every 30 minutes and increase as tolerated.

Pumped Breast Milk for Bottle-Fed Infants, Reduce the Amount Per Feeding:

If your child vomits only once, give half the regular amount every 1-2 hours.
If your child vomits more than once within the last 2 hours, give 1 ounce every 30-60 minutes.
If your child continues to vomit, give 1-2 teaspoons every 5 minutes. If not tolerating breast milk, switch to ORS.
After 4 hours without vomiting, return to regular feedings. Start with 1 ounce every 30 minutes and slowly increase as tolerated.

Children Over 1 Year Old:

Water or ice chips are best for vomiting in older children. Popsicles work great for some kids.
Vomiting with watery diarrhea requires ORS. If your child refuses ORS, use half-strength Gatorade. Make it by mixing equal amounts of Gatorade and water.
The key to success is offering small amounts of fluid frequently. Offer 2-3 teaspoons every 5 minutes. Older kids can just slowly sip ORS.
After 4 hours without vomiting, increase the amount.
After 8 hours without vomiting, return to regular fluids. Avoid fruit juice and soft drinks.

Stop Solid Foods:

Avoid all solid foods in kids who are vomiting.
After 8 hours without throwing up, gradually add them back.
Start with starchy foods that are easy to digest (e.g., cereals, crackers, bread).
Return to a completely normal diet in 24-48 hours.

Avoid Medicines:

Discontinue all nonessential medicines for 8 hours as they can make vomiting worse.
For higher fevers, consider an acetaminophen suppository. Before administering medication, please review our medication dosing guides.
Never give oral ibuprofen when vomiting; it is a stomach irritant.

Try to Sleep:

Help your child go to sleep for a few hours. Sleep often empties the stomach and relieves the need to vomit.

Severe or Continuous Vomiting, But Well-Hydrated:

Sometimes children vomit almost everything for 3 or 4 hours, even if given small amounts.
Some fluid is still being absorbed and will help prevent dehydration. Continue offering clear fluids.

Expected Course

For the first 3 or 4 hours, your child may vomit everything until the stomach settles down. Vomiting from viral gastritis usually stops in 12 to 24 hours. Mild vomiting (1-2 times/day) with diarrhea can continue intermittently for up to a week.

When to Call the Office

Vomiting becomes severe (vomits everything) over 8 hours.
Vomiting persists over 24 hours.
Signs of dehydration occur.
Blood appears in vomit or diarrhea.
Stomach pain becomes constant or severe.
Your child becomes worse.

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.