Vomiting (Child)
Vomiting is common in children. There are many possible causes. The most common cause is a viral infection. Other causes include heartburn, a seasonal cold, an ear or urinary tract infection, or an infection of the stomach or intestines.
Vomiting in young children can often be treated at home. The doctor often won’t prescribe medicines to prevent vomiting unless symptoms are severe. The main danger from vomiting is dehydration. This means that your child may lose too much water and minerals. To prevent dehydration, you'll need to replace your child's lost body fluids with oral rehydration solution. You can get this at pharmacies and most grocery stores without a prescription. Ask your child's doctor which product is best for your child.
Home care
The first step to treat vomiting and prevent dehydration is to give your child small amounts of fluids often. Follow the directions from your child’s doctor. One method is described below:
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Start with oral rehydration solution. Give 1 to 2 teaspoons (5 to 10 ml) every 1 to 2 minutes. Even if your child vomits, keep feeding as directed. Your child will still absorb much of the fluid.
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As your child vomits less, give larger amounts of rehydration solution at longer intervals. Keep doing this until your child is making urine and is no longer thirsty (has no interest in drinking).
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If frequent vomiting goes on for more than 2 hours, contact the doctor.
Your child may be thirsty and want to drink faster. But if they're vomiting, only give your child fluids at the prescribed rate. Too much fluid in the stomach will cause more vomiting.
Follow these guidelines when continuing to care for your child:
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After 2 hours with no vomiting, give small amounts of full-strength formula, ice chips, broth, or other fluids. Don't give sweetened juice or sodas. Give more fluids as your child is able to tolerate them.
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After 24 hours with no vomiting, restart soft, solid foods. These include rice cereal, other cereals, oatmeal, bread, noodles, carrots, mashed bananas, mashed potatoes, rice, applesauce, dry toast, crackers, soups with rice or noodles, and cooked vegetables. Give as much fluid as your child wants. Slowly return to a normal diet.
Note: Some children may be sensitive to the lactose in milk or formula. Their symptoms may get worse. If that happens, use oral rehydration solution instead of milk or formula during this illness.
Follow-up care
Follow up with your child’s doctor as directed. If testing was done, you will be told the results when they are ready. In some cases, more treatment may be needed.
When to get medical advice
Contact your doctor right away if your child:
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Has a fever (see Fever and children below).
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Continues to vomit after the first 2 hours on fluids.
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Is vomiting for more than 24 hours.
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Has blood or material that looks like coffee grounds in the vomit.
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Has blood in stool, or the stool looks tarry and black.
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Has a swollen belly or signs of belly pain.
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Has dark urine or no urine for 4 to 6 hours in babies and young children, or 6 for 8 hours in older children, no tears when crying, sunken eyes, or dry mouth.
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Won’t stop fussing or keeps crying and can’t be soothed.
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Develops a new rash.
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Has a headache that won't go away.
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Has belly pain that continues or gets worse.
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Has symptoms that get worse or new symptoms.
Call 911
Call 911 if your child:
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Has trouble breathing.
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Is very confused.
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Is very drowsy or has trouble waking up.
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Faints (loses consciousness).
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Has an abnormally fast heart rate.
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Has yellow or green-tinged vomit.
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Has large amounts of blood in the vomit or stool.
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Is vomiting forcefully (projectile vomiting).
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Has a seizure.
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Has a stiff neck.
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Has trouble walking.
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The doctor may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The doctor may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel okay using a rectal thermometer, ask the doctor what type to use instead. When you talk with any health care provider about your child’s fever, tell them which type you used.
Below is when to contact the doctor if your child has a fever. Your child’s doctor may give you different numbers. Follow their instructions.
When to contact a doctor about your child’s fever
For a baby under 3 months old:
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First, ask your child’s doctor how you should take the temperature.
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Rectal or forehead: 100.4°F (38°C) or higher
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Armpit: 99°F (37.2°C) or higher
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A fever of ___________as advised by the doctor
For a child age 3 months to 36 months (3 years):
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Rectal or forehead: 102°F (38.9°C) or higher
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Ear (only for use over age 6 months): 102°F (38.9°C) or higher
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A fever of ___________ as advised by the doctor
In these cases:
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Armpit temperature of 103°F (39.4°C) or higher in a child of any age
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Temperature of 104°F (40°C) or higher in a child of any age
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A fever of ___________ as advised by the doctor