Short Answer:  It’s natural to worry when your child isn’t able to eat or keep food down. Most of the time when a child is vomiting it isn’t anything serious. You can usually help ease your child’s discomfort with home treatment until the episode passes. But occasionally, vomiting is a symptom of a more serious problem, so it’s important for parents to know what signs to watch out for.  

Vomiting Versus Spitting Up

When it comes to infants, you need to determine if they are truly vomiting or just “spitting up”. Vomiting is forceful and repeated. Spitting up usually occurs after feeding and doesn’t cause visible discomfort. Spitting up is normal for babies. It may mean they gulped air, took in too much formula, or their formula is upsetting their stomach. It isn’t anything to worry about unless it increases in frequency or changes to full-blown vomiting, in which case contact your doctor.

Signs To Watch Out For With Infants And Vomiting:

  • Infant under 10 weeks of age forcefully vomiting large amounts of formula or fluid and appears dehydrated. This type of vomiting may indicate a blockage at the end of the stomach called pyloric stenosis. See a doctor or get to an ER RIGHT AWAY. This condition is potentially serious and may require surgery.
  • Infant (under 2 years) crying uncontrollably, may be pulling his/her knees to their chest, has red-colored diarrhea and vomits all liquids. Your child may have an obstruction of the intestines called intussusception. Contact your doctor right away.
  • Infant (under 2 years) vomiting continuously for 6-12 hours.Little ones can dehydrate fast, so if vomiting continues this long contact your doctor to be safe.

Before taking your infant to the doctor, be sure to note the color of their vomit and the number of times they have vomited. This information may help determine the cause.

Vomiting In Children Age 2 And Up:

If a child is vomiting it’s usually caused by some type of stomach flu virus (gastroenteritis). Vomiting can also be caused by food poisoning, intestinal illnesses, a severe cough/cold, bladder infection, intestinal obstruction, or injury from a fall.  

The cause of vomiting is often hard to determine at the onset, because the initial symptoms generally present the same way; profuse vomiting every 5 to 45 minutes for 1 to 12 hours. Understanding how the various causes run their course, and what symptoms to watch out for, will help you determine if and when to take your child to the doctor. Of course, if you have any questions or concerns, you should always contact your doctor and let them determine if your child needs to be seen or not.

  • Stomach Flu Virus – Sudden onset of vomiting, may be accompanied by fever and some stomach pain. Diarrhea usually begins after the first 12 hours. Vomiting generally lasts for 12 hours, but may continue for 72 (the worst!).
  • Food Poisoning – Don’t panic, this doesn’t actually mean your child ate “poison”, it just means there was some bad bacteria in something they ate (such as spoiled mayo or salad dressing, or undercooked chicken, beef or fish).  With food poisoning there usually is no fever and it happens a few hours after eating a potential source of “bad” food (like after a picnic, party, or restaurant meal). Vomiting may be accompanied by stomach cramps. The vomiting generally doesn’t last beyond 12 hours.

Important Note: If you have a toddler in the house that starts vomiting, you want to be sure they aren’t suffering from actual poisoning due to swallowing household liquids, medicines, or other toxins.

Look around for evidence of open packaging, empty containers, or spills. If your child swallowed something, there may be pills in their vomit or the vomit may have an unusual color, appearance, or smell. If you suspect your child swallowed something toxic, call 911 or take them to the ER. If you have the packaging the medicine or household liquid came in, be sure to bring it with you.

  • Bladder Infection – Occasionally, vomiting will be a side effect of a bladder infection. If your child has a fever for several days with occasional vomiting, and they complain of their urine burning or it has a foul odor, this may be the cause. Contact your doctor.
  • Other Intestinal or Bacterial Illnesses – If it’s not the stomach flu, it could be a number of other illnesses such as Rotavirus, E-Coli, or Salmonella. The vomiting pattern for all of these is similar to the flu, so you may never know the real culprit. But it’s not really necessary, since treatment is the same.
  • Severe Cough/Cold Kids may occasionally vomit after an especially bad coughing fit. This isn’t really a stomach issue, it’s a cough issue and should be treated that way. Follow normal protocols for treating a cold/cough. Contact your doctor if the coughing continues for more than a few days, your child complains of chest pain, your child is wheezing, or they cough up mucus.
  • Intestinal Obstruction This is a rare but SERIOUS condition that occurs when the intestines become twisted. The main symptom is severe abdominal pain. If there is no pain (or mild pain) it most likely is not an obstruction. If it is indeed an obstruction, the sharp abdominal pain will be followed by persistent dark-green vomiting. Your child may also appear pale and sweaty, and will have no bowel movements. Call 911 or get your child to an ER immediately if you suspect obstruction.
  • Injury A child that falls down and hits his head or stomach may vomit due to injury in those areas. If your child has been in an accident, fallen, or you suspect they may have fallen (check for bruises and other signs of injury) they may be vomiting as a result. See your doctor or get to an ER right away. Your child may also be suffering from a concussion or other internal injury you want to have checked out.

What To Do When Your Child Is Vomiting

Keep calm. Most vomiting is caused by the flu, intestinal illness or food poisoning and will usually run its course after 12 hours or so. During the period of heaviest vomiting, don’t even try to give your child liquids … it will just come back up. If they really want to drink something, give a small sip of water, but don’t expect them to keep it down.

Once the initial severe vomiting subsides, you can offer small sips of liquids about every ten minutes. Oral electrolyte solutions (like Pedialyte) are a good choice since they have a good balance of what your child needs. For nursing infants, breast milk is good.  White grape juice diluted with water works too, or Gatorade. Don’t give juices like apple, cherry or pear that have a lot of sugar. This can worsen diarrhea which can lead to dehydration.

When the vomiting finally seems to be stopping, you can start introducing bland foods like toast, broth, soup, crackers, etc. to see if your child can keep it down. If the vomiting resumes go back to pedialyte until it stops, then try the food again.  

 

Don’t Worry Too Much About:

  • Persistent vomiting that lasts 6 hours or less in infants, or 12 hours or less in children.  
  • Mild dehydration.
  • Vomiting that stops, then comes back after a day or two. (This may happen with a virus.)  If it happens more than once, or the vomiting spell lasts more than 12 hours, call your doctor.
  • Fever (comes with virus).  See how to handle Fevers.
  • Small drops of blood in the vomit.  This can come from tiny tears in the throat and isn’t dangerous.  

Call Or See A Doctor When:

  • Persistent vomiting lasts longer than 6 hours in infants, or longer than 12 hours in children over one year old.  This may lead to severe dehydration, which should be treated.
  • Significant Blood in vomit.  If it’s more than a few drops, call or see your doctor.
  • Child complains of painful urination or urine is dark or foul smelling.
  • Child experiences severe stomach pain.
  • Child also has a severe headache, stiffness or pain in the neck, and a fever along with the vomiting.  This could indicate meningitis.
  • You suspect your child may have swallowed something toxic.
  • You suspect your child may have a head or other injury.