Vomiting in Children

When should you take a child who is throwing up to the doctor?

The majority of illnesses involving vomiting and/or diarrhea are viral and are very contagious to people of all ages. Children who are ill should stay home from daycare and school until they’ve had no fever, vomiting or diarrhea for 24 hours. The same goes for adults at school and work!

Children with vomiting should be given small amounts of clear liquids, such as Pedialyte, Rehydralyte or an electrolyte solution such as Gatorade, on a very frequent basis. They should not be given solid food until they haven’t vomited for at least 6-8 hours.

Children with fever and vomiting may tolerate acetaminophen better than ibuprofen, as ibuprofen can irritate the stomach more than acetaminophen.

Antibiotics are not usually prescribed, since most of these illnesses are viral, and could actually make the vomiting worse due to additional stomach upset.

What action should I take if my child has a vomiting-related illness?

There is no magic number of episodes of vomiting or diarrhea that should trigger a visit to a doctor, as the number varies with patient age and size, as well as how much liquid is coming in or going out with each episode. Please keep an eye on your child and bring them to their primary care pediatrician or an urgent care facility if you detect these symptoms:

1. Multiple episodes of vomiting and unable to tolerate even small amounts of fluids orally.
2. Refusal to take liquids orally. Your child needs to intake an adequate amount of fluids containing sugar and electrolytes.
3. Signs of significant dehydration: no urine output for 4-6 hours (infants), 6-8 hours (toddlers) and 10-12 hours (children/teens); the eyes are dry and the child cries with no tears; there appears to be little to no saliva in the mouth; or the child has a poor activity level or is very cranky even when they don’t have a fever.

If your child has the following symptoms, they should be taken to an emergency department for further testing:

1. Lethargic and not responding normally to caregivers.
2. Vomiting green fluid, especially dark green (bile) or appearance of blood in the vomit.
3. Severe stomach pain, either intermittently or constantly.

Lou Romig, MD, FAAP, FACEP, Medical Director

After Hours Pediatrics Urgent Care

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