When Your Child Has Vomiting and/or Diarrhea
Vomiting and diarrhea can be harmful because they can cause dehydration. Dehydration occurs when you lose too much fluid. Young children can become dehydrated quickly, but dehydration can happen at any age.
Vomiting (throwing up more than several mouthfuls of stomach contents) and diarrhea (frequent watery bowel movements) are most often caused by viruses. Vomiting may also be caused by foods that are hard to digest, food poisoning, emotional stress, fatigue or over eating. Diarrhea may be caused by too much fruit juice, or antibiotics. Infections from bacteria or parasites can also cause vomiting or diarrhea.
If you are breast feeding, continue to give your baby breast milk after the tummy has rested for an hour. The key to treatment is giving breast milk in smaller amounts than usual. If your baby vomits once, nurse as usual. If your baby vomits twice, nurse on one side for 10 minutes every 1-2 hours. If vomiting occurs 3 or more times, nurse for 4-5 minutes every 30 to 60 minutes. As soon as 4 hours have passed without vomiting, return to normal nursing on both sides. If you feed your baby formula, switch to an oral rehydration solution (ORS) like Pedialyte®, Ricelyte® or Infalyte®. If this is not available continue formula, give 1 teaspoon every 5 minutes. After 4 hours increase volume to 2 teaspoons every 5 minutes. If no vomiting occurs after 4 hours, offer small amounts formula. If your child vomits using this treatment, rest the tummy for 1 hour and then start over. Use a spoon or oral syringe to keep the amounts of liquid small.
For toddlers and young children offer 1 tablespoon of “clear” liquid every 10 to 15 minutes for one hour, advance amount slowly. Clear liquids are liquids you can “see through”. This includes ORS (like Pedialyte®, Ricelyte® or Infalyte®). You can find this at drug stores and grocery stores, already mixed, as a powder, or Popsicle®. Juice (not apple) diluted with water, non-diet clear soda, Popsicles®, Kool-Aid® or diluted sports drinks.
The most common reason a child continues to vomit is drinking too much liquid at one time. Small amounts are less likely to upset your child’s tummy.
After 8 hours without vomiting, start feeding solid foods with small amounts of “bland” foods such as bananas, peeled apple, applesauce, rice (or baby rice cereal), boiled potatoes, crackers, plain noodles, dry cereal or plain toast. Usually your child can be back on a normal diet within 24 hours. Stay away from high fat foods for 24-48 hours.
Call your doctor if:
• Infant is under 6 months of age
• Your child is older than 6 months and fever is higher than 101.4
• Your child has severe tummy pain lasting more than 2 hours
• Your child has had an injury to the head or abdomen
• Blood seen in the vomit
• Your child might have swallowed something that could be poisonous(plants,
medications, spoiled food)
• Your child choked or had trouble swallowing
• Vomiting or retching has not improved after 8 hours or vomiting with great
• No urine output for 8 hours
• Your child has a stiff neck
• Your child is listless or unusually sleepy
• Your child has a chronic health condition
• Your child shows signs of dehydration
Signs of Dehydration:
• Little or lack of urine – urinating fewer than 6 wet diapers in 24 hours for
infants; no urine for 8 hours or more for children. Urine is darker than usual.
• Thirsty – babies may show signs of thirst by crying or being irritable. Babies
and children may be eager to drink when fluids are offered.
• Dry mouth and tongue, cracked lips
• Sunken eyes, dark colored skin under eyes
• No tears with crying
• Infants have a sunken soft spot
• Skin may feel cold, dry, and less elastic
• Crabby, weak, not interested in playing
• Dizzy when standing up in older children.
Diarrhea is frequent, large, watery stools usually caused by a virus. Normally infants have liquid, curdy or soft stools 5-6 times a day. Children sometimes have loose or soft stools, which are normal.
With diarrhea there may be cramping, tummy pain, fever, loss of appetite, weight loss, feeling tired or dehydration. Some causes of diarrhea include viruses, food intolerances, allergies, lactose intolerance, inflammatory bowel disease, celiac disease and certain medications. A child with “viral” diarrhea often starts the illness with some vomiting.
If your infant has diarrhea, continue to breast feed or give regular formula. Offer more frequent, smaller feedings. Some good choices would be rice cereal, mashed potatoes, applesauce, strained bananas or carrots. Avoid fruit juices.
For toddlers or older children give a bland or BRAT diet. This includes bananas, rice, applesauce and toast. Other bland foods would be dry cereal, bread, crackers, mashed potatoes and noodles. Stay away from foods high in fat or sugar. Diluted white grape juice is a good choice for fluids. Avoid dairy products for 48 hours. Yogurt with acidophilus or probiotic might be helpful to bring back the ‘good’ bacteria in the gut.
Children, normally, should not take diarrhea medicines. Always talk with your doctor first.
Call your doctor if:
• Infant is under 6 months of age
• Infant is under 12 months of age with a fever over 102
• Child has severe tummy pain lasting over 1 hour
• Child has vomited 2 or more times along with the diarrhea
• Child refuses to drink fluids
• Child is urinating less
• Diarrhea contains blood, mucus or pus
• Diarrhea has not improved in 3 days
• Child also has a chronic health condition
• Child is showing signs of dehydration (see above)
Mild diarrhea may last 3-6 days. You should not worry about loose stools as long as the child acts well and is taking enough fluids and foods. Some children can not drink cow’s milk when they have diarrhea due to the milks sugar, lactose.
The most common infections that cause diarrhea are highly contagious and easily transmitted through dirty hands, contaminated food or water, or contact with dirty diapers or the toilet. Children can become sick when they touch surfaces that are contaminated, and put their fingers in their mouths. Washing hands well is the best way to prevent infections from spreading.
The Spanish Version is #5867
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/28/2013
Copyright © 08/28/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4896
Print Health Fact For You