When Your Child Has Vomiting and/or Diarrhea HF#4896

 

Vomiting

 

Vomiting is forcefully throwing up more than 1-2 mouthfuls of stomach contents.  The most common cause of vomiting is a virus.  Other causes include food intolerance, food poisoning, emotional stress, fatigue, and eating too much.

 

This handout will explain how to care for your child at home and when you should call the doctor.  If you have any questions, please call us.  It is helpful to know that children vomit more than adults do.  No treatment is needed if your child vomits only once.  If they vomit two or more times, start treatment as follows:

 

Home Treatment (with or without diarrhea)

 

• Rest the stomach for at least 20-30 minutes after your child vomits.
• Start feeding with small amounts of fluids given often.

 

Infants (up to one year)

 

• Breast fed babies should keep breast feeding after their stomach has rested for 1-2 hours. If they vomit once, nurse as usual.  If they vomit twice, nurse on only one side for 10 minutes every 1-2 hours.  If they vomit three times or more, nurse for 4 to 5 minutes every 30-60 minutes.  Return to normal feedings when there has been no vomiting for 8 hours.

• Bottle fed babies should have one teaspoon (5 ml) of Pedialyte®, Ricelyte®, or Infalyte® every 15 minutes.  After one hour, they may be given two teaspoons every 15 minutes.  After two hours, increase to three teaspoons given every 15 minutes; keep giving fluids often.  If no vomiting has occurred, offer formula (in small amounts often) after three hours. 

 

^*If you cannot purchase one of these products, another option is to make your own mixture using one quart of water with 4 tablespoons of table sugar, 1/2 teaspoon of salt and 1/2 teaspoon of baking soda.

 

Toddlers and Older Children

 

• One tablespoon (15 ml) of “clear” liquids should be given every 15 minutes for one hour.  If no vomiting occurs, the amount can be slowly increased.  Clear liquids are ones you can see through such as: dilute juices (white grape or cranberry), non-diet soda (7-Up® or cola), popsicles, Kool-aid®, dilute sport drinks such as ½-strength Gatorade®, Jello, caffeine-free tea, or broth.  Water is okay, but your child should receive a clear liquid that has sugar and salt during the course of the day (such as the ones listed).  Pedialyte popsicles can also be purchased.

 

One way to keep the amounts of liquid small is to feed from a spoon rather than a bottle or cup.  The most common reason a child continues to vomit is drinking too much liquid at one time.

 

• After 4-6 hours without vomiting, offer your child solids starting with small amounts of “bland” high carbohydrate foods such as bananas, peeled apple, rice, boiled potatoes, applesauce, crackers, noodles, toast, or rice cereals.  You should avoid high fat foods for 1-2 days.  Do not force your child to eat solid foods.  Your child can advance to milk and milk products in 12-24 hours after drinking clear liquids without vomiting.

 

• If your child cannot keep down milk or any of the “bland” solids for 12-24 hours after vomiting has stopped, you should call your nurse or doctor.

 

Reasons to Call

 

Call your nurse or doctor if your child has vomited two or more times AND:

 

• Your baby is less than six months old.
• Your child has had an injury to his head or abdomen.
• Your child has severe stomach pain lasting one hour or more.
• There is blood in the vomit.
• Your child choked or had trouble swallowing.
• Your child may have eaten a poison (such as a plant, medicine, spoiled food).
• Your child is showing signs of dehydration (see below).
• Vomiting or retching does not improve with home treatment after 4-6 hours.
• Your child has a chronic health condition.

 

Signs of Dehydration   Dry, cracked lips; dry mouth or tongue. Urinating less often, (less than three times in 24 hours). Sunken and dark under eyes; no tears with crying. Cold, dry skin with less elasticity. Soft spot on infants feels more sunken. Weakness; lack of interest in things. Dizzy when stands up in older children

 

 

Diarrhea

 

Diarrhea is frequent, large, watery stools.  Children will sometimes have loose or soft stools, which are normal.  Newborn infants will usually have liquid, curdy, or soft stools up to five or six times a day.  This also is often normal.  Diarrhea is often caused by a virus.  It can also be from antibiotics or drinking too much fruit juice (like apple juice).  Not as often, infection from bacteria or parasites can cause diarrhea.

 

Home Treatment of Diarrhea (without vomiting)

 

Infants (up to 1 year old)

 

• Continue to breast feed or give regular formula, and offer solids.

 

Toddlers and Older Children

 

• Keep feeding your child the same foods as normal, avoiding fatty foods and sugary foods and drinks.  A change in diet is often not needed.  Some fruit juices such as apple juice and pear juice are so concentrated (have increased amounts of sorbitol, a type of sugar that draws fluid into the digestive tract and causes diarrhea) that they can make diarrhea worse.  If your child enjoys fruit juice and is having diarrhea, the juices should be diluted as follows: 1 part juice to 1 part water.  White grape juice is low in sorbitol.  Help your child to drink more fluids by leaving drinks out for your child.

 

• Feeding yogurt to your child may be helpful because of the helpful bacteria used in making yogurt (active cultures “acidophilus”).

 

• Offer smaller, more frequent meals.

 

Reasons to Call

 

Call your doctor or nurse if your child has diarrhea and

• Your baby is less than six months old.
• Your child has severe stomach pain lasting one hour or more.
• Your child has vomited more than twice along with the diarrhea.
• There is blood or pus in the stools.
• Your child is showing signs of dehydration (see above).
• The diarrhea does not improve after three days of home treatment.
• Your child has a chronic health condition.
• Do not use diarrhea medication without talking with your childs doctor first.

 

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: 03/10/2010

Copyright © 03/10/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4896

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