What is vomiting?

Vomiting (also called emesis) is not a disease but a symptom. In children, a variety of conditions can cause vomiting, the most common of which is viral infection of the gastrointestinal tract, or gastroenteritis (also known as “stomach flu”). Bacterial infections and parasites in the gastrointestinal tract are other common causes of both vomiting and diarrhea in children. Because a child loses substantial amount of fluids with vomiting, especially if the vomiting lasts for more than 24 hours and is accompanied by diarrhea, it can lead to dehydration, which untreated can be life threatening. Regardless of the underlying cause, children suffering from vomiting should drink plenty of fluids to replenish water loss from the body.

A note of caution: Avoid giving plain water to an infant younger than 12 months. Formula and breast milk are the best sources of hydration in children under one year of age.Your pediatrician can advise you about other fluids that may be given to infants, how much to give and how often.

Less common causes of vomiting include head trauma or brain injury and brain tumors. Other conditions can lead to vomiting as well, including disorders of the liver, intestines, gallbladder and pancreas.

Symptoms

• Vomiting

• Nausea (may or may not be present)

• Depending on the cause, vomiting may be accompanied by diarrhea, malaise and fever

• Dehydration is a dangerous and common side effect of vomiting in children.

Watch for the following signs of dehydration:

• Dry mouth

• Few or no tears when crying

• Fussiness and irritability in infants

• Fewer than four wet diapers in 24 hours

• Reduced frequency of urination and amount of urine at urination

• Fatigue, drowsiness, excessive sleepiness

• Disorientation, confusion

• Deep, rapid breathing

• Rapid heartbeat

Diagnosis

If a child’s vomiting doesn’t go away in a couple of days, a pediatrician should be contacted for diagnosis of the underlying cause leading to the vomiting. In addition to physical exam and blood tests, sometimes imaging studies (like ultrasound or X-rays) of the gastrointestinal tract may be needed.

Treatment 

Because vomiting is a symptom rather than a condition, treatment depends on the underlying cause. 

When to Call for Help

Call your pediatrician if your child has vomiting that doesn’t go away after 24 hours or starts again once a normal diet is resumed; if vomiting is accompanied by fever (temperature over 100.4 degrees in an infant or 101 degrees in a child over six months); if your child is vomiting blood or vomiting a substance that looks like coffee grounds; or if your child is vomiting yellowish or greenish fluid. Take your child to a hospital if your child vomits after hurting his or her head.