Children And Vomiting

Overview

Vomiting is when the stomach pushes its contents up and out through the mouth. It is very common in children and is often the body's way of getting rid of something that is irritating it, such as a stomach bug. Throwing up can look worrying, but most children feel better within a day or two. The most important thing you can do is help your child keep enough fluid in.

Yes. Vomiting is one of the most common reasons parents contact a doctor or nurse. Nearly every child will have episodes of vomiting, especially in the early years, and most recover quickly with simple care at home.

It affects children of all ages. Babies and young children are at higher risk of dehydration because they are small and lose fluid quickly. Children in nursery, preschool and school often pick up stomach infections from each other.

Symptoms

Common symptoms

• Feeling sick or retching before being sick
• Bringing up food or liquid, once or several times
• Tummy ache or cramping
• Feeling hot or having a temperature
• Loose poo or diarrhoea alongside the vomiting
• Not wanting to eat or drink much
• Looking pale, tired or clingy

Symptoms in children

• Signs of dehydration: dry mouth, no tears when crying, fewer wet nappies, sunken eyes, or a sunken soft spot on a baby's head
• Being more sleepy or floppy than usual, or harder to wake
• Refusing feeds or drinks for a long time
• Vomit that is green, yellow-green, or contains blood
• A swollen or very tender tummy
• Vomiting after a bump to the head
• Possetting (bringing up a little milk after a feed) is normal in babies and is different from forceful vomiting

Symptoms in older adults

• Older children and teenagers can usually describe feeling sick and may notice a headache or tummy pain before vomiting
• They can often drink and manage their own fluids, but still need reminders to sip regularly
• Dehydration risk rises if they also have another long-term condition or are taking regular medicines, so ask your pharmacist or doctor for advice

Causes

Main causes

• Stomach bugs (gastroenteritis) caused by viruses or bacteria are by far the most common cause
• Food poisoning from food that was not stored or cooked safely
• Other infections, such as ear infections, urine infections or chest infections
• Reflux, where milk or food comes back up easily, especially in babies
• Motion sickness from car or boat travel
• Eating too much, or eating something the stomach does not tolerate
• Stress or strong emotions, which can cause vomiting in some children
• Rarely, a blockage or inflammation in the bowel, which needs urgent medical care

Risk factors

• Being around other children, for example at nursery or school
• Not washing hands well, especially before eating and after using the toilet
• Sharing cups, cutlery or toys with someone who is unwell
• Being a baby or young child, because small bodies lose fluid quickly
• Travelling on winding roads or by boat
• Having another health condition that makes dehydration more likely

When to see a doctor

See a doctor urgently if:

• Any sign of dehydration, such as a dry mouth, no tears when crying, fewer wet nappies, or sunken eyes
• Your baby is under 6 months and vomiting
• Green or bloody vomit
• Severe or worsening tummy pain, or a swollen tummy
• Your child is very sleepy, floppy, or hard to rouse
• Vomiting after a head injury
• A high temperature in a young baby, or any fever with a rash that does not fade under pressure

Book a routine appointment if:

• Vomiting keeps coming back over weeks without a clear cause
• Your child is not gaining weight or is losing weight
• Vomiting happens mostly after meals or at night and seems linked to reflux
• Your child seems well but you are worried or want advice

Diagnosis

A doctor or nurse will usually work out the cause by talking with you and examining your child. They will ask how often your child is being sick, what the vomit looks like, how much your child is drinking, how many wet nappies or trips to the toilet there have been, and whether anyone else at home is unwell. They will check your child's temperature, tummy, weight and level of alertness, and look for signs of dehydration. In most cases no tests are needed.

Tests that may be done

• A urine sample, to check for a urine infection
• A blood test, if dehydration or another serious problem is suspected
• A stool (poo) sample, if an infection needs identifying
• A scan of the tummy, if a blockage or inflammation is suspected
• Other tests depending on your child's age and symptoms

What to expect at your appointment

The check-up is usually quick and gentle. Your child may be weighed and asked to sit still while their tummy is felt. If tests are needed, the doctor will explain why. Most families leave with advice on fluids and clear guidance on when to come back.

Treatment

The main treatment for vomiting in children is to replace the fluid and salts the body has lost. Most children do not need medicine and recover with careful fluids at home. If there is an underlying cause, such as an infection or a blockage, that will be treated.

Self-care at home

• Offer small sips of fluid often, for example a spoonful every few minutes, rather than a large amount at once
• Rehydration drinks from a pharmacist are designed to replace water and salts; ask your pharmacist which one suits your child's age
• Keep breastfeeding or formula feeding your baby; offer shorter, more frequent feeds
• Avoid fizzy drinks, undiluted juice and sports drinks, as they can make things worse
• Let your child rest and keep them comfortable
• When they feel hungry again, offer plain, light food such as toast, rice, or crackers, and build up slowly
• Keep your child off nursery or school until 48 hours after the last episode of vomiting, to avoid passing on a stomach bug
• Wash hands often with soap and water, and clean up vomit carefully

Medical treatments

Doctors sometimes suggest anti-sickness medicine in specific situations, such as persistent vomiting or travel sickness, but this is not needed for most children. If your child is dehydrated, they may need fluids given through a drip in hospital. Any infection or other condition found during the check-up will be treated in the appropriate way. Always ask your doctor or pharmacist before giving any medicine to a child, and never give medicine meant for adults.

When is surgery considered?

Surgery is only needed in rare cases, such as when vomiting is caused by a blockage or inflammation in the bowel, an appendix problem, or a hernia. Your child's medical team will explain the reasons clearly if this applies.

Living with this condition

During a bout of vomiting, the day is mostly about fluids, rest and watching how your child looks and behaves. Keep a simple note of how often they are sick and how many wet nappies or trips to the toilet they have. This helps you and your doctor see how they are doing. Stay close and offer comfort; children often feel frightened or worn out after being sick.

Lifestyle tips

• Keep offering fluids gently, even if your child refuses at first
• Wash hands regularly and keep surfaces, cups and toys clean
• Store and cook food safely, and keep raw meat away from ready-to-eat food
• Let your child return to normal activity gradually once they are keeping fluids down
• Keep a thermometer and rehydration drinks at home so you are prepared

Diet and exercise

There is no special diet needed in most cases. Offer small, plain foods when your child feels hungry, and avoid heavy, greasy or very sweet foods for a day or two. Exercise can wait until your child is eating and drinking normally and has plenty of energy. Gentle play at home is fine when they feel up to it.

Mental health and emotional wellbeing

Vomiting can be upsetting for children and worrying for parents. Some children become anxious about being sick again, especially if it happened at school or at night. Younger children may want extra cuddles and reassurance. If your child seems very anxious, or if you are feeling overwhelmed, speak to your doctor or nurse. Support is available, and asking for help is a sign of strength.

Prevention

Not all vomiting can be prevented, but many stomach infections can be avoided with good hand hygiene and safe food handling. Teaching children to wash their hands after the toilet and before eating makes a real difference.

Vaccines

Some causes of vomiting are preventable with vaccines. For example, the rotavirus vaccine, which protects against a common cause of severe vomiting and diarrhoea in babies, is part of the routine childhood schedule in many countries, including the UK. Ask your doctor or health visitor which vaccines are recommended where you live.

Screening programmes

There is no routine screening for vomiting. If vomiting keeps happening without a clear reason, your doctor may arrange checks to look for an underlying cause.

Complications

If left untreated

• Dehydration, where the body loses too much water and salt; this is the most common concern and can become serious quickly in babies
• Tiredness and weakness from not eating or drinking
• Rarely, serious problems such as a bowel blockage, a tear in the food pipe, or breathing in vomit
• Worry and disrupted sleep for both children and parents

Long-term outlook

The outlook is very good. Most children with vomiting caused by a stomach bug are back to normal within a few days, and simple fluid care at home is usually all that is needed. Keeping an eye out for dehydration and knowing when to ask for help means serious problems are usually caught early.

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