Vomiting In Children

Vomiting In Children | Here’s How You Can Help Your Child At Home Before Visiting A Doctor In Panic

Vomiting in children: Why it occurs, causes, diagnosis, care at home, diet & fluids, medicines, prevention, key points

Vomiting in children

Vomiting in children: Vomiting is a common occurrence in infancy and childhood and most often is a sign of viral infection or indigestion. However, it can be a harbinger of more serious problems. It can lead to dehydration and therefore it is important to address.

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While most children recover without any treatment, it is important to know when to seek help. It must be differentiated from spitting up in infants which is usually normal and of little consequences. It differs from spit up and usually has more force behind it and is larger in amount. Spitting up often occurs with a burp after feeding.

Why does vomiting occur?

It is a reaction of the body when nerves in the body or brain sense a trigger, such as food poisoning, certain infections or medicines, or motion. Nausea, an unpleasant sensation in the stomach that may occur before vomiting but younger children may not be able to recognize it or complain about it.

It often has a benefit since it provides a way for the body to get rid of potentially harmful substances. However, in no condition should a child be made to vomit to expel a harmful substance and must be immediately taken to emergency.

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Causes of vomiting

It can be caused by a number of different problems. It includes infection, indigestion, surgical conditions, head trauma etc.

The possible causes of depending upon a child’s age, whether it is acute, chronic or episodic and the relevant history.

The nature of the vomit is also important. The doctor notes if it is projectile, bilious (yellow to green colour) or has streaks of blood.

General signs and symptoms are also necessary to decide on the cause e.g. whether there is fever, diarrhea, headache, lethargy or ingestion of outside foods.

Newborns and young infants — Sometimes it is hard to tell if an infant is spitting up or vomiting because some infants reflux forcefully or in large amounts. However, if the milk is curdled it is usually reflux. In any case, the health professional will be able to help diagnose.

Forceful vomiting in newborns always requires further evaluation. Some of the serious causes of in newborns and young infants include a blockage or narrowing of the stomach (pyloric stenosis) or a blockage of the intestines (intestinal obstruction).

Infants can also vomit because of infections of the intestine or other parts of the body.

Older infants and children — The most common cause in older infants and children is because of viral infection of the stomach or intestines (gastroenteritis).

Vomiting in such a case usually begins suddenly and resolves quickly, often within 24 to 48 hours.

Other signs of gastroenteritis can include nausea, diarrhea, fever, or abdominal pain. It often develops after eating contaminated food or putting a contaminated object into the mouth as viruses spread easily.

Occasionally, vomiting occurs after consuming improperly stored or prepared foods that contain bacteria or toxins and is called food poisoning.

Other illnesses can also cause vomiting in older infants and children, including gastroesophageal reflux, peptic ulcer disease, an intestinal blockage (obstruction), cyclic vomiting syndrome, respiratory and urinary tract infections, and others.

Adolescents — Again the most common cause of nausea and vomiting in adolescents is infectious gastroenteritis usually caused by viruses.

Less common causes in adolescents include appendicitis (inflammation of the appendix), induced vomiting (eg, as seen with bulimia), pregnancy, gastric ulcers (of the stomach), inflammatory bowel disease (eg, Crohn’s disease), and consumption of toxic substances (eg, overdose).

Vomiting In Children | https://www.singhaniaclinic.com/pediatrician/vomiting-in-children/ Here's How You Can Help Your Child At Home Before Visiting A Doctor In Panic

Vomiting In Children

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Nausea and vomiting diagnosis

Monitor for signs that the child is getting worse or not getting better within 24 hours. If your child has severe or persistent pain or has signs of dehydration, they should be seen sooner.

Concerning signs — Warning signs that may indicate a serious cause of vomiting include:

  • Nonspecific symptoms
    • Prolonged vomiting
    • Profound lethargy
    • Significant weight loss
  • Symptoms of gastrointestinal obstruction or disease
    • Bilious vomiting
    • Projectile vomiting in an infant three to six weeks of age
    • Blood in stool or vomitus
  • Symptoms or signs suggesting neurologic or systemic disease
    • Bulging soft part of the head in a neonate or young infant
    • Headache
    • Altered consciousness, seizures
    • History of head trauma

Care at home

Most importantly monitor and prevent dehydration.

Signs of mild dehydration include:

  • A slightly dry mouth
  • Thirst

Signs of moderate or severe dehydration include:

  • Decreased urination (not going to the bathroom or no wet diaper in six hours)
  • A dry mouth
  • Sunken eyes
  • Listlessness

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Diet and fluids

Children who are vomiting but are not dehydrated can continue to eat a regular diet as tolerated. Dehydrated children require rehydration (water+pinch of salt +spoonful sugar). If an exclusively breastfeeding infant vomits, he or she should continue to breastfeed and oral rehydration solutions are not usually needed.

Breastfeed more frequently if vomiting occurs immediately after a feed. In a formula fed baby, ORS can be alternated with formula. If worsens or does not improve within 24 hours, go to the doctor.

Medicines

Medicines to reduce nausea and vomiting, called antiemetics, might be recommended in certain situations (to reduce the risk of dehydration in children who vomit repeatedly or to reduce motion sickness). These medicines should only be given on the recommendation of a doctor.

Preventing spread

If your child is vomiting, you need to be careful to avoid spreading the infection to yourself, your family, and friends. Wash your hands frequently and keep sick children out of school or daycare. Children with vomiting (two or more times in 24 hours) that is caused by a contagious condition should be kept out of school or daycare until they have not vomited for 24 hours.

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Key points

  • Monitor for signs of dehydration, and do not force the child to eat, especially during the first 24 hours
  • Encourage the child to drink fluids. The best fluids are the commercially prepared oral rehydration solutions (ORS). Other fluids, including water, diluted juice, or soda can be given in small quantities. ORS can be given frequently, small sips or small amounts by spoon, bottle, or cup over three to four hours
  • Juices and other drinks with high sugar content should be avoided. Sports drinks should also be avoided since they have too much sugar and have inappropriate electrolyte levels
  • Recommended foods include a combination of complex carbohydrates (rice, wheat, potatoes, bread), yogurt, fruits, and vegetables. High-fat foods are more difficult to digest and should be avoided.Try the BRAT diet (bananas, rice, applesauce, toast) to decrease diarrhea
  • Prevent spread by frequent washing and containing the child at home
  • Avoid medicines to stop vomiting unless recommended by a doctor
  • Seek help immediately if the child is lethargic, cannot keep anything down, has a high fever, has bloody stool or is an infant
Vomiting In Children | https://www.singhaniaclinic.com/pediatrician/vomiting-in-children/ Here's How You Can Help Your Child At Home Before Visiting A Doctor In Panic

Vomiting In Children

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Vomiting In Children was last modified: April 4th, 2017 by Dr. Rajeshree Singhania