Nausea and Vomiting, Age 11 and Younger
Nausea and Vomiting, Age 11 and YoungerSkip to the navigationTopic OverviewVomiting occurs when a child's stomach contents are forced up the esophagus and out of the mouth. Although nausea may accompany vomiting in adults and older children, children younger than age 3 are usually not able to tell you if they are having nausea. Most of the time vomiting is not serious. Home treatment will often ease your child's discomfort. Vomiting in a baby should not be confused with spitting up. Vomiting is forceful and repeated. Spitting up may seem forceful but it usually occurs shortly after feeding, is effortless, and causes no discomfort. Causes of vomitingA baby may spit up for no reason at all. Overfeeding, not burping your baby after feeding, intolerance to milk or formula, and exposure to tobacco smoke are other reasons why your baby may spit up. Most vomiting in children is caused by a viral stomach illness (gastroenteritis). A child with a stomach illness also may have other symptoms, such as diarrhea, fever, and stomach cramps. With home treatment, the vomiting usually will stop within 12 hours. Diarrhea may last for a few days or more. Rotavirus is a virus that can cause severe vomiting and diarrhea. Rotavirus vaccine helps protect against rotavirus disease. Vomiting can also be caused by an infection in another part of the body, such as strep throat, pneumonia, or a urinary tract infection. In rare cases, vomiting can be a symptom of a serious condition, such as a blockage of the digestive tract (pyloric stenosis), an infection (meningitis) of the fluid (cerebrospinal fluid) and tissues (meninges) that surround the brain and spinal cord, or Reye syndrome. When a toddler vomits, it is important to make sure he or she has not swallowed medicines, household liquids, or other poisons. Look around the house for empty containers and spills. There may be pills in your child's vomit, or the vomit may have an unusual appearance, color, or odor. For more information, see the topic Poisoning. A child who falls down and forcefully hits his or her head or belly may vomit because of an injury to those areas. Check your child's body for bruises and other injuries. TreatmentBabies and children younger than 1 year old need special attention if they continue to vomit. They can quickly become dehydrated. It is important to replace lost fluids when your child is vomiting. Watch your child carefully, and pay close attention to the amount of fluid he or she is able to drink. Look for early symptoms of dehydration: - The mouth and eyes may be drier than usual.
- The urine may be less than usual.
- He or she may feel cranky, tired, or dizzy.
Also, be sure to notice the color of the vomit, and count the number of times your child vomits. If your child vomits so frequently that you can't get him or her to drink or vomits every time he or she takes a drink, the risk of dehydration is greater. Check your child's symptoms to decide if and when your child should see a doctor. Check Your SymptomsIs your child nauseated or vomiting? Nauseated means you feel sick to your stomach, like you are going to vomit. How old are you? Less than 3 months Less than 3 months 3 to 11 months 3 to 11 months 12 months to 3 years 12 months to 3 years 4 to 11 years 4 to 11 years 12 years or older 12 years or older Does your child have moderate to severe belly pain? Has your child had a head injury in the past 24 hours? Yes Head injury in past 24 hours No Head injury in past 24 hours Has your child swallowed or inhaled something that might be poisonous? Yes Ingested known or suspected poison No Ingested known or suspected poison Does your baby seem sick? A sick baby probably will not be acting normally. For example, the baby may be much fussier than usual or not want to eat. How sick do you think your baby is? Extremely sick Baby is very sick (limp and not responsive) Sick Baby is sick (sleepier than usual, not eating or drinking like usual) Moderate Moderate dehydration Are the symptoms severe, moderate, or mild? Moderate Moderate dehydration Is your child having trouble drinking enough to replace the fluids he or she has lost? Little sips of fluid usually are not enough. The child needs to be able to take in and keep down plenty of fluids. Yes Unable to drink enough fluids No Able to drink enough fluids Does your child have symptoms of a serious illness? Yes Symptoms of serious illness No Symptoms of serious illness Do you think your baby has a fever? Did you take a rectal temperature? Taking a rectal temperature is the only way to be sure that a baby this age does not have a fever. If you don't know the rectal temperature, it's safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious. Yes Rectal temperature taken No Rectal temperature taken Is it 100.4°F (38°C) or higher? Yes Temperature at least 100.4°F (38°C) No Temperature at least 100.4°F (38°C) Within the past week, has your child had an injury to the abdomen, like a blow to the belly or a hard fall? Yes Abdominal injury within past week No Abdominal injury within past week Do you think the nausea or vomiting may be caused by an injury or by abuse? Yes Nausea or vomiting may be caused by injury or abuse No Nausea or vomiting may be caused by injury or abuse Do you think your child has a fever? Did you take your child's temperature? How high is the fever? The answer may depend on how you took the temperature. High: 104°F (40°C) or higher, oral High fever: 104°F (40°C) or higher, oral Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral Mild: 100.3°F (37.9°C) or lower, oral Mild fever: 100.3°F (37.9°C) or lower, oral How high do you think the fever is? Moderate Feels fever is moderate Mild or low Feels fever is mild How long has your child had a fever? Less than 2 days (48 hours) Fever for less than 2 days From 2 days to less than 1 week Fever for more than 2 days and less than 1 week 1 week or longer Fever for 1 week or more Does your child have a health problem or take medicine that weakens his or her immune system? Yes Disease or medicine that causes immune system problems No Disease or medicine that causes immune system problems Does your child have shaking chills or very heavy sweating? Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off the child or soaking through his or her clothes. Yes Shaking chills or heavy sweating No Shaking chills or heavy sweating Has there been any blood, yellow or green liquid (bile), or what looks like coffee grounds in the vomit? Sometimes a food (like yellow squash or green peas) can be the reason for the vomit's color. But unless food is the obvious cause, vomit that is yellow, green, or bloody may be a sign of a serious medical problem. Yes Blood or yellow or green liquid (bile) in vomit No Blood or yellow or green liquid (bile) in vomit Has your baby vomited after 2 feedings in a row? Vomiting is not the same as spitting up. Spitting up usually occurs right after eating, happens easily without any effort by the child, and is not forceful or painful like vomiting can be. Yes Vomited after 2 feedings in a row No Vomited after 2 feedings in a row Has there been any blood, yellow or green liquid (bile), or what looks like coffee grounds in the vomit? Sometimes a food (like yellow squash or green peas) can be the reason for the vomit's color. But unless food is the obvious cause, vomit that is yellow, green, or bloody may be a sign of a serious medical problem. Yes Blood or yellow or green liquid (bile) in vomit No Blood or yellow or green liquid (bile) in vomit How much blood or bile has your child vomited? Vomit is mostly blood or bile, or contains what looks like coffee grounds Vomit is mostly blood or bile, or contains material that looks like coffee grounds Streaks of blood or a small amount of bile Streaks of blood or small amount of bile in vomit Is your child vomiting all the time, again and again, or is your child vomiting just now and then? How often the child vomits is important. Repeated vomiting is more serious than vomiting that occurs now and then. All the time Repeated vomiting Now and then Occasional vomiting Has your child been vomiting for more than 4 hours? Yes Vomiting for more than 4 hours No Vomiting for more than 4 hours Has your child been vomiting for more than 8 hours? Yes Vomiting for more than 8 hours No Vomiting for more than 8 hours Has the vomiting gone on for more than 3 days? Yes Vomiting for more than 3 days No Vomiting for more than 3 days Has the vomiting gone on for more than 1 week? Yes Vomiting for more than 1 week No Vomiting for more than 1 week Is your child starting to vomit more often, or is the vomiting getting more severe? Yes Occasional vomiting is becoming more frequent or severe No Occasional vomiting is becoming more frequent or severe Does your child have diabetes? Is your child's diabetes getting out of control because your child is sick? Yes Diabetes is affected by illness No Diabetes is affected by illness Is the plan helping get your child's blood sugar under control? Yes Diabetes illness plan working No Diabetes illness plan not working How fast is it getting out of control? Quickly (over several hours) Blood sugar quickly worsening Slowly (over days) Blood sugar slowly worsening Has your baby been vomiting for more than 2 days? Yes Vomiting for more than 2 days No Vomiting for more than 2 days Has your child vomited after 2 or more feedings or meals in a row? Yes Vomited after 2 or more feedings/meals in a row No Vomited after 2 or more feedings/meals in a row Does your child spit up often? Spitting up is not the same as vomiting. It usually occurs right after eating, happens easily without any effort by the child, and is not forceful or painful like vomiting can be. Has your child been spitting up more than usual? This can mean more often than usual or larger amounts than usual. Yes Spitting up is increased in amount or more frequent No Spitting up is increased in amount or more frequent Does spitting up occur with other symptoms, such as diarrhea, constipation, or fussiness? Yes Spitting up occurs with other symptoms No Spitting up occurs with other symptoms Has your child been spitting up for more than 1 month? Yes Spitting up for more than 1 month No Spitting up for more than 1 month Do you think that a medicine could be causing the nausea or vomiting? Think about whether the nausea or vomiting started after you began using a new medicine or a higher dose of a medicine. Yes Medicine may be causing nausea or vomiting No Medicine may be causing nausea or vomiting Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
If you're not sure if a child's fever is high, moderate, or
mild, think about these issues: With a high fever: - The child feels very hot.
- It is likely
one of the highest fevers the child has ever had.
With a moderate fever: - The child feels warm or hot.
- You are
sure the child has a fever.
With a mild fever: - The child may feel a little warm.
- You
think the child might have a fever, but you're not sure.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in children are: - Diseases such as diabetes, cystic fibrosis, sickle
cell disease, and congenital heart disease.
- Steroid medicines,
which are used to treat a variety of conditions.
- Medicines taken
after organ transplant.
- Chemotherapy and radiation therapy for
cancer.
- Not having a spleen.
Temperature varies a little depending on how you measure it.
For children up to 11 years old, here are the ranges for high, moderate, and
mild according to how you took the temperature. Oral (by mouth), ear, or rectal temperature - High:
104°F (40°C) and
higher
- Moderate:
100.4°F (38°C) to
103.9°F (39.9°C)
- Mild:
100.3°F (37.9°C) and
lower
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature. Armpit (axillary) temperature - High: 103°F (39.5°C) and higher
- Moderate:
99.4°F (37.4°C) to
102.9°F (39.4°C)
- Mild: 99.3°F (37.3°C) and lower
Note: For children under 5 years old, rectal temperatures are
the most accurate. Babies can quickly get dehydrated when they lose fluids because of problems like
vomiting or fever. Symptoms of dehydration can range from mild to
severe. For example: - The baby may be fussy or cranky (mild dehydration),
or the baby may be very sleepy and hard to wake up (severe
dehydration).
- The baby may have a little less urine than usual
(mild dehydration), or the baby may not be urinating at all (severe
dehydration).
You can get dehydrated when
you lose a lot of fluids because of problems like vomiting or fever. Symptoms of dehydration can range from mild to severe. For
example: - You may feel tired and edgy (mild dehydration), or
you may feel weak, not alert, and not able to think clearly (severe
dehydration).
- You may pass less urine than usual (mild
dehydration), or you may not be passing urine at all (severe
dehydration).
Severe dehydration means: - The baby may be very sleepy and hard to wake
up.
- The baby may have a very dry mouth and very dry eyes (no
tears).
- The baby may have no wet diapers in 12 or more hours.
Moderate dehydration means: - The baby may have no wet diapers in 6 hours.
- The
baby may have a dry mouth and dry eyes (fewer tears than usual).
Mild dehydration means: - The baby may pass a little less urine than usual.
Severe dehydration means: - The child's mouth and eyes may be extremely dry.
- The child may pass little or no urine for 12 or more
hours.
- The child may not seem alert or able to think clearly.
- The child may be too weak or dizzy to stand.
- The
child may pass out.
Moderate dehydration means: - The child may be a lot more thirsty than
usual.
- The child's mouth and eyes may be drier than
usual.
- The child may pass little or no urine for 8 or more hours.
- The child may feel dizzy when he or she stands or sits up.
Mild dehydration means: - The child may be more thirsty than
usual.
- The child may pass less urine than usual.
Many nonprescription and prescription medicines can cause
nausea or vomiting. A few examples are: - Antibiotics.
- Antidepressants.
- Aspirin, ibuprofen (such as Advil or
Motrin), and naproxen (such as Aleve).
- Medicines used to treat
cancer (chemotherapy).
- Opioid pain
medicines.
- Vitamins and mineral supplements, such as iron.
Starting a new medicine or increasing the dose can cause nausea
and vomiting. Nausea and vomiting also may mean that there is too much medicine
in your body, even if you took it properly. Repeated vomiting: The child vomits
nearly every time he or she tries to drink something. This type of vomiting
makes it impossible to keep down any fluids or solid food, which greatly
increases the chance of becoming dehydrated. The child has an even greater
chance of dehydration if he or she also has diarrhea. Occasional vomiting: Some young children vomit every once in a
while for no clear reason. This usually does not increase the risk of
dehydration or other problems as long as the child can keep down fluids between
vomiting. The more time that passes between episodes of vomiting, the less
serious it probably is. But if the vomiting continues, it may be important to
find the cause. Symptoms of serious illness in a baby
may include the following: - The baby is limp and floppy like a rag doll.
- The baby doesn't respond at all to being held, touched, or talked
to.
- The baby is hard to wake up.
Symptoms of serious illness may
include: - A severe headache.
- A stiff
neck.
- Mental changes, such as feeling confused or much less
alert.
- Extreme fatigue (to the point where it's hard for you to
function).
- Shaking chills.
An illness plan for people with diabetes usually covers things like: - How often to test blood sugar and what the target
range is.
- Whether and how to adjust the dose and timing of insulin
or other diabetes medicines.
- What to do if you have trouble keeping
food or fluids down.
- When to call your doctor.
The plan is designed to help keep your diabetes in control even
though you are sick. When you have diabetes, even a minor illness can cause
problems. It is easy for your diabetes to become out of control when
you are sick. Because of an illness: - Your blood sugar may be too high or too
low.
- You may not be able take your diabetes medicine (if you are
vomiting or having trouble keeping food or fluids down).
- You may
not know how to adjust the timing or dose of your diabetes
medicine.
- You may not be eating enough or drinking enough
fluids.
Colic is an extreme type of crying in
a baby between 3 weeks and 3 months of age. All babies cry, but a colicky baby
will cry for hours at a time, no matter what you do. During a
crying episode, a colicky baby may cry loudly and continuously and be hard to
comfort. The baby may get red in the face, clench the fists, and arch his or
her back or pull the legs up to the belly. A baby that is extremely sick: - May be limp and floppy like a rag
doll.
- May not respond at all to being held, touched, or talked
to.
- May be hard to wake up.
A baby that is sick (but not extremely
sick): - May be sleepier than usual.
- May not eat
or drink as much as usual.
Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Nausea and Vomiting, Age 12 and Older Abdominal Pain, Age 11 and Younger Head Injury, Age 3 and Younger Head Injury, Age 4 and Older Poisoning Home TreatmentNewborns and babies younger than 1 year of age Don't wait until you see signs of dehydration in your baby. These signs include your baby being thirstier than usual and having less urine than usual. - If you breastfeed your baby, nurse him or her more often. Offer each breast to your baby for 1 to 2 minutes every 10 minutes.
- If you use a bottle to feed your baby, increase the number of feedings to make up for lost fluids. The amount of extra fluid your baby needs depends on your baby's age and size. For example, a newborn may need as little as 1 fl oz (30 mL) at each extra feeding, while a 12-month-old baby may need as much as 3 fl oz (90 mL) at each extra feeding.
- Ask your doctor if you need to use an oral rehydration solution (ORS) if your baby still isn't getting enough fluids from formula or the breast. The amount of ORS your baby needs depends on your baby's age and size. You can give the ORS in a dropper, spoon, or bottle.
- If your baby has started eating cereal, you may replace lost fluids with cereal. You also may feed your baby strained bananas and mashed potatoes if your child has had these foods before.
Children ages 1 through 11- Make sure your child is drinking often. Frequent, small amounts work best.
- Allow your child to drink as much fluid as he or she wants. Encourage your child to drink extra fluids or suck on flavored ice pops, such as Popsicles. Note: Do not give your child fruit juice or soda pop. Fruit juice and soda pop contain too much sugar and not enough of the essential minerals (electrolytes) that are being lost. Diet soda pop lacks calories that your child needs.
- Cereal mixed with milk or water may also be used to replace lost fluids.
- If your child still is not getting enough fluids, you can try an oral rehydration solution (ORS).
- Gradually start to offer your child regular foods after 6 hours with no vomiting.
- Offer your child solid foods if he or she was eating solids before. Offer crackers, toast, broths, mild soups, mashed potatoes, rice, and breads to your older child.
- Avoid high-fiber foods, such as beans, and foods with a lot of sugar, such as candy or ice cream.
If your child also has diarrhea, try home treatment for diarrhea. Symptoms to watch for during home treatmentCall your child's doctor if any of the following occur during home treatment: - Dehydration develops. Signs include your child being thirstier than usual and having less urine than usual.
- Your child's vomiting returns or becomes severe.
- Blood or yellow or green liquid (bile) is present in your child's vomit.
- Your child's vomiting does not get better.
- Your child's symptoms become more severe or frequent.
PreventionBabiesIt is normal for babies to spit up after a feeding. Vomiting after a single feeding may happen sometimes and does not mean your baby has a problem. Repeated vomiting after feedings is more of a concern. The following tips may help your baby spit up less often. If this advice does not help, talk with your doctor. - Feed your baby smaller amounts at each feeding.
- Feed your baby slowly.
- Hold your baby during feedings.
- Do not prop your baby's bottle.
- Do not place your baby in an infant seat during feedings.
- Try a new type of bottle or use a nipple with a smaller opening to reduce air intake.
- Limit active and rough play after feedings.
- Try putting your baby in different positions during and after feeding.
- Burp your baby frequently during feedings.
- Consider talking to your doctor about starting your baby on hypoallergenic formula. About 1% of babies who spit up are allergic to milk protein.
- Do not add cereal to formula without first consulting your child's doctor.
- Do not smoke when you are feeding your baby. Children who are exposed to tobacco smoke are more likely to develop illnesses that cause vomiting. If you smoke, quit. If you can't quit, do not smoke when you are holding or feeding your baby or when you are in the house or the car. For more information, see the topic Quitting Smoking.
- Consider getting your child the rotavirus vaccine.
Toddlers- Limit active and rough play after feedings.
- Teach your children how to wash their hands well, especially if there is an illness in the house.
If you use child care, talk to the caregivers about their program or policies for sick children. Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your doctor diagnose and treat your child's condition by being prepared to answer the following questions: - Did you have problems during your pregnancy or with the delivery of this child?
- What do you think might be causing your baby's vomiting?
- Has your child been exposed to someone with a similar illness?
- How long has the vomiting been going on?
- Does your child have any other symptoms, such as fever, belly pain, or diarrhea?
- Has your child had a recent fall or injury?
- How many times has your child vomited? How much fluid is lost each time?
- Is your child able to hold down fluids?
- What does the vomit look like?
- Is there any blood or yellow or green liquid (bile) in the vomit?
- Did you find any unusual liquids or pills in the vomit?
- What does the vomit smell like?
- What prescription or nonprescription medicines are in your home?
- Did your child's symptoms start after eating at a restaurant? Has anyone else who ate there with you become ill?
- Has your child recently eaten raw or undercooked seafood?
- Do you think your child may have eaten any contaminated food?
- Has your child recently visited a foreign country?
- Has your child recently drunk water from a lake, stream, or private well?
- Has your child had any known exposure to toxic materials, chemicals, or fumes?
- Does your child have any health risks?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Kathleen Romito, MD - Family Medicine Specialist Medical ReviewerAdam Husney, MD - Family Medicine Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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