Vomiting in toddlers and children

Why is my kid throwing up?

Viral illnesses are often to blame, but toddlers and young children can vomit for a variety of reasons. Although vomiting usually isn't serious, you'll want to find out the cause, so you can help your child feel better and get the care they need. (See the end of this article for advice on when to see a doctor or seek emergency help.)

If your child throws up once and that's the end of it, maybe they just ate too much at their last meal. If they continue to throw up, common causes include:

Viral or bacterial infection

• The stomach flu or other intestinal illness is the most likely culprit. If a virus or bacteria has infected your child's stomach lining or intestines, they may also have diarrhea, loss of appetite, abdominal pain, or fever. Throwing up usually stops within 12 to 24 hours.
• Congestion or a respiratory infection, such as a cold, can also lead to vomiting, especially if your child is coughing hard. And the mucus produced during a cold can drip down the back of the throat and irritate the stomach. Some children throw up to clear the mucus out of their system. If your child has a lot of phlegm and mucus, you can help prevent vomiting by encouraging them to blow their nose.
• A urinary tract infection, pneumonia, meningitis, appendicitis, strep throat, and ear infection can also cause nausea and vomiting.

Vitamins and medications

Some vitamins (such as iron), and some medications (such as certain antibiotics, antivirals, and anti-inflammatories like ibuprofen) may cause your child to throw up. If the medication can be taken with food (some need to be taken on an empty stomach), try giving it with a meal or snack. If that doesn't help, talk with the doctor to see if there's an alternative medication.

Excessive crying

A prolonged bout of crying can trigger the gag reflex and make your child vomit. Although it's troubling for both of you, throwing up during a crying spell won't physically harm your child. If they appear otherwise healthy, there's no reason to be concerned.

Stress

Your child might have physical symptoms that coincide with stress or anxiety. These symptoms might include headaches, stomach aches, and even throwing up. Take note if they throw up at the same time consistently – before heading to school or daycare, for example. Encourage your child to talk about how they're feeling, and explore stress-reduction techniques that are appropriate for their age, such as taking deep breaths.

Motion sickness

Some children tend to get motion sickness. Experts believe that motion sickness happens when there's a disconnect between what your child sees and what they sense with the motion-sensitive parts of the body, such as the inner ears and some nerves.

Food allergy

Nausea and vomiting are among the symptoms your child might have if they have a food allergy. (They might not have a reaction the first time they eat a food.) Symptoms may show up within minutes, or it may take hours. The most common allergens are eggs, fish, milk, peanuts, shellfish, soy, tree nuts, and wheat.

Concussion

In most cases, when a child hits their head when they fall, there's nothing to worry about. But if your child is throwing up more than once in the day or two after a fall or a blow to the head, they may have a concussion. Other symptoms are drowsiness, dizziness, irritability, and confusion. Call the doctor if this happens.

Warning: Call 911 if your child starts breathing irregularly, has convulsions, or is unconscious.

Migraine headache

Migraines can hit kids at any age, but they usually first appear in children between the ages of 5 and 8. This type of headache is often on one side of the head and causes throbbing pain. In addition to nausea and vomiting, migraines can cause mood changes, skin pallor, fatigue, dizziness, blurred vision, food cravings or loss of appetite, diarrhea, or fever. Most kids outgrow migraines, but talk with your child's doctor if your child has migraine symptoms.

Poisonous substance

Your child could be throwing up if they swallowed something toxic, like a drug, plant, medicine, or chemical. Or they may have gotten food poisoning from contaminated food or water. Your child may have diarrhea instead of or in addition to vomiting. See "What should I do if I think my child has swallowed something poisonous?" below.

Intestinal obstruction

Sudden and persistent vomiting in children can be a symptom of a handful of rare conditions involving an intestinal blockage, such as intussusception (when one part of the bowel slides into the next part), malrotation (a twisting of the intestines), and Hirschprung disease (a blockage due to poor muscle movement in the bowel). Because blockages can lead to malnutrition, dehydration, and other health problems, they usually require immediate medical attention and surgery.

What should I do for vomiting?

Vomiting is usually no cause for alarm and will probably stop on its own without treatment, but here are some things you can do:

• Watch your child's position. While they're throwing up, keep your child upright or lying on their stomach or side to keep them from inhaling vomit into the upper airway and lungs. When it's nap time or bedtime, let your child sleep in the position they find most comfortable. (And don't worry – they won't choke if they vomit in their sleep. The body will automatically clear fluids and protect the airway.)
• Avoid solid foods for the first 24 hours or so.
• Prevent dehydration by making sure your child gets enough fluids to make up for what they lose through vomiting. See the following tips in "How can I keep my child from getting dehydrated after throwing up?"

• Don't give your child anti-nausea medication, either prescription or over-the-counter, unless the doctor recommends it.

• Brew up a tummy-friendly tea if your child will drink it, such as chamomile, peppermint, or ginger. To prevent scalding, serve it warm, not hot.

How can I keep my child from getting dehydrated after throwing up?

It depends on how often and how much they're vomiting. Ask the doctor about the best way to rehydrate your child. Dehydration can be a serious problem for young children, and if your child is throwing up, they're losing precious fluids.

• Don't force your child to drink anything when they're still thowing up frequently (every five or 10 minutes). But after their tummy's been calm for half an hour or so, offer slow, frequent sips of water. Try about 1 teaspoon (5 ml) every five minutes (2 ounces an hour) to start, and if your child tolerates that well, increase slowly until they're able to start drinking normally again. If your child doesn't feel like drinking, you can try to get them to suck on very small chips of ice. (Don't give ice cubes, which are a choking hazard for young children. Even for kids who are old enough not to choke on them, crunching on them isn't good for their teeth.)
• If your child's vomiting is severe or prolonged, the doctor may recommend an over-the-counter pediatric electrolyte solution, available as a liquid or as ice pops. The doctor can recommend a specific electrolyte product for your child and advise how much to give based on their weight and age.
• Juice can sometimes make matters worse (too much juice can cause diarrhea), but if juice is the only liquid your child will drink, dilute it half and half with water. Avoid carbonated drinks and sports drinks, which have high amounts of sugar.

When can my child eat solids again?

Doctors usually recommend keeping children off solid foods for the first 24 hours of any illness that causes vomiting. After that, if your child's throwing up diminishes or stops, and their appetite returns, you can slowly reintroduce other fluids as well as healthy foods.

The American Academy of Pediatrics (AAP) recommends that a child recovering from stomach troubles resume a normal diet as soon as possible. Offer whatever solid foods your child normally eats, including complex carbohydrates (like breads, cereals, and rice), lean meats, yogurt, fruits, and vegetables, but avoid fatty foods because they're harder to digest.

Note: This differs from the BRAT diet (bananas, rice, applesauce, and toast) that doctors used to prescribe. Studies show that reintroducing a standard diet can shorten recovery time because it restores essential nutrients the body needs to fight infection. If your toddler or young child misses a few days' worth of good nutrition, don't worry. Just make sure to keep them hydrated.

By the way, doctors' recommendations about milk consumption after vomiting vary widely. It's worth a discussion with your child's doctor to see what they think.

Can I do anything to prevent motion sickness?

To help minimize motion sickness, try:

• Rest stops: Stop frequently during your trips to give your child a chance to get some fresh air and calm their tummy.
• Snacks: Give your child a small snack before the trip – having something in their stomach will help.
• Fluids: Offer plenty of fluids to keep them hydrated. Otherwise, your child may get a headache or even feel dizzy or weak.

Medication

Talk to the doctor before giving your child medication for motion sickness, and have them try it before starting out on a trip to see if there are side effects. Certain medications may cause drowsiness or dry mouth and nose (keep those fluids handy), but sometimes they have the opposite effect and cause irritability and hyperactivity.

Caution: Motion sickness patches aren't for use on children under age 12, even in a smaller dose.

Why is my toddler throwing up with no fever?

There are many reasons why your toddler or older child might vomit but not have a fever (see "Why is my child throwing up?" above). They may simply have eaten too much, or they might not tolerate a winding car ride. On the other hand, your child might have an obstruction or something else that needs immediate medical attention. Use the guidelines below to help figure out when to seek medical care. But if you have any doubts or concerns, don't hesitate to call the doctor.

When should I call my child's doctor?

Call your child's doctor if your child:

• Has been throwing up for more than 24 hours. For some illnesses, this is normal, but check with the doctor to be sure.
• Shows signs of becoming dehydrated, including decreased urination, dry lips and mouth, crying without tears, lethargy, and dark yellow urine.

• Has vomit with blood: A little blood in the vomit is usually nothing to worry about, because the force of vomiting can cause tiny tears in the blood vessels lining the esophagus. Vomit may also be tinged with red if your child has swallowed blood from a cut in their mouth or a nosebleed within the past six hours. But call the doctor if your child continues to have blood in their vomit or if the amount increases. If the blood resembles dark coffee grounds, go to the emergency room right away.
• Shows signs of jaundice, including skin or the whites of their eyes looking yellow. If your child additionally has pain in the upper right side of the abdomen, they could have hepatitis.

• Regularly throws up when exposed to certain people or places.

Call 911 immediately if your child:

• Is having trouble breathing.
• Shows signs of severe dehydration, such as sunken eyes, excessive sleepiness, lightheadedness, dizziness, delirium, or cold, splotchy hands and feet.

Take your child to the emergency room if your child:

• Has severe abdominal pain. If they're old enough, have your child point to the part of the tummy that hurts. (Pain that's centered around the navel and then moves to the lower right side of the abdomen could signal appendicitis.) If your child is too young to explain exactly where it hurts, you can still probably tell when they're in considerable pain. Your child could have a blockage in their bowel or some other problem that needs immediate attention.
• Has vomit with blood that resembles dark coffee grounds or contains bile (a green substance). The doctor will probably want to see a sample of the vomit if it contains blood or bile, so try to save some in a plastic baggie. Bile can indicate that the intestines are blocked, a condition that needs immediate attention.
• Has a swollen, tender abdomen. This could indicate a buildup of fluid or gas, a blocked intestine, a hernia, or some other digestive tract problem. Blockages are uncommon but serious.
• Vomits more than once after suffering a head injury, which may indicate a concussion.
• Has a stiff neck, which is the hallmark sign of meningitis.

What should I do if I think my child has swallowed something poisonous?

If you can identify what they swallowed – for example, you find an empty medicine bottle – tell the medical experts what it is, and they'll tell you what to do.

Experts no longer advise keeping syrup of ipecac or activated charcoal on hand in case of a poisoning emergency. Ipecac is not an effective treatment for poisoning; if you have ipecac in your home, the AAP recommends that you dispose of it immediately and safely. Activated charcoal hasn't been proven a safe or effective remedy to give to children at home. (Never throw away any medications in a garbage can that your child can get into.)

Protect your child by poison-proofing your home.

Learn more

• Why is my baby throwing up?
• Stomach flu (gastroenteritis)
• How to prevent gas pain in kids
• Stomach ache in children