My Child is Vomiting: When to Go to ER for Vomiting?

Vomiting is the most common reason parents call their pediatrician. Most vomiting (throwing up) is caused by a stomach virus. Often, diarrhea (frequent, loose and or watery stools) follows within 12-24 hours. Vomiting can also be caused by food poisoning. If vomiting without diarrhea persists for more than 24 hours, more serious causes may be considered. Serious causes of vomiting include appendicitis, poisoning, meningitis, liver or kidney infections or new onset diabetes. Vomiting is different than spitting up in that vomiting is forceful, causes discomfort and the baby looks or acts sick.

When to Call 911

your child is very weak, limp, not moving, unresponsive, difficult to awaken or confused when awake.

When to Go to ER for Vomiting?

if your child has a stiff neck, soft spot is bulging, could have been poisoned by a plant, medicine or other chemical or is a newborn less than 4 weeks old with temperature higher than 100.4°F.

When to Call the Doctor: Anytime Day or Night

you notice blood in the vomit, your child has constant or severe intermittent abdominal pain, has a recent head or abdominal injury, is 4-12 weeks old, is vomiting and has temperature higher than 100.4°F, or if your child is at high risk. Examples of high risk are recent surgery, diabetes, weak immune system or recent hospitalization.

When to Call the Doctor During Business Hours

if you notice any signs of dehydration (dry mouth, no tears, no urine for more than 8 hours), bile (green fluid) in the vomit, continuous abdominal pain or crying for more than 2 hours, your baby less than 12 weeks old vomited more than 2 times, fever over 105°F, severe headache or if you suspect diabetes.

Home Care for Vomiting Due to a Stomach Virus

Mild to moderate vomiting from a stomach virus can be treated at home. This varies based on your child’s age. In general, it is a good idea to encourage your child to sleep for a little while after vomiting. Sleeping helps the stomach to empty and relieves the need to vomit.

Infants

For infants that have vomited more than once, offer oral rehydration solution (like Pedialyte) in small amounts for 8 hours. Try to spoon or syringe feed 1-2 teaspoons every 5 minutes. If you are breastfeeding, offer 5 minute feedings at one breast every 30-60 minutes.

Children Over One-Year-Old

For children over one year old, offer small amounts of water, ice chips or other clear fluids for 8 hours. Give small amounts: 2-3 teaspoons every 5minutes. After 4 hours without vomiting, increase the amount. After 8 hours without vomiting, return to regular fluids and bland solids such as crackers or toast. Most children can return to a normal diet in 24-48 hours.

Recovery Time

Vomiting from a stomach virus usually stops in 12 to 24 hours. Mild vomiting with nausea may last 3 days. Your child can return to daycare or school after vomiting and fever are gone.