Vomiting

Many childhood illnesses can cause vomiting, therefore you can expect your child to have this problem several times during the early years. However, vomiting usually ends quickly without specific treatment required.

Vomiting occurs when the abdominal muscles and diaphragm vigorously contract while the stomach is relaxed, forcing the stomach contents through the mouth. This reflex action occurs when the “vomiting center” of the brain is stimulated by 1) nerves from the stomach or small intestines when swelling or irritation occur (either due to infection or blockage); 2) psychological stimuli (ie. sights or smells); 3) chemicals in the blood (ie. drugs, toxins, poisons); or 4) stimuli from the inner ear (ie. inner ear infection or motion sickness). The common causes of vomiting differ with the age of the child.

Spitting Up

Infants who are less than one year old have a tendency to spit up small amounts of formula or breastmilk within an hour of a feeding, especially if the child is burped infrequently or if active play is immediately following a feeding. Spitting up is the easy flow of stomach contents out of the mouth, which is different than vomiting, and tends to decrease as the baby becomes older. Spitting up is not serious and does not interfere with a child’s ability to gain weight properly.

GERD

Occasionally, the spitting up in the first months of life gets worse instead of better. That is, although it’s not forceful, it happens more frequently. This can happen because the muscles at the end of the esophagus become overly relaxed and allow the stomach contents to go back up the esophagus into the mouth. This condition is called “gastroesophageal reflux disease” (ie. GERD). If your child is experiencing these symptoms, you can try to control them by 1) Burping the child more frequently; 2) Give smaller feedings more frequently to avoid overfeeding; 3) Keeping the child in an upright position for 20-30 minutes after each feeding; or 4) Speak to the pediatrician about thickening your child’s milk with cereal (do not try this without the advice of your pediatrician).

Persistent Vomiting

Infants between 2 weeks and 4 months of age, persistent forceful vomiting occurring within 15-30 minutes after a feeding may be a sign of a condition called “hypertrophic pyloric stenosis”, a thickening of the muscle at the exit of the stomach. Anytime you notice this, please call your pediatrician as this diagnosis requires medical intervention.

Infection

Most vomiting in children older than 3 months of age is caused by infection in the stomach or instestine (“gastroenteritis”). Viruses are the most common infecting agents, however bacteria and even parasites can be the occasional cause of vomiting. The infection is usually contagious and may also produce fever, diarrhea, nausea and abdominal pain. In most cases, vomiting will stop without specific medical treatment.

Occasionally, infections outside of the gastrointestinal tract can cause vomiting in children including ear infections, strep throat, pneumonia, urinary tract infections, appendicitis and meningitis. Some of these conditions require immediate medical attention, therefore be on the look-out for any of the troubling signs and call your pediatrician immediately if they occur:

  • Blood or bile (green substance) in the vomit
  • Worsening, severe belly pain
  • Distended or rigid belly
  • Severe irritability or lethargy
  • Convulsions (seizures)
  • Signs or symptoms of dehydration including dry mouth, lack of tears, sunken “soft spot”, decreased urination
  • Inability to drink adequate amount of fluid
  • Vomiting that continues for more than 24 hours.

Treatment

In most cases, vomiting will stop on its own without specific medical treatment. You should never use over-the-counter or prescription remedies unless they have been prescribed by your child’s pediatrician and for this particular illness. When there is continued vomiting, it is important prevent dehydration by encouraging your child to drink enough fluids to restore what has been lost through vomiting. This can be done by giving small amounts at a time – either by syringe or teaspoon for infants, or by sips of fluids for older children – to prevent gulping large amounts which can cause more vomiting. You may offer water and oral electrolyte solutions (ie. Pedialyte, Gatorade, Powerade), in addition to other clear liquids such as broth, gelatin (Jell-O) or popsicles. You may continue to offer their usual milk/formula as well as their normal diet of solid food, however, your child may refuse it temporarily until the vomiting subsides and your child is feeling better. Focus on keeping your child hydrated and call your pediatrician if you notice signs of dehydration or if your child is unable to tolerate fluid intake by mouth.

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Pathway Pediatrics, LLC
Westfall Medical Park
2225 South Clinton Avenue, Suite 1A
Rochester, NY 14618
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