Somerset Pediatrics
HOME CARE FOR VOMITING
Most vomiting is caused by a viral infection of the stomach or by your child’s eating
something that irritates the stomach lining. The viral type is often associated with diarrhea.
Nausea and abdominal discomfort usually precede each bout of vomiting. Vomiting usually stops in
12 to 24 hours. Temporarily changing your child’s diet generally speeds recovery.
Vomiting should not be confused with regurgitation – the effortless spitting up of one or
two mouthfuls of stomach contents – that is commonly seen in babies under 1 year of age.
I.
Children Less than 1 year of age:
Bottle-fed Infants
For vomiting 2 or more times, offer Pedialyte. Offer 1 tsp. every 10 to 15 minutes.
If there has been no vomiting for 2 hours, increase the Pedialyte to 1 oz. every 15 minutes. If there
has been no vomiting for 4 hours, slowly increase the amount of Pedialyte. After 8 to 12 hours
without vomiting, return to formula. Start with ½ the usual amount and increase slowly. Infants over
4 months of age who have been on rice cereal may return to small amounts of it at this time.
Breast-fed Infants
For vomiting 2 or more times, nurse 4 to 5 minutes every 30 to 60 minutes. If no vomiting
after 4 hours, increase the length of each feed. After 8 hours without vomiting, return to regular
breast-feeding and small amounts of rice cereal for infants over 4 months of age who have been on
rice cereal.
II.
Children over 1 year of age:
For vomiting 2 or more times, offer clear fluids in small amounts for 8 hours. Water or ice
chips are OK. Pedialyte is still the best choice. The freezer pops made of Pedialyte are often taken
well. Older children may take Gatorade. “Flat” soda is not recommended.
Start with 1 Tablespoon for children between 1 and 6 years of age and 1 ounce for school
age children, every 10 to 15 minutes. If there has been no vomiting for 2 hours, increase the volume
to 1 oz. every 15 minutes for children 1 to 6 years. If there has been no vomiting for 4 hours, try
slowly increasing the volume. If the increased volume results in vomiting, rest the stomach 1 hour
and start over but with smaller amounts. The one-swallow-at-a-time approach rarely fails!
After 8 hours without vomiting, gradually return to a normal diet. Start with food such as
saltine crackers, jelly or honey on white bread or toast, pasta without sauce, white rice, mashed or
baked potatoes, pretzels, dry Cheerios or Rice Krispies, white chicken or turkey meat, bananas and
rice cakes. Solids should be offered – not forced – in small amounts and increased as tolerated. A
normal diet (including milk and dairy products) is OK in most children 24 to 48 hours after vomiting
stops.
III.
Severe vomiting / dry heaves
If the above suggestions have not helped or if dry heaves are persistent, rest the stomach
for 2 hours. Then give coke syrup (sold as Emetrol over the counter), corn syrup (only if child is
over 1 year of age due to concern of botulism), or “heavy syrup” (i.e. canned fruit syrup). Give 1 to 2
tsp. every 15 minutes times 4. Then start clear liquids in very small amounts as discussed.
IV.
Additional suggestions and information:
Stop all nonessential medicines by mouth for 8 hours.
Acetaminophen suppositories (available without a prescription) may be helpful if fever is
present.
Pedialyte may be flavored with Nutrasweet (OK in small amounts for this brief time) or a
squeeze of lemon or orange. Chilling may help the acceptance. Pedialyte should not be mixed with
juices, soda or powders (i.e. Kool-Aid, Tang). Mixing it alters the ideal balance of sugar and
electrolytes. A Pedialyte Freezer Pop is equal to 2 oz.
V.
Summary:
Frequent, small amounts of clear liquids are the key to preventing dehydration. If there has
been no vomiting for 4 hours, slowly increase the amount of clear fluids. If there has been no
vomiting for 8 hours, gradually introduce foods or formula.
Please call the office if severe abdominal pain accompanies vomiting, vomiting is a pure
yellow liquid (may be bile), the guidelines failed to control the vomiting, or your child is acting very
sick.