Unexplained Vomiting in Your Child and When To See a Doctor

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As parents, we go through many “firsts” with our children, some joyful and others troubling. One new experience that can stand out as particularly unpleasant is the startled or fearful reaction of your child the first time they vomit.

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We stand by helplessly trying to reassure our kiddos that, yes, even though this doesn’t make sense in anybody’s world, food can sometimes go up, in the wrong direction. Children just don’t understand what’s happening or why. They just want it to stop — and so do you.

While vomiting is typically a sign of a stomach virus, unexplained vomiting in a child can be harder to identify and can be worrisome.

Family medicine physician Matthew Goldman, MD, and pediatric gastroenterologist Ben Freiberg, MD, explain how to take care of a child who’s vomiting and when you should talk to a doctor.

What causes vomiting and why does it happen?

Vomiting itself isn’t a condition or illness. It’s a symptom of another problem. Finding the underlying cause is the key to treating it.

Sometimes, episodes of vomiting are mild and short-lived. Most times, your child may start throwing up out of the blue. Other times, vomiting is a sign of something more serious.

Pinpointing what’s behind a bout of vomiting — especially causes of sudden vomiting — in a child may not be straightforward, Dr. Goldman says.

“Kids, especially younger ones, can be more sensitive to certain bacteria, making them more susceptible to viruses or food poisoning,” he continues. “They don’t respond the same way adults with a more developed immune system do.”

Age factors

They may struggle to articulate how they feel. And a lot may depend on your child’s age.

In infants and toddlers, sometimes an anatomical issue (existing from birth) is responsible. For example, the connection between their food pipe and stomach isn’t fully developed, making it easier for stuff to come up. In most cases, a doctor can often fix it before your child reaches adulthood, Dr. Goldman says.

In infants, you may see excessive spitting up or reflux. With toddlers, it’s usually a stomach virus, he adds.

In older children, your healthcare provider may consider other sudden vomiting causes, from common ailments (such as a viral infection) to emergency situations (such as toxic substance overdose or appendicitis).

Other possible causes

Depending on the range of symptoms, your child’s provider may probe for stomach or digestive issues, including:

  • Peptic ulcers.
  • Gastric ulcers.
  • An intestinal block.
  • Pancreatitis.
  • Inflammatory bowel disease.
  • Pyloric stenosis (a condition that prevents food from passing from the stomach to the small intestines).

“Ultimately, vomiting is our body’s response to a noxious stimuli or a sensation that isn’t right and it wants to get rid of it,” explains Dr. Freiberg. “And with the stomach, there’s one of two ways that things can move. It can either move forward, or it can be expelled back up. And it’s a signal that’s it’s something bad — it’s dangerous, it might harm us and our bodies will want to get rid of it.”

In other cases, your provider may see signs of conditions with a strong psychological aspect, such as bulimia. There are also times when they may suspect pregnancy.

Treatment of vomiting in children

If your child has an illness that’s causing vomiting, Dr. Goldman and Dr. Freiberg offer these tips:

  • Give fluids. Encourage your child to drink water or other rehydration fluids. Jello and Popsicles® may also help. Avoid juices with high sugar content (apple, pear, cherry) and sports drinks.
  • Don’t push food. “Remember, it’s common for kids to have little or no appetite during the vomiting process,” Dr. Goldman says. “Monitor them for dehydration, but don’t force them to eat.”
  • Go slow. Once the vomiting stops, you can help your child ease back into their regular diet starting with small amounts of complex carbohydrates (rice, potatoes, bread). “These foods wouldn’t irritate their stomach,” says Dr. Freiberg. “Avoid spicy or acidic foods, which will irritate their stomach’s lining.”

Watch your child’s symptoms carefully and, if vomiting continues or resumes, work with your healthcare provider to pinpoint the issue.

If you have a baby who’s vomiting, advice varies based on whether they’re breastfed or bottle-fed:

  • Breastfed infants. Go ahead and breastfeed (unless your healthcare provider says otherwise). But it’s a good idea to breastfeed more frequently for shorter periods, at first. If vomiting improves, resume normal feeding. If not, seek medical care within 24 hours.
  • Formula-fed infants. Give your child 1/2 ounce to 1 ounce of rehydration fluid (such as Pedialyte®) every 15 minutes for two to three hours. If your baby vomits again, try again in 30 minutes. Resume normal feeding if your infant’s condition improves. Otherwise, seek care within 24 hours.

Preventing vomiting in children

Sometimes, kids get sick. They go through illnesses as they build stronger immune systems.

Instilling good handwashing habits can help your child avoid some illnesses that cause vomiting. Encourage your children to wash their hands regularly with soap and warm water for at least 30 seconds. Remind them to scrub their fingernails and in between their fingers as well.

When to see a doctor

A short episode of vomiting isn’t usually concerning. But you should see your child’s healthcare provider if certain other symptoms accompany the vomiting.

Watch for decreased urination in any child who’s having trouble with vomiting. For infants, this means no wet diapers within six hours. Also, if your baby is experiencing projectile vomiting, call your provider.

In all kids, watch for green color in vomit, as well as fever of 102 degrees Fahrenheit (38.8 degrees Celsius) — or fever of 101 F (38.3 C) for more than three days.

Also, look for these signs of dehydration:

  • Lack of tears when crying.
  • Dry mouth.
  • Sunken eyes.
  • Cool, clammy hands and feet.
  • Lack of energy.

“If your child is throwing up and not able to keep anything down, particularly liquids, then they really need to be seen by a doctor,” stresses Dr. Freiberg. “They might need help getting the fluids into them through an IV to make sure that they stay well hydrated.”

If any symptom(s) concern you, call your healthcare provider.

Vomiting is one of those symptoms we all dread, especially for our kids. Remember that your provider is there to help.

“If you have any questions or any concerns, definitely seek out medical attention,” encourages Dr. Freiberg. “Don’t hesitate to meet or talk with a doctor to see what we can do to help.”

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