Fort Worth, Texas,
10:03 AM

What To Do When Your Child Is Vomiting

A pediatrician on common causes and how to help with dehydration

We always get plenty of phone calls about vomiting during this time of year. The causes of vomiting can be many as it can be a major symptom of several different conditions.

Here are some common scenarios for which we have parents call our office:

Vomiting with diarrhea—could be a viral gastroenteritis, commonly called the “stomach flu”. It’s usually not dangerous, but very uncomfortable. Very young children are most at risk for dehydration. But, because most children are very resilient, significant dehydration won’t occur if the child is able to take sips of liquids frequently during the illness and the illness is short, typically a day or 2.

Vomiting with fever—many conditions can cause this from early symptoms of a cold or the flu to some gastroenteritis or strep throat.

Vomiting with bloody diarrhea—could be due to serious intestinal infections and the child should be seen as soon as possible.

Vomiting with change in mental status (confusion, disorientation, excessive sleepiness)—could be due to a head injury, a poisoning, etc. A child with this presentation should be seen immediately.

Vomiting with a headache—may be due to a migraine, an infection such as the flu or strep, but if these symptoms occur after a head injury, this could signal a serious problem due to the injury. In this case, go to the emergency room.

Over -the-counter products are not typically recommended for young children.

If a clinician determines that the condition isn’t serious, then recommendations for home treatment will be given.

We would love to be able to “turn it off” so your child feels better, but most of these conditions are only treated with supportive care and TLC—care that parents can provide at home.

Often we see children in the office to assess for dehydration. Signs to watch for include:

  • Dry cracked lips and a dry mouth
  • Decreased urine output and very dark urine
  • Drowsiness or irritability
  • Cold or dry skin
  • Low energy levels, appears weak or limp
  • No tears when crying
  • Eyes sunken or a baby’s soft spot (fontanelle) sunken in

Commercially available solutions such as Pedialyte, Gastrolyte or Enfalyte will contain the properly balanced amounts of water, sugars, and salts to promote absorption of the fluid. Oral rehydration is the best option for mild to moderate dehydration. Give your child 5-10 milliliters (1-2 teaspoons) of one the previously mentioned drinks every 5 minutes, slowly increasing the amount as your child tolerates. If you breastfeed your child, continue to do so.

If your child refuses to take an oral rehydration solution, try giving fluids you know your child likes, such as milk or water mixed with juice. But if your child has severe diarrhea, milk and juice may make it worse. So encourage the oral rehydration as best you can.

If you think your child is severely dehydrated, go to the Emergency Department immediately.

Get to know Bradley Mercer, M.D.

Dr. Brad Mercer is pediatrician at Cook Children's Pediatrics (Fort Worth). He grew up in Fort Worth and attended Brewer High School. He earned his undergraduate degree from Texas A&M University and his medical degree from the University of Texas Health Science Center in Houston. He completed his residency at Texas A&M/Scott and White Hospital in Temple, Texas. Dr. Mercer joined Cook Children's Physician Network and has been a board member for CCPN, Cook Children's Health Care System and Cook Children's Health Plan, as well as the Tarrant Country Academy of Medicine and Fort Worth Academy school board. Dr. Mercer and his wife have two high-school aged children. His hobbies include traveling, camping, hiking, cycling and running. To make an appointment, click here or call 817-592-8182.


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