Vomiting is the forceful emptying (throwing up) of a large portion of the stomach’s contents. Nausea and abdominal discomfort usually precede each bout of vomiting. Most vomiting is caused by a viral infection of the stomach or mild food poisoning. Vomiting is the body’s way of protecting the lower GI tract. The main concern with vomiting is dehydration.
For Formula-Fed Infants, Offer Oral Rehydration Solution (ORS) Such as Pedialyte:
- If your child has vomited more than once, offer ORS for 8 hours.
- ORS is a special electrolyte solution that can prevent dehydration. It’s readily available in most supermarkets and drugstores.
- Spoon or syringe feed 1-2 teaspoons of ORS every 5 minutes.
- After 4 hours without vomiting, double the amount.
- After 8 hours without vomiting, return to regular formula.
For Breastfed Infants, Reduce the Amount Per Feeding:
- If your child vomits only once, nurse 1 side every 1 to 2 hours.
- If your child vomits more than once, nurse for 5 minutes every 30 to 60 minutes.
- If your child continues to vomit, switch to pumped breastmilk: 1-2 teaspoons every 5 minutes.
- After 4 hours without vomiting, return to regular breastfeeding. Start with small feedings of 5 minutes every 30 minutes and increase as tolerated.
Pumped Breast Milk for Bottle-Fed Infants, Reduce the Amount Per Feeding:
- If your child vomits only once, give half the regular amount every 1-2 hours.
- If your child vomits more than once within the last 2 hours, give 1 ounce every 30-60 minutes.
- If your child continues to vomit, give 1-2 teaspoons every 5 minutes. If not tolerating breast milk, switch to ORS.
- After 4 hours without vomiting, return to regular feedings. Start with 1 ounce every 30 minutes and slowly increase as tolerated.
Children Over 1 Year Old:
- Water or ice chips are best for vomiting in older children. Popsicles work great for some kids.
- Vomiting with watery diarrhea requires ORS. If your child refuses ORS, use half-strength Gatorade. Make it by mixing equal amounts of Gatorade and water.
- The key to success is offering small amounts of fluid frequently. Offer 2-3 teaspoons every 5 minutes. Older kids can just slowly sip ORS.
- After 4 hours without vomiting, increase the amount.
- After 8 hours without vomiting, return to regular fluids. Avoid fruit juice and soft drinks.
Stop Solid Foods:
- Avoid all solid foods in kids who are vomiting.
- After 8 hours without throwing up, gradually add them back.
- Start with starchy foods that are easy to digest (e.g., cereals, crackers, bread).
- Return to a completely normal diet in 24-48 hours.
- Discontinue all nonessential medicines for 8 hours as they can make vomiting worse.
- For higher fevers, consider an acetaminophen suppository. Before administering medication, please review our medication dosing guides.
- Never give oral ibuprofen when vomiting; it is a stomach irritant.
Try to Sleep:
Help your child go to sleep for a few hours. Sleep often empties the stomach and relieves the need to vomit.
Severe or Continuous Vomiting, But Well-Hydrated:
- Sometimes children vomit almost everything for 3 or 4 hours, even if given small amounts.
- Some fluid is still being absorbed and will help prevent dehydration. Continue offering clear fluids.
For the first 3 or 4 hours, your child may vomit everything until the stomach settles down. Vomiting from viral gastritis usually stops in 12 to 24 hours. Mild vomiting (1-2 times/day) with diarrhea can continue intermittently for up to a week.
When to Call the Office
- Vomiting becomes severe (vomits everything) over 8 hours.
- Vomiting persists over 24 hours.
- Signs of dehydration occur.
- Blood appears in vomit or diarrhea.
- Stomach pain becomes constant or severe.
- Your child becomes worse.
©1994-2022 Schmitt Pediatric Guidelines, LLC.
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.