|Vomiting With Diarrhea|
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|Does this describe your child's symptoms?|
Severity of Vomiting
The following is an arbitrary attempt to classify vomiting by risk for dehydration:
Dehydration: How to Recognize
Return to School
|When to Call Your Doctor|
|Call 911 Now (your child may need an ambulance) If|
|Call Your Doctor Now (night or day) If|
|Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If|
|Call Your Doctor During Weekday Office Hours If|
|Parent Care at Home If|
|HOME CARE ADVICE FOR VOMITING WITH DIARRHEA|
- Most vomiting is caused by a viral infection of the stomach and intestines or by food poisoning.
- Vomiting is the body's way of protecting the lower intestinal tract.
- When vomiting and diarrhea occur together, treat the vomiting. Don't do anything special for the diarrhea.
- For Bottlefed Infants Offer Oral Rehydration Solution (ORS) for 8 Hours:
- ORS (eg. Pedialyte or the store brand) is a special electrolyte solution that can prevent dehydration. It's readily available in supermarkets and drug stores.
- For vomiting once, continue regular formula.
- For vomiting more than once, offer ORS for 8 hours. If ORS not available, use formula.
- Spoon or syringe feed small amounts: 1-2 teaspoons (5-10 ml) every 5 minutes.
- After 4 hours without vomiting, double the amount.
- After 8 hours without vomiting, return to regular formula.
- For infants over 4 months old, also return to cereal, strained bananas, etc.
- Return to normal diet in 24-48 hours.
- For Breastfed Infants, Reduce the Amount Per Feeding:
- If vomits once, nurse 1 side every 1 to 2 hours.
- If vomits more than once, nurse for 5 minutes every 30 to 60 minutes. After 4 hours without vomiting, return to regular breastfeeding.
- If continues to vomit, switch to ORS (e.g., Pedialyte) for 4 hours.
- Spoon or syringe feed small amounts of ORS: 1-2 teaspoons (5-10 ml) 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.
- For Older Children (over 1 Year Old) Offer Small Amounts of Clear Fluids For 8 Hours:
- ORS: Vomiting with watery diarrhea needs ORS (e.g, Pedialyte). If refuses ORS, use ½ strength Gatorade.
- Give small amounts: 2-3 teaspoons (10-15 ml) every 5 minutes.
- After 4 hours without vomiting, increase the amount.
- After 8 hours without vomiting, return to regular fluids.
- Solids: After 8 hours without vomiting, add solids:
- Limit solids to bland foods. Starchy foods are easiest to digest.
- Start with saltine crackers, white bread, cereals, rice, mashed potatoes, etc.
- Return to normal diet in 24-48 hours.
- Avoid Medicines:
- Discontinue all non-prescription medicines for 8 hours (reason: usually make vomiting worse).
- Fever: Fevers usually don't need any medicine. For higher fevers, consider acetaminophen (Tylenol) suppositories. Never give oral ibuprofen; it is a stomach irritant.
- Call your doctor if: vomiting a prescription medicine.
- Contagiousness: Your child can return to child care or school after vomiting and fever are gone.
- Expected Course: Moderate vomiting usually stops in 12 to 24 hours. Mild vomiting (1-2 times/day) with diarrhea can continue intermittently for up to a week.
- Call Your Doctor If:
- Vomiting becomes severe (vomits everything) over 8 hours
- Vomiting persists over 24 hours
- Signs of dehydration
- Diarrhea is severe
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 11/15/2011
Last Revised: 4/6/2012
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.