Vomiting is common in children and can happen for a number of reasons. It’s usually due to an infection in the gut – gastroenteritis – and will clear in a day or two. Occasionally it can indicate something serious, but other signs also guide you to recognise this. Gastroenteritis can also cause diarrhoea – this may appear a few hours or a day after vomiting starts – and abdominal pain or cramps. Children are usually off their food, and they may have a mild fever. If it lasts longer than a couple of days or they are struggling to keep fluids down, it’s time to contact your doctor.
Gastroenteritis is an infection by a virus and norovirus is known as the vomiting bug, although it can also cause diarrhoea. Bacteria is less common but can also infect the gut and cause vomiting. These can be picked up from other children – from contaminated poo to fingers to mouth – or from food. Vomiting can sometimes be a sign of something serious. Meningitis is a bacterial infection affecting the brain, and your child may become suddenly unwell, with neck stiffness, being unable to tolerate the light (photophobia), and possibly a rash that doesn’t go away with a glass tumbler pressed on it. In babies, posseting is common after feeds and nothing serious, but projectile vomiting is not common and may indicate something serious if it persists after feeds. Vomiting can also occur from car sickness or other motion, from an ear infection if balance is affected, from a head injury or concussion, with appendicitis and if they’ve simply eaten too much.
Your child or baby is contagious from the time they get the first symptoms until they have recovered. They should stay off school and avoid pregnant or immune-compromised people until their symptoms have resolved for 48 hours. Other parents will thank you for that. Make sure that you maintain could hand hygiene at home, to avoid other children or members of the household catching any bug. If you can, give them a bathroom just for them, and make sure you wash your hands and theirs thoroughly after vomiting, toileting or before preparing or eating food.
The main thing to do is to keep the child or baby hydrated. Babies should continue to feed as usual, and you can supplement a little water between their feeds. Older children should be encouraged to have regular, small but frequent sips of water to prevent dehydration. Avoid them taking big gulps or drinking lots of water in one go, as this can stretch the stomach lining and can activate the vomit reflex. They can lose lots of important salts through repeated vomiting – potassium, sodium and chloride – so it can be a good idea to give oral rehydration salts with water to replace any lost salts and keep their body in balance. Dairy products, sugary foods, and spicy or flavourful food should be avoided. Sticking to soft, dry, basic foods like soup or dry toast is advised.
If your child is vomiting clear fluids for more than 8 hours, is unable to keep fluids down, vomiting blood, has blood in the poo or shows any sign of dehydration, you should seek urgent medical attention. Signs of dehydration include fewer wet nappies, persistent diarrhoea or vomiting with no signs of improvement, persistent fevers, and lethargy, irritability or increased fussiness. Vomiting lasting more than 2 days should be discussed with your doctor. Any sign of meningitis – a non-blanching rash, neck stiffness and photophobia – is an emergency and you should attend the emergency department or call 999.