The staff of Panda Pediatrics, located in Washington, D.C.
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Most vomiting is caused by a viral infection of the stomach (viral gastroenteritis) or eating something that is tainted. It can occur with diarrhea or by itself. In infants, it is important to distinguish between normal amounts of spitting up and vomiting. Many normal infants may have mild reflux and may spit up small amounts of undigested milk soon after feeding. Often, the viral type is associated with diarrhea. The expected course is usually 12 to 24 hours Dietary changes usually speed recovery. If diarrhea is present, it usually continues for several days to a week.
Home care for vomiting includes special dietary changes according to age and normal diet. For bottle-fed infants less than 1 year of age, offer oral rehydration solutions (ORS), such as Infalyte or Pedialyte, for 8 hours. Offer small amounts (1 teaspoon) every 5 minutes for the first hour, then 2 teaspoons every 10 minutes, then 3 teaspoons every 15 minutes. You should aim for total of about 2 ounces per hour, After 4 hours without vomiting, increase the amount. After 6-8 hours without vomiting, return to formula. For infants more than 4 months of age, also return to cereal, bananas, etc.
A normal diet is okay in 24 to 48 hours. If your child refuses the Pedialyte, you may give Gatorade, herbal tea, chicken broth or flat sodas. Coca cola syrup is particularly effective in “settling” the stomach.” Try to avoid diet sodas and plain water since they lack any sugar and electrolytes. Once your child has managed to tolerate fluids for at least four hours, you may offer mild foods as tolerated.
For breast-fed infants, reduce the amount or feeding and feed more frequently. Your goal is to avoid filling the stomach. Nurse for 5 minutes every 1-2 hours. After 6-8 hours without vomiting, return to regular breast-feeding.
For children over 1 year of age, offer clear fluids (water, Pedialyte, or Gatorade) in small amounts for 8 hours. Give small amounts (1 tablespoon) every 10 minutes. After 4 hours without vomiting, increase the amount. For severe vomiting, rest the stomach completely for 1 hour, then start over with smaller amounts. Add bland foods after 6 hours without vomiting. Stay on bland, starchy foods (saltine crackers, white bread, rice, mashed potatoes, etc.) for 24 hours.
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