Vomiting Without Diarrhea
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- Vomiting is the forceful emptying (throwing up) of a large portion of the stomach's contents through the mouth
- Nausea and abdominal discomfort usually precede each bout of vomiting
- Main cause: stomach infection (gastritis) from a stomach virus (e.g., Rotavirus). The illness starts with vomiting but diarrhea usually follows within 12-24 hours.
- Food poisoning from toxins produced by bacteria growing in poorly refrigerated foods (e.g. Staphylococcus toxin in egg salad or Bacillus cereus toxin in rice dishes).
- Serious causes: If vomiting persists as an isolated symptom (without diarrhea) for more than 24 hours, more serious causes must be considered. Examples are appendicitis, kidney infection, meningitis, head injury, etc.
- Vomiting can also be triggered by hard coughing. This is common especially in children with reflux.
Severity of Vomiting
The following is an arbitrary attempt to classify vomiting by risk for dehydration:
- MILD: 1 - 2 times/day
- MODERATE: 3 - 7 times/day
- SEVERE: Vomits everything or nearly everything or 8 or more times/day
- Severity relates even more to the length of time that the particular severity level has persisted. At the beginning of a vomiting illness (especially following food poisoning), it's common for a child to vomit everything for 3 or 4 hours and then become stable with mild or moderate vomiting.
- The younger the child, the greater the risk for dehydration.
Return to School
- Your child can return to child care or school after vomiting and fever are gone.
When to Call for Vomiting Without Diarrhea
Call 911 Now (your child may need an ambulance) If
Call Us Now (night or day) If
Call Us Within 24 Hours (between 9 am and 4 pm) If
Call Us During Weekday Office Hours If
Parent Care at Home If
HOME CARE ADVICE FOR VOMITING WITHOUT DIARRHEAReassurance:
- 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 intestinal tract.
- Fortunately, vomiting illnesses are usually brief.
- 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.
- 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.
- Water or ice chips are best for vomiting in older children. (Reason: Water is directly absorbed across the stomach wall)
- ORS: If child vomits water, offer Oral Rehydration Solution (e.g., Pedialyte). If refuses ORS, use ½ strength Gatorade.
- Give small amounts: 2-3 teaspoons (10-15 ml) every 5 minutes.
- Other options: ½ strength flat lemon-lime soda, popsicles or ORS frozen pops.
- After 4 hours without vomiting, increase the amount.
- After 8 hours without vomiting, return to regular fluids.
- Caution: if vomiting continues over 12 hours, switch to ORS or half-strength Gatorade.
- 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.