Home Care Advice for Vomiting

1. Sleep: Help your child go to sleep for a few hours (Reason: sleep often empties the stomach and relieves the need to vomit.)

2. For Bottlefed Infants Offer Oral Rehydration Solution (ORS).

	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 1 or 2 times, offer 1/2 strength formula for 2 feedings, then regular formula.
	For vomiting >2 times, 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 > 4 months old, also return to cereal, strained bananas, etc. Normal diet OK in 24-48 hours.

3. For Breastfed Infants, Reduce the Amount Per Feeding.

	If vomits once or twice, nurse 1 side every 1 to 2 hours.
	If vomits > 2 times, nurse for 4 to 5 minutes every 30 to 60 minutes.
	If continues to vomit, switch to ORS for 4 hours.
	Spoon or syringe feed small amounts: 1-2 teaspoons (5-10 ml) every 5 minutes.
	After 4 hours without vomiting, return to regular breastfeeding.

4. For Older Children (>1 Year Old) Small Amounts of Clear Fluids For 8 Hours.

	Water or ice chips are best for vomiting in older children. (Reason: water is directly absorbed across the stomach wall) (Exception: vomiting with watery diarrhea needs ORS. If refuses ORS, use 1/2 strength Gatorade.)
	Give small amounts: 2-3 teaspoons (10-15 ml) every 5 minutes.
	Other options: 1/2 strength flat lemon-lime soda, Popsicles or ORS frozen pops.
	After 4 hours without vomiting, double the amount.
	After 8 hours without vomiting, add solids.
	Limit solids to bland foods for 24 hours. Start with saltine crackers, white bread, cereals, rice, mashed potatoes, etc. Normal diet OK in 24-48 hours.

5. Avoid Medicines: Discontinue all nonessential medicines for 8 hours. (Reason: usually make vomiting worse.) Call if vomiting an essential medicine.

6. Contagiousness: Your child can return to day care or school after vomiting and fever are gone.

7. Expected Course: Vomiting from viral gastritis usually stops in 12 to 24 hours. If diarrhea is present, it usually continues for several days.

8. Call Your Doctor If:

	Vomiting becomes severe (vomits everything) > 8 hours
	Vomiting persists > 24 hours
	Signs of dehydration
	Your child becomes worse or develops any of the "Call Your Doctor" symptoms

Last reviewed: 8/2005
Last revised: 8/2005