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Vomiting

What is Vomiting?
Vomiting (also called emesis) is not a disease but a symptom. In children, a variety of conditions can cause vomiting, the most common of which is viral infection of the gastrointestinal tract, or gastroenteritis, also known as “stomach flu.” Bacterial infections and parasites in the gastrointestinal tract are other common causes of both vomiting and diarrhea in children. Because a child loses substantial amount of fluids with vomiting, especially if the vomiting lasts for more than 24 hours and is accompanied by diarrhea, it can lead to dehydration, which untreated can be life threatening. Regardless of the underlying cause, children suffering from vomiting should drink plenty of fluids to replenish water loss from the body. A note of caution: Avoid giving plain water to an infant younger than 12 months. Formula and breast milk are best sources of hydration in children under 1 year of age.Your pediatrician will advise you what other fluids may be given to infants, what amounts and how often. Less common causes of vomiting include head trauma or brain injury and brain tumors. Other conditions can lead to vomiting as well, including disorders of the liver, intestines, gallbladder and the pancreas.

Symptoms 

  • Vomiting
  • Nausea (may or may not be present)
  • Depending on the cause, vomiting may be accompanied by diarrhea, malaise and fever
  • Dehydration is a dangerous and common side effect of vomiting in children.

Watch for the following:

  • dry mouth
  • few or no tears when crying
  • fussiness, irritability in infants
  • fewer than four wet diapers in 24 hours
  • reduced frequency of urination and amount of urine at urination
  • fatigue, drowsiness, excessive sleepiness
  • disorientation, confusion
  • deep, rapid breathing
  • rapid heartbeat

Diagnosis
If a child’s vomiting doesn’t go away in a couple of days, a pediatrician should be contacted for diagnosis of the underlying cause leading to the vomiting. In addition to physical exam and blood tests, sometimes imaging studies (such as ultrasound or X-rays) of the gastrointestinal tract may be needed.

Treatment 
Because vomiting is a symptom rather than a condition, treatment depends on the underlying cause. 

When to Call for Help
Call your pediatrician, if your child has vomiting that doesn’t go away after 24 hours or it starts again once a child resumes normal diet, if vomiting is accompanied by fever (temperature over 100.4 degrees in an infant or 101 degrees in a child over 6 months), if your child is vomiting blood, vomiting a substance that looks like coffee grounds or vomiting yellowish or greenish fluid. Take your child to a hospital, if your child vomits after hurting his or her head. 

At Hopkins Children’s, vomiting is treated by the division of Gastroenterology and Nutrition, sometimes in tandem with other divisions depending on the underlying cause. 

External Links:

National Library of Medicine
http://www.nlm.nih.gov/medlineplus/nauseaandvomiting.html 

American Academy of Family Physicians
http://familydoctor.org/online/famdocen/home/children/parents/common/stomach/196.printerview.html