Vomiting is the forceful expulsion of stomach contents through strong contractions; it differs from the effortless spitting up/regurgitation seen in newborns (milk coming up from the corner of the mouth). Spitting up is physiological; vomiting, on the other hand, is a symptom whose cause needs to be investigated.

Common Causes

  • Gastroenteritis (most common; usually accompanied by diarrhea)
  • Feeding errors, overfeeding
  • Reflux
  • Other infections: UTI, otitis, URTI
  • In a 2–8 week old baby, progressively increasing projectile vomiting after feeding: pyloric stenosis (requires surgical evaluation)
  • Head trauma, ingestion of a drug or toxin

What Should You Give a Vomiting Child?

20–30 minutes after vomiting, fluids are started in small sips, at frequent intervals: breastfeeding is not stopped; in an older child, oral rehydration solution (ORS) is the most suitable option. Giving a full glass at once triggers vomiting. As it is tolerated, the amount is increased; once vomiting stops, light foods are introduced. Cola, soda, and packaged fruit juices are not suitable.

Situations Requiring Emergency Care

  • Bilious (green) or bloody vomiting
  • Severe headache, neck stiffness, or vomiting after head trauma
  • Signs of dehydration: reduced urination, dry mouth, absence of tears, sunken fontanelle, listlessness
  • Abdominal swelling and rigidity, severe abdominal pain
  • Any persistent vomiting in a newborn