Vomit Medicine For Baby

Formula Fed Babies – Give Oral Rehydration Solution (ORS) for 8 Hours:

  • If vomits once, give half the regular amount every 1 to 2 hours.
  • If vomits more than once, offer ORS for 8 hours. …
  • ORS is a special fluid that can help your child stay hydrated. …
  • Spoon or syringe feed small amounts.

ORS is a special fluid that can help your baby stay hydrated, even if she vomits. If your baby vomits once, offer half the regular amount every 1 to 2 hours. If she vomits more than once, offer ORS for 8 hours; you don’t need to worry about her getting dehydrated again so long as there are no other signs of trouble. Spoon or syringe feed small amounts of ORS each time she vomits it back up

Formula fed babies are more likely to get dehydrated from a stomach bug, and can also vomit more often than breastfed babies. If you’re formula feeding, give your baby ORS for 8 hours if they vomit more than once.

If your child vomits once, take a chance and offer about half the amount of formula she would normally get. If your child vomits again within a few hours, offer half the normal amount every 2 hours. If she throws up 8 times or more, keep offering half the regular amount for 8 hours or until the vomiting stops.

ORS is the best way to keep your baby hydrated. Offer how much ORS your baby will take every 1-2 hours. If your baby vomits, don’t worry. Offer ORS again after waiting 10 minutes. Keep offering until your baby has had 8 scary hours of ORS and no more vomiting!

Syrup to Stop Vomiting in Child

Nausea is the sensation of impending emesis and is frequently accompanied by autonomic changes, such as increased heart rate and salivation. Nausea and vomiting typically occur in sequence; however, they can occur separately (eg, vomiting can occur without preceding nausea as a result of increased intracranial pressure).

Vomiting is uncomfortable and can cause dehydration because fluid is lost and because the ability to rehydrate by drinking is limited.

Pathophysiology

Vomiting is the final part of a sequence of events coordinated by the emetic center located in the medulla. The emetic center can be activated by afferent neural pathways from digestive (eg, pharynx, stomach, small bowel) and nondigestive (eg, heart, testes) organs, the chemoreceptor trigger zone located in the area postrema on the floor of the 4th ventricle (containing dopamine and serotonin receptors), and other central nervous system centers (eg, brain stem, vestibular system).

Etiology

The causes of vomiting vary with age and range from relatively benign to potentially life threatening ( see Table: Some Causes of Vomiting in Infants, Children, and Adolescents). Vomiting is a protective mechanism that provides a means to expel potential toxins; however, it can also indicate serious disease (eg, intestinal obstruction). Bilious vomiting indicates a high intestinal obstruction and, especially in an infant, requires immediate evaluation.

Infants

Infants normally spit up small amounts (usually < 5 to 10 mL) during or soon after feedings, often when being burped. Rapid feeding, air swallowing, and overfeeding may be causes, although spitting up occurs even without these factors. Occasional vomiting may also be normal, but repeated vomiting is abnormal.

The most common causes of vomiting in infants and neonates include the following:

Other important causes in infants and neonates include the following:

Less common causes of recurrent vomiting include sepsis and food intolerance. Metabolic disorders (eg, urea cycle disorders, organic acidemias) are uncommon but can manifest with vomiting.

Older children

The most common cause is

Nongastrointestinal infections may cause a few episodes of vomiting. Other causes to consider include serious infection (eg, meningitis, pyelonephritis), acute abdomen (eg, appendicitis), increased intracranial pressure secondary to a space-occupying lesion (eg, caused by trauma or tumor), and cyclic vomiting.

In adolescents, causes of vomiting also include pregnancyeating disorders, and toxic ingestions (eg, acetaminopheniron, ethanol).

TABLE

Some Causes of Vomiting in Infants, Children, and Adolescents

Evaluation

Evaluation includes assessment of severity (eg, presence of dehydration, surgical or other life-threatening disorder) and diagnosis of cause.

History

History of present illness should determine when vomiting episodes started, frequency, and character of episodes (particularly whether vomiting is projectile, bilious, or small in amount and more consistent with spitting up). Any pattern to the vomiting (eg, after feeding, only with certain foods, primarily in the morning or in recurrent cyclic episodes) should be established. Important associated symptoms include diarrhea (with or without blood), fever, anorexia, and abdominal pain, distention, or both. Stool frequency and consistency and urinary output should be noted.

Review of systems should seek symptoms of causative disorders, including weakness, poor suck, and failure to thrive (metabolic disorders); delay in passage of meconium, abdominal distention, and lethargy (intestinal obstruction); headache, nuchal rigidity, and vision changes (intracranial disorders); food bingeing or signs of distorted body image (eating disorders); missed periods and breast swelling (pregnancy); rashes (eczema or urticaria in food allergies, petechiae in sepsis or meningitis); ear pain or sore throat (focal nongastrointestinal infection); and fever with headache, neck or back pain, or abdominal pain (meningitis, pyelonephritis, or appendicitis).

Past medical history should note history of travel (possible infectious gastroenteritis), any recent head trauma, and unprotected sex (pregnancy).

Physical examination

Vital signs are reviewed for indicators of infection (eg, fever) and volume depletion (eg, tachycardia, hypotension).

During the general examination, signs of distress (eg, lethargy, irritability, inconsolable crying) and signs of weight loss (cachexia) or gain are noted.

Because the abdominal examination may cause discomfort, the physical examination should begin with the head. The head and neck examination should focus on signs of infection (eg, red, bulging tympanic membrane; bulging anterior fontanelle; erythematous tonsils) and dehydration (eg, dry mucous membranes, lack of tears). The neck should be passively flexed to detect resistance or discomfort, suggesting meningeal irritation.

Cardiac examination should note presence of tachycardia (eg, dehydration, fever, distress). Abdominal examination should note distention; presence and quality of bowel sounds (eg, high-pitched, normal, absent); tenderness and any associated guarding, rigidity, or rebound (peritoneal signs); and presence of organomegaly or mass.

The skin and extremities are examined for petechiae or purpura (severe infection) or other rashes (possible viral infection or signs of atopy), jaundice (possible metabolic disorder), and signs of dehydration (eg, poor skin turgor, delayed capillary refill).

Growth parameters and signs of developmental progress should be noted.

Red flags

The following findings are of particular concern:

  • Bilious emesis
  • Lethargy or listlessness
  • Inconsolability and bulging fontanelle in infant
  • Nuchal rigidity, photophobia, and fever in older child
  • Peritoneal signs or abdominal distention (surgical abdomen)
  • Persistent vomiting with poor growth or development

Interpretation of findings

Initial findings help determine severity of diagnosis and need for immediate intervention.

  • Any neonate or infant with recurrent or bilious (yellow or green) emesis or projectile vomiting most likely has a gastrointestinal obstruction and probably requires surgical intervention.
  • An infant or young child with colicky abdominal pain, signs of intermittent pain or listlessness, and absent or bloody stools needs to be evaluated for an intussusception.
  • A child or adolescent with fever, nuchal rigidity, and photophobia should be evaluated for meningitis.
  • A child or adolescent with fever and abdominal pain followed by vomiting, anorexia, and decreased bowel sounds should be evaluated for appendicitis.
  • Recent history of head trauma or chronic progressive headaches with morning vomiting and vision changes indicate intracranial hypertension.

Other findings can be interpreted primarily depending on age ( see Table: Some Causes of Vomiting in Infants, Children, and Adolescents).

In infants, irritability, choking, and respiratory signs (eg, stridor) may be manifestations of gastroesophageal reflux. A history of poor development or neurologic manifestations suggests a central nervous system or metabolic disorder. Delayed passage of meconium, later onset of vomiting, or both may indicate Hirschsprung disease or intestinal stenosis.

In children and adolescents, fever suggests infection; the combination of vomiting and diarrhea suggests acute gastroenteritis. Lesions on fingers and erosion of tooth enamel or an adolescent unconcerned about weight loss or with distorted body image suggests an eating disorder. Morning nausea and vomiting, amenorrhea, and possibly weight gain suggest pregnancy. Vomiting that has occurred in the past and is episodic, short-lived, and has no other accompanying symptoms suggests cyclic vomiting.

Testing

Testing should be directed by suspected causative disorders ( see Table: Some Causes of Vomiting in Infants, Children, and Adolescents). Imaging studies are typically done to evaluate abdominal or central nervous system pathology. Various specific blood tests or cultures are done to diagnose inherited metabolic disorders or serious infection.

If dehydration is suspected, serum electrolytes should be measured.

Treatment

Treatment of nausea and vomiting is targeted at the causative disorder. Rehydration is important.

Drugs frequently used in adults to decrease nausea and vomiting are used less often in children because the usefulness of treatment has not been proved and because these drugs have potential risks of adverse effects and of masking an underlying condition. However, if nausea or vomiting is severe or unremitting, antiemetic drugs can be used cautiously in children > 2 years. Useful drugs include

  • Promethazine: For children > 2 years, 0.25 to 1 mg/kg (maximum 25 mg) orally, IM, IV, or rectally every 4 to 6 hours
  • Prochlorperazine: For children > 2 years and weighing 9 to 13 kg, 2.5 mg orally every 12 to 24 hours; for those 13 to 18 kg, 2.5 mg orally every 8 to 12 hours; for those 18 to 39 kg, 2.5 mg orally every 8 hours; for those > 39 kg, 5 to 10 mg orally every 6 to 8 hours
  • Metoclopramide: 0.1 mg/kg orally or IV every 6 hours (maximum 10 mg/dose)
  • Ondansetron: 0.15 mg/kg (maximum 8 mg) IV every 8 hours or, if the oral form is used, for children 2 to 4 years, 2 mg every 8 hours; for those 4 to 11 years, 4 mg every 8 hours; for those ≥ 12 years, 8 mg every 8 hours

Promethazine is an H1 receptor blocker (antihistamine) that inhibits the emetic center response to peripheral stimulants. The most common adverse effects are respiratory depression, sedation, dizziness, anxiety, blurred vision, dry mouth, impotence, and constipation; the drug is contraindicated in children < 2 years. Therapeutic doses of promethazine can cause extrapyramidal adverse effects, including torticollis.

Prochlorperazine is a weak dopamine receptor blocker that depresses the chemoreceptor trigger zone. Drowsiness, dizziness, anxiety, strange dreams, insomnia, galactorrhea, akathisia, and dystonia are the most common adverse effects.

Metoclopramide is a dopamine receptor antagonist that acts both centrally and peripherally by increasing gastric motility and decreasing afferent impulses to the chemoreceptor trigger zone. Drowsiness, dizziness, agitation, headache, diarrhea, akathisia, and dystonia are the most common adverse effects.

Ondansetron is a selective serotonin (5-HT3) receptor blocker that inhibits the initiation of the vomiting reflex in the periphery. A single dose of ondansetron is safe and effective in children who have acute gastroenteritis and do not respond to oral rehydration therapy (ORT). By facilitating ORT, this drug may prevent the need for IV fluids or, in children given IV fluids, may help prevent hospitalization. Typically, only a single dose is used because repeated doses can cause persistent diarrhea. Other common adverse effects include headache, dizziness, drowsiness, blurred vision, constipation, muscle stiffness, tachycardia, and hallucinations.

Key Points

  • In general, the most common cause of vomiting is acute viral gastroenteritis.
  • Associated diarrhea suggests an infectious gastrointestinal cause.
  • Bilious emesis, bloody stools, or lack of bowel movements suggests an obstructive cause.
  • Persistent vomiting (especially in an infant) requires immediate evaluation.

If your baby’s vomiting has slowed down and they are just having a few small spits up, you can help by feeding them small amounts of breast milk or formula every 1 to 2 hours. …

Medicine for Vomiting Child 3 Year Old

Is this your child’s symptom?

  • Vomiting (throwing up) stomach contents
  • Other names for vomiting are puking, barfing and heaving

Causes of Vomiting

  • Viral Gastritis. Stomach infection from a stomach virus is the most common cause. Also called stomach flu. A common cause is the Rotavirus. The illness starts with vomiting. Watery loose stools may follow within 12-24 hours.
  • Food Allergy. Vomiting can be the only symptom of a food reaction. The vomiting comes on quickly after eating the food. Uncommon in infants, but main foods are eggs and peanut butter.
  • Coughing. Hard coughing can also cause your child to throw up. This is more common in children with reflux.
  • Serious Causes. Vomiting alone should stop within about 24 hours. If it lasts over 24 hours, you must think about more serious causes. An example is a kidney infection. A serious cause in young babies is pyloric stenosis. See below for more on this.

Pyloric Stenosis (Serious Cause)

  • The most common cause of true vomiting in young babies.
  • Onset of vomiting is age 2 weeks to 2 months
  • Vomiting is forceful. It becomes projectile and shoots out.
  • Right after vomiting, the baby is hungry and wants to feed. (“hungry vomiter”)
  • Cause: The pylorus is the channel between the stomach and the gut. In these babies, it becomes narrow and tight.
  • Risk: Weight loss or dehydration
  • Treatment: Cured by surgery.

Vomiting Scale

  • Mild: 1 – 2 times/day
  • Moderate: 3 – 7 times/day
  • Severe: Vomits everything, nearly everything or 8 or more times/day
  • Severity relates even more to how long the vomiting goes on for. At the start of the illness, it’s common for a child to vomit everything. This can last for 3 or 4 hours. Children then often become stable and change to mild vomiting.
  • The main risk of vomiting is dehydration. Dehydration means the body has lost too much fluid.
  • The younger the child, the greater the risk for dehydration.

Dehydration: How to Tell

  • The main risk of vomiting is dehydration. Dehydration means the body has lost too much water.
  • Vomiting with watery diarrhea is the most common cause of dehydration.
  • Dehydration is a reason to see a doctor right away.
  • Your child may have dehydration if not drinking much fluid and:
  • The urine is dark yellow and has not passed any in over 8 hours.
  • Inside of the mouth and tongue are very dry.
  • No tears if your child cries.
  • Slow blood refill test: Longer than 2 seconds. First, press on the thumbnail and make it pale. Then let go. Count the seconds it takes for the nail to turn pink again. Ask your doctor to teach you how to do this test.

When to Call for Vomiting (0-12 Months)

Call 911 Now

  • Can’t wake up
  • Not moving
  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Dehydration suspected. No urine in over 8 hours, dark urine, very dry mouth and no tears.
  • Stomach pain when not vomiting. Exception: stomach pain or crying just before vomiting is quite common.
  • Age less than 12 weeks old with vomiting 2 or more times. Exception: normal spitting up.
  • Vomited 3 or more times and also has diarrhea
  • Severe vomiting (vomits everything) more than 8 hours while getting Pedialyte (or breastmilk)
  • Head injury within the last 24 hours
  • Weak immune system. Examples are sickle cell disease, HIV, cancer, organ transplant, taking oral steroids.
  • Vomiting a prescription medicine
  • Fever over 104° F (40° C)
  • Fever in baby less than 12 weeks old. Caution: Do NOT give your baby any fever medicine before being seen.
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • All other infants (age less than 1 year) with vomiting. See Care Advice while waiting to discuss with doctor.

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Vomiting

  1. What You Should Know About Vomiting:
    • Most vomiting is caused by a viral infection of the stomach.
    • Vomiting is the body’s way of protecting the lower gut.
    • The good news is that stomach illnesses last only a short time.
    • The main risk of vomiting is dehydration. Dehydration means the body has lost too much fluid.
    • Here is some care advice that should help.
  2. Formula Fed Babies – Give Oral Rehydration Solution (ORS) for 8 Hours:
    • If vomits once, give half the regular amount every 1 to 2 hours.
    • If vomits more than once, offer ORS for 8 hours. If you don’t have ORS, use formula until you can get some.
    • ORS is a special fluid that can help your child stay hydrated. You can use Pedialyte or the store brand of ORS. It can be bought in food stores or drug stores.
    • Spoon or syringe feed small amounts. Give 1-2 teaspoons (5-10 ml) every 5 minutes.
    • After 4 hours without throwing up, double the amount.
    • Return to Formula. After 8 hours without throwing up, go back to regular formula.
  3. Breastfed Babies – Reduce the Amount Per Feeding:
    • If vomits once, nurse half the regular time every 1 to 2 hours.
    • If vomits more than once, nurse for 5 minutes every 30 to 60 minutes. After 4 hours without throwing up, return to regular nursing.
    • If continues to vomit, switch to pumped breastmilk. (ORS is rarely needed in breastfed babies. It can be used if vomiting becomes worse).
    • Spoon or syringe feed small amounts of pumped milk. Give 1-2 teaspoons (5-10 ml) every 5 minutes.
    • After 4 hours without throwing up, return to regular feeding at the breast. Start with small feedings of 5 minutes every 30 minutes. As your baby keeps down the smaller amounts, slowly give more.
  4. Stop All Solid Foods:
    • Avoid all solid foods and baby foods in kids who are vomiting.
    • After 8 hours without throwing up, gradually add them back.
    • If on solid foods, start with starchy foods that are easy to digest. Examples are cereals, crackers and bread.
  5. Do Not Give Medicines:
    • Stop using any drug that is over-the-counter for 8 hours. Reason: Some of these can make vomiting worse.
    • Fever. Mild fevers don’t need to be treated with any drugs. For higher fevers, you can use an acetaminophen suppository (such as FeverAll). This is a form of the drug you put in the rectum (bottom). Ask a pharmacist for help finding this product. Do not use ibuprofen. It can upset the stomach.
    • Call your doctor if: Your child vomits a drug ordered by your doctor.
  6. Try to Sleep:
    • Help your child go to sleep for a few hours.
    • Reason: Sleep often empties the stomach and removes the need to vomit.
    • Your child doesn’t have to drink anything if his stomach feels upset and he doesn’t have any diarrhea.
  7. Return to Child Care:
    • Your child can return to child care after the vomiting and fever are gone.
  8. What to Expect:
    • For the first 3 or 4 hours, your child may vomit everything. Then the stomach settles down.
    • Vomiting from a viral illness often stops in 12 to 24 hours.
    • Mild vomiting and nausea may last up to 3 days.
  9. Call Your Doctor If:
    • Vomits clear fluids for more than 8 hours
    • Vomiting lasts more than 24 hours
    • Blood or bile (green color) in the vomit
    • Stomach ache present when not vomiting
    • Dehydration suspected (no urine in over 8 hours, dark urine, very dry mouth, and no tears)
    • You think your child needs to be seen
    • Your child becomes worse

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