Vomiting

Liquids You May Give

• Older children often do well with water or clear liquids to prevent dehydration. Clear liquids include lemonade, fruit juices without pulp (cranberry, cranapple, or apple juice), and popsicles. The popsicles must be free from cream, pudding, yogurt, or bits of fruit.
• Your child may need to drink an oral rehydration solution (ORS) like Pedialyte^®. An ORS helps replace the electrolytes and fluids that your child needs.
  • You can buy ORS in liquid or powder form or as popsicles at most pharmacies without a prescription. ORS store brands are just as good as a brand name.
  • Do not water down (dilute) or mix an ORS with formula.
  • Offer your child other things to drink. ORS should not be given as the only fluid for more then 6 hours. 

Children Younger Than 1 Year of Age:

• ORS 
• Breast milk or formula mixed the normal way if they can drink it
• No water except when used to make formula
• Do not give fruit juices or liquids that are high in sugar, such as Hawaiian Punch^®, Hi-C^®, Kool-Aid^®, sodas, or syrups. Do not give teas or broths. These liquids could make your child feel worse.

Children Older Than 1 Year of Age:

Same as above and:

• Water
• Clear liquids
• Ice popsicles made from ORS
• Milk, if tolerated
• Flavored gelatin cube 

How to Give Liquids

When your child is vomiting:

• Offer clear liquids after your child has not vomited for 30 to 60 minutes. This gives the stomach time to rest.
• Breastfeeding should not be stopped. Try to nurse your baby more often.
• If needed, you can stop giving formula if you are giving ORS. Try to restart formula as soon as possible.
• Start slow. Give small sips of liquids often. This may reduce the vomiting.
  • For children under 1 year: use a spoon or syringe to give 1 to 2 teaspoons every few minutes (5 to 10 mL).
  • For older than 1 year: give ½ to 1 ounce (1 to 2 tablespoons or 15 to 30 mL) every 20 minutes for a few hours.

• When your child can drink without vomiting, gradually increase the amount. If they still vomit, wait 30 to 60 minutes, and start again.
• Do not force your child to drink or wake them up to drink if they are sleeping.
• Do not give any kind of milk or yogurt drinks until the vomiting has stopped for 8 hours.

Amount of Liquid to Give to Prevent Dehydration

* Minimum fluid goals per hour may increase if vomiting, diarrhea, or fever are present.

Solid Foods

• When children are vomiting, they usually don't feel like eating solid food. It will not hurt them to miss a few meals as long as they can drink enough fluids.
• After about 6 to 8 hours of giving clear liquids and your child is no longer vomiting, try to get them to start eating some food. Starchy, bland foods like cereals, crackers, or bread are easier to digest. Avoid foods high in sugar and greasy, fried foods. Do not give them red-colored foods that might look like blood in vomit.

Other Things to Know

Medicine: Some medicines used for vomiting in older children or adults are very dangerous for young children. WARNING: Do not give your child any medicine unless their doctor or health care provider tells you it's safe for them.

Sleep: It's important that your child gets plenty of rest. Sleep helps the stomach finish digesting any food in it. It may calm your child’s vomiting.

Preventing the Spread of Infection

You can help stop the spread of viruses and protect others by:

• Make sure your child washes their hands with soap and water after using the toilet and before eating.
• Wash you hands often and after touching your child, their eating utensils, or anything that might have vomit on it. Use soap and water or a hand sanitizer.
• Keep the things your child uses, like toys and dirty clothes, away from others. Wash them in hot, soapy water.
• Clean the toilet and hard surfaces often with disinfectants or alcohol wipes. Let dry for 15 seconds.
• Use clean wipes or washcloths for each diaper change. Put the used diaper in the diaper pail or trash right away.

When To Call the Doctor

Call your child's doctor or health care provider if you think they're getting worse, do not get any better in 24 hours, will not breastfeed, or show these signs:

• Vomiting gets worse or happens more often. Vomit is bright green or has blood or dark specks that look like coffee grounds in it.
• Your child shows signs of being dried out (dehydration).
  • Urine is very dark
    • Newborn (0 to 4 months) has less then 6 wet diapers in a day
    • Child (4 months or older) has less than 3 wet diapers in a day or pees less than 3 times in a day
  • No tears when crying
  • Dry or sticky mouth
  • Hard or fast breathing
  • Sunken-looking eyes
  • Soft spot on baby’s head is flat, sunken, or pulls in
  • Hard to wake up (lethargic), acts confused or does not know what they are doing
• Your child has a high fever. Use a digital thermometer and wash it after each use.
  • Younger than 3 months of age - 100.4° Fahrenheit (F) or 38° Celsius (C) or above
  • Older than 3 months of age - 104°F (40°C) or above, above 102F (38.9C) for more than 2 days or keeps coming back, or they have been treated to bring their fever down but it hasn't worked.
• If your child has a fever and:
  • Looks very ill, is fussy, or is drowsy
  • Has an unusual rash
  • Has a stiff neck, a bad headache, or sore throat
  • Has immune system problems that make them more likely to get sick, such as sickle cell disease or cancer, or takes medicine that weakens the immune system

Helping Hands Patient Education Materials

Written and illustrated by medical, nursing and allied health professionals at Nationwide Children's Hospital, Helping Hand instructions are intended as a supplement to verbal instructions provided by a medical professional. The information is periodically reviewed and revised to reflect our current practice. However, Nationwide Children's Hospital is not responsible for any consequences resulting from the use or misuse of the information in the Helping Hands.

HH-I-71  | ©1977, revised 8/22, Nationwide Children’s Hospital