Vomiting in children​​​

Vomiting is a symptom of many childhood illnesses. In children, vomiting is usually due to an infection of the gut, also known as gastroenteritis. Viruses are by far the most common infecting agent, but occasionally bacteria and parasites are the causes.

The infection is often accompanied by fever, nausea, abdominal pain and diarrhoea, and has a self-limited course lasting several days.​​

Since vomiting is mostly due to viruses, antibiotics are not prescribed unless a bacterium is suspected. "It is important that your child remains well hydrated by taking small but frequent amounts of fluids," say doctors from the Department of Neonatal and Developmental Medicine​ at Singapore General Hospita​l​ (SGH), a member of the SingHealth​ group.​​​

When do I need to consult a doctor for vomiting?

Seek medical help if your child has persistent vomiting and diarrhoea, is eating poorly, or has the following signs of dehydration:

  1. ​Dry and sticky mouth
  2. Crying without tears
  3. Passes urine or wets diapers less than five times a day
  4. No or very little urine in eight hours
  5. Sunken eyes
  6. Depressed fontanelle (soft spot on an infant’s head)
  7. Lethargy, excessive sleep or drowsiness
  8. Deep and rapid breathing
  9. Fast or weak pulse

It is normal to be worried when your child starts to vomit. Remember that vomiting is not an illness but a symptom. Although most vomiting is due to gastroenteritis, it could also point to something more serious. Occasionally, a hospital stay may be necessary.

When do I really need to worry about vomiting?

Your child should be taken to see the doctor if any of the following occurs:

  1. Projectile or forceful vomiting, especially if your child is less than three months old. This could mean an obstruction of the gut.
  2. The vomit is bright green, also a sign of gut obstruction.
  3. The vomit is bloody or resembles coffee grounds. Blood mixed with stomach acid looks like coffee grounds.
  4. Vomiting follows a head injury.
  5. Severe abdominal pain. It could be appendicitis if the pain is well localised on the right side of the abdomen.
  6. Abdomen feels hard, bloated or tender.
  7. Painful or discharge in ears. This could be a middle ear infection.
  8. Painful urination or foul-smelling urine, which is a sign of a urinary tract infection.
  9. Breathing difficulties, which may be due to a chest infection.
  10. Fever with severe headache, stiff neck or photophobia (child complains that the light hurts his eyes).
  11. Seizures.
  12. The child has accidentally swallowed chemicals or medicines. Many drugs can cause vomiting.
  13. Lethargy or severe irritability.

If your child is unable to stay upright while vomiting, keep him lying on the side as much as possible to minimise the chance of him inhaling vomit into the upper airways and lungs. Always consult your doctor when in doubt. Remember not to use any medicine unless your child’s doctor has prescribed it.

Ref: O17​​