Vomiting With Diarrhea
Vomiting With Diarrhea
Does this describe your child's symptoms? |
Definition
Causes
Severity of Vomiting The following is an arbitrary attempt to classify vomiting by risk for dehydration:
Dehydration: How to Recognize
Return to School
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If not, see these topics
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When to Call Your Doctor |
Call 911 Now (your child may need an ambulance) If |
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Call Your Doctor Now (night or day) If |
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Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If |
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Call Your Doctor During Weekday Office Hours If |
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Parent Care at Home If |
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HOME CARE ADVICE FOR VOMITING WITH DIARRHEA |
Reassurance:
Most vomiting is caused by a viral infection of the stomach and intestines or by food poisoning.
Vomiting is the body's way of protecting the lower intestinal tract.
When vomiting and diarrhea occur together, treat the vomiting. Don't do anything special for the diarrhea.
For Bottlefed Infants Offer Oral Rehydration Solution (ORS) for 8 Hours:
ORS (eg. Pedialyte or the store brand) is a special electrolyte solution that can prevent dehydration. It's readily available in supermarkets and drug stores.
For vomiting once, continue regular formula.
For vomiting more than once, offer ORS for 8 hours. If ORS not available, use formula.
Spoon or syringe feed small amounts: 1-2 teaspoons (5-10 ml) every 5 minutes.
After 4 hours without vomiting, double the amount.
After 8 hours without vomiting, return to regular formula.
For infants over 4 months old, also return to cereal, strained bananas, etc.
Return to normal diet in 24-48 hours.
For Breastfed Infants, Reduce the Amount Per Feeding:
If vomits once, nurse 1 side every 1 to 2 hours.
If vomits more than once, nurse for 5 minutes every 30 to 60 minutes. After 4 hours without vomiting, return to regular breastfeeding.
If continues to vomit, switch to ORS (e.g., Pedialyte) for 4 hours.
Spoon or syringe feed small amounts of ORS: 1-2 teaspoons (5-10 ml) every 5 minutes.
After 4 hours without vomiting, return to regular breastfeeding. Start with small feedings of 5 minutes every 30 minutes and increase as tolerated.
For Older Children (over 1 Year Old) Offer Small Amounts of Clear Fluids For 8 Hours:
ORS: Vomiting with watery diarrhea needs ORS (e.g, Pedialyte). If refuses ORS, use ½ strength Gatorade.
Give small amounts: 2-3 teaspoons (10-15 ml) every 5 minutes.
After 4 hours without vomiting, increase the amount.
After 8 hours without vomiting, return to regular fluids.
Solids: After 8 hours without vomiting, add solids:
Limit solids to bland foods. Starchy foods are easiest to digest.
Start with saltine crackers, white bread, cereals, rice, mashed potatoes, etc.
Return to normal diet in 24-48 hours.
Avoid Medicines:
Discontinue all non-prescription medicines for 8 hours (reason: usually make vomiting worse).
Fever: Fevers usually don't need any medicine. For higher fevers, consider acetaminophen (Tylenol) suppositories. Never give oral ibuprofen; it is a stomach irritant.
Call your doctor if: vomiting a prescription medicine.
Contagiousness: Your child can return to child care or school after vomiting and fever are gone.
Expected Course: Moderate vomiting usually stops in 12 to 24 hours. Mild vomiting (1-2 times/day) with diarrhea can continue intermittently for up to a week.
Call Your Doctor If:
Vomiting becomes severe (vomits everything) over 8 hours
Vomiting persists over 24 hours
Signs of dehydration
Diarrhea is severe
Your child becomes worse
And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
Updated:  
March 22, 2017