Vomiting Without Diarrhea

Definition

• Vomiting is the forceful emptying (throwing up) of what is in the stomach
• It’s normal for nausea (upset stomach) to come before each bout of vomiting
• Other names for vomiting are puking, barfing and heaving

Causes

• Main Cause. Stomach infection from a stomach virus (such as Rotavirus). The illness starts with vomiting. Watery loose stools follow within 12-24 hours.
• Food Poisoning. This causes rapid vomiting and diarrhea within hours after eating the bad food. Caused by toxins from germs growing in foods left out too long. An example is Staph toxin in egg salad.
• Coughing. Hard coughing can also cause your child to throw up. This is common in children with reflux.
• Serious Causes. Vomiting alone (without diarrhea) should stop within about 24 hours. If it lasts over 24 hours, you must think about more serious causes. Examples are appendicitis, a kidney infection or head injury.

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.

Return to School:

• Your child can return to school after the vomiting and fever are gone.

When to Call Us for Vomiting Without Diarrhea

Call 911 Now If: Click to View

Call 911 Now (your child may need an ambulance) If:

• Can’t wake up
• Not moving or too weak to stand
• You think your child has a life-threatening emergency

Call Us Now (night or day) If:

• Your child looks or acts very sick
• or talks confused
• Hard to wake up
• Stiff neck or bulging soft spot
• Headache
• Dehydration suspected. (No urine in over 8 hours, dark urine, very dry mouth and no tears)
• Blood in the vomit that’s not from a nosebleed
• Bile (green color) in the vomit (Exception: Stomach juice which is yellow)
• Stomach pain when not vomiting. (Exception: Stomach pain or crying just before vomiting is quite common.)
• Appendicitis suspected. (pain low on right side, won’t jump, wants to lie still)
• Diabetes suspected (drinking lots, frequent urine, weight loss)
• Poisoning suspected
• Age under 12 weeks old with vomiting 2 or more times. (Exception: normal spitting up)
• Getting Pedialyte (or clear fluids) and vomits all of it for more than 8 hours
• High-risk child (such as diabetes, stomach or head injury)
Weak immune system. (Such as sickle cell disease, HIV, cancer, organ transplant, taking oral steroids)
• Vomiting a prescription medicine
• Fever over 104° F (40° C)
• Age under 12 weeks old with fever. (Caution: Do NOT give your baby any fever medicine before being seen.)
• You think your child needs to be seen urgently

Call Us Within 24 Hours If: Click to View

Call Us Within 24 Hours (between 9 am and 4 pm) If:

• You have other questions or concerns
• Vomiting is a frequent problem

Parent Care at Home If: Click to View

Parent Care at Home If:

• Mild or moderate vomiting (most likely viral gastritis)

Care Advice for Vomiting Without Diarrhea

What You Should Know:

• Most vomiting is caused by a viral infection of the stomach. Sometimes, mild food poisoning is the cause.
• Vomiting is the body’s way of protecting the lower gut.
• The good news is that stomach illnesses last only a short time.
• Here is some care advice that should help

For Bottlefed Babies, Give Oral Rehydration Solution (ORS) for 8 Hours:

• 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 or drug stores.
• If vomits once, keep on regular formula.
• If more than once, offer ORS for 8 hours. If you don’t have ORS, use formula.
• 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.
• Return to Solid Foods. If over 4 months old and after 8 hours without vomiting, add solids. Start with cereals. Then, slowly add other baby foods.
• Return to normal diet in 24-48 hours.

For Breastfed Babies, Reduce the Amount Per Feeding:

• If vomits once, nurse 1 side every 1 to 2 hours.
• If 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 ORS (such as Pedialyte). Do this for 4 hours.
• Spoon or syringe feed small amounts of ORS. 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.

For Older Children (over 1 Year Old), Offer Small Amounts of Clear Fluids For 8 Hours:

• Water or ice chips are best for older children. (Reason: Water is easily absorbed in the stomach.)
• ORS. If your child vomits water, offer ORS. ORS is a special fluid that can help your child stay hydrated. You can use Pedialyte or the store brand. It can be bought in food or drug stores.
• If refuses ORS, use half-strength Gatorade. Make it by mixing equal amounts of Gatorade and water.
• Give small amounts. Use 2-3 teaspoons (10-15 ml) every 5 minutes.
• Other options. Half-strength flat lemon-lime soda, popsicles or ORS frozen pops.
• After 4 hours without throwing up, increase the amount.
• After 8 hours without throwing up, return to regular fluids.
• Caution: If vomits over 12 hours, switch to ORS or half-strength Gatorade.
• Return to Solid Foods. After 8 hours without throwing up, add solid food.
• Limit solids to bland foods. Starchy foods are easiest to digest.
• Start with crackers, bread, cereals, rice, mashed potatoes, noodles.
• Return to normal diet in 24-48 hours.

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 (Tylenol) suppository. This is a form of the drug you put in the rectum. 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.

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

Return to School:

• Your child can return to school after the vomiting and fever are gone.

What to Expect:

• Vomiting from a viral illness often stops in 12 to 24 hours.
• Mild vomiting and nausea may last up to 3 days.

Call your Doctor if:

• Vomits clear fluids for more than 8 hours
• Vomiting lasts more than 24 hours
• Signs of dehydration occur
• Your child becomes worse