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Vomiting in children

Key points about vomiting in children

Vomiting (throwing up) is unpleasant but normally isn't harmful.
But ongoing vomiting can lead to dehydration, so ensuring your child gets enough fluid is important.
Call 111 for an ambulance or go to your nearest A&E department immediately if your child is vomiting and:
- has a headache, stiff neck and a rash (this could be meningitis)
- develops sudden and severe tummy pain (this could be due to ingesting something poisonous)
- it started after a head injury
- is floppy, irritable or not very responsive.

The most common cause of vomiting in both adults and children is gastroenteritis, which is commonly known as 'gastro' or tummy bug. Other causes include food allergy, poisoning, reflux, meningitis, overeating, stress, infection or illness.

There are many things which can cause vomiting in children. Some of the causes, and the other symptoms you may see with them, are described below.

Gastroenteritis

Vomiting + diarrhea + mild fever

Also called gastro or tummy bug, it is the most common cause of vomiting and diarrhoea in adults and children.
Gastroenteritis can be caused by viruses (such as rotavirus), bacteria (such as Campylobacter or E. coli which can cause food poisoning) or parasites (such as giardia).
Read more about gastroenteritis.

Food allergy

Nausea + vomiting + rash

Symptoms of food allergy can occur within minutes or hours of eating a certain food.
Call 111 immediately if your child has shortness of breath or swelling of the mouth or throat. An extreme allergic reaction can be fatal if you don't act fast.
Read more about food allergy.

Eating or drinking something poisonous

If you think your child has swallowed a poison, follow these steps:

If they are awake, call the New Zealand National Poisons Centre(external link) on 0800 POISON (0800 764 766).
If they are sleepy or unconscious, lie them on their side and dial 111 for an ambulance.
Do NOT try to make your child vomit or give them food or liquid until you have been given advice.

Bacterial meningitis

Vomiting + high fever + piercing scream (babies) or stiff neck (older children)

This is a potentially serious brain infection which since the development of the Haemophilus influenzae type b (Hib) vaccine is now rarely seen.
See your doctor straight away if your baby is vomiting, running a fever, and irritable, or if your older child is vomiting and complains of a stiff neck or seems dizzy and confused.
Read more about meningitis.

Reflux / spilling

Bringing up milk after a feed is sometimes mistaken for vomiting. The main difference is that vomiting is an effortful process while reflux or spilling is effortless. For babies less than 1 year old, spilling is a normal process that helps to relieve an uncomfortably full stomach. Read more about reflux.

Other causes include:

Eating too much – especially rich food that they do not normally eat a lot of (for example sweet or fatty foods)
Being very worried, anxious or stressed (this is more common in older children and adults)
Having a gut obstruction - vomit in this case is usually greenish-looking
Being sick with the flu or other illness
Having an infection, such as appendicitis.

Ongoing vomiting can lead to dehydration which can be dangerous. The risk of dehydration is increased when the child has diarrhoea and vomiting at the same time.

The main sign of dehydration is not passing much or any urine, having fewer wet nappies, or urine being very dark and smelly. Other signs include dry mouth and tongue, sunken eyes, cold hands and feet, unusual sleepiness and/or lack of energy. Read more about dehydration.

Preventing dehydration

Children can easily become dehydrated if fluid lost by vomiting is not replaced. To prevent this, make sure your child is taking in enough fluid between vomiting episodes.

For babies	For children
Carry on breastfeeding or giving them milk feeds as normal. If they are younger than 6 months of age seek advice from your doctor; babies can quickly become dehydrated. If your baby becomes dehydrated, they will need extra fluids. Your doctor or pharmacist will advise you on the best oral rehydration solution to use.	Offer your child small, regular sips of cool fluid. Water, clear soup, or watered-down fruit juice are good options. If your child doesn’t want to drink, offer ice to suck, use a novelty straw or try a timer to encourage them to have a small drink every 10–15 minutes. Avoid milk drinks, fizzy drinks and full-strength fruit juice. If vomiting lasts more than 24 hours, an oral rehydration solution such Gastrolyte or Pedialyte can be use. Try freezing the rehydration drink into iceblocks if your child doesn’t like the taste.

For babies

For children

Carry on breastfeeding or giving them milk feeds as normal.
If they are younger than 6 months of age seek advice from your doctor; babies can quickly become dehydrated.
If your baby becomes dehydrated, they will need extra fluids. Your doctor or pharmacist will advise you on the best oral rehydration solution to use.

Offer your child small, regular sips of cool fluid. Water, clear soup, or watered-down fruit juice are good options.
If your child doesn’t want to drink, offer ice to suck, use a novelty straw or try a timer to encourage them to have a small drink every 10–15 minutes.
Avoid milk drinks, fizzy drinks and full-strength fruit juice.
If vomiting lasts more than 24 hours, an oral rehydration solution such Gastrolyte or Pedialyte can be use. Try freezing the rehydration drink into iceblocks if your child doesn’t like the taste.

Any baby under 6 months old with vomiting should be seen by a doctor urgently – babies become dehydrated and unwell quickly.

For older children with vomiting, see your doctor if you notice:

signs of dehydration such as dry mouth and tongue, sunken eyes, cold hands and feet, unusual sleepiness or lack of energy, fewer wet nappies or not passing as much urine as usual
blood or bile (greenish fluid) in the vomit
severe tummy pain or a swollen tummy
the child's skin colour or whites of the eyes have become yellowish.

When your child is vomiting, sit them forward to prevent them from choking on the vomit. Keep a close eye on them and see your doctor straight away if you are worried.

Vomiting can be unsettling, and even frightening, for young children. Support your child by helping them stay calm and making sure they don't become dehydrated.

Allow your child to rest or play quietly if they feel up to it – keeping their minds busy will help distract them from their discomfort. Make sure the room is not too hot or stuffy.

If your child has stomach cramps, try a warm (not hot) wheat pack or hot water bottle on their tummy.

Preventing dehydration

Children can easily become dehydrated if fluid lost by vomiting is not replaced. To prevent this, make sure your child is taking in enough fluid between vomiting episodes.

For babies	For children
Carry on breastfeeding or giving them milk feeds as normal. If they are younger than 6 months of age seek advice from your doctor; babies can quickly become dehydrated. If your baby becomes dehydrated, they will need extra fluids. Your doctor or pharmacist will advise you on the best oral rehydration solution to use.	Offer your child small, regular sips of cool fluid. Water, clear soup, or watered-down fruit juice are good options. If your child doesn’t want to drink, offer ice to suck, use a novelty straw or try a timer to encourage them to have a small drink every 10–15 minutes. Avoid milk drinks, fizzy drinks and full-strength fruit juice. If vomiting lasts more than 24 hours, an oral rehydration solution such Gastrolyte or Pedialyte can be use. Try freezing the rehydration drink into iceblocks if your child doesn’t like the taste.

For babies

For children

Carry on breastfeeding or giving them milk feeds as normal.
If they are younger than 6 months of age seek advice from your doctor; babies can quickly become dehydrated.
If your baby becomes dehydrated, they will need extra fluids. Your doctor or pharmacist will advise you on the best oral rehydration solution to use.

Offer your child small, regular sips of cool fluid. Water, clear soup, or watered-down fruit juice are good options.
If your child doesn’t want to drink, offer ice to suck, use a novelty straw or try a timer to encourage them to have a small drink every 10–15 minutes.
Avoid milk drinks, fizzy drinks and full-strength fruit juice.
If vomiting lasts more than 24 hours, an oral rehydration solution such Gastrolyte or Pedialyte can be use. Try freezing the rehydration drink into iceblocks if your child doesn’t like the taste.

Your child probably won't feel like eating when they are vomiting.

If your child is hungry let them eat small amounts. Otherwise, don’t worry about food.
Try easily digested foods such as bananas, crackers, rice, pasta and bread.
Avoid foods high in fibre such as whole fruits (except bananas) and vegetables, spicy or fatty foods, alcohol and caffeinated drinks.
Go back to your child’s normal diet after 24–48 hours.

Adventures in vomiting(external link) WebMD, US
Vomiting in children and babies(external link) NHS Choices, UK
Vomiting(external link) Ministry of Health, NZ