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Vomiting in children

Key points about vomiting in children

Vomiting (throwing up or being sick) is unpleasant but isn't normally harmful.
Ongoing vomiting can cause dehydration, so it's important your child gets enough water.
Medicines aren't usually needed, or safe, for vomiting children.
Vomiting is common and is only rarely caused by anything serious but there may be times when you need to seek help urgently (see the important information below).

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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 swallowing 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. Your child may also have diarrhoea (runny poo) and a fever (high temperature).

Other causes include:

Food allergy: This starts within minutes or hours of eating a certain food. Can come with hives (urticaria). If your child is having trouble breathing or has swelling of the mouth or tongue call 111 for an ambulance.

Poisoning: 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.

Reflux: Bringing up milk after a feed is sometimes mistaken for vomiting. The main difference is that vomiting uses effort (you will see your child retch and use their neck, chest and tummy muscles) while reflux or 'spilling' is effortless (the milk will just come out of their mouth). For babies less than 1 year old, spilling is a normal process that helps to relieve an uncomfortably full stomach. Read more about reflux. (external link)

Motion sickness: Caused by movement when travelling.

Overeating: This will stop after 1 or 2 vomits.

Being very worried or anxious: This is more common in older children. Your child will usually vomit once only. The situation the vomiting happens in should be the clue.

Infection: Ear infections, urine infections, flu, COVID-19 and other infections can cause vomiting. Children are more likely to vomit with infections than adults.

Meningitis: This is a potentially serious brain infection. See your healthcare provider 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.(external link)

Other illnesses: Illnesses such as migraine, diabetes, bowel obstruction and appendicitis can cause vomiting. Your child would have other symptoms such as pain or not eating which would let you know to make an appointment with your healthcare provider.

When your child is vomiting, sit them forward to prevent them from choking on the vomit. If they're asleep, lie them on their side.
Vomiting can be unsettling, and even frightening, for young tamariki. Support your child by helping them stay calm.
Allow your child to rest or play quietly if they feel up to it – keeping their minds busy will help distract them. 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.
Digestion slows down when your child is ill. They may vomit food they ate a long time ago. When they have vomited many times there won't be any food left in their stomach. Then they will vomit stomach acid, which is bright yellow. This is different from bile, which is dark green and comes from further down in their gut.

Preventing dehydration

Children who vomit more than once in a day, or for several days, can lose a lot of water. This water needs to be replaced in between vomits or they can get dehydrated. This can be dangerous, especially for babies. The risk of dehydration is greater when your child has diarrhoea (runny poo) and vomiting (being sick) at the same time.

Signs of dehydration

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 in childen and babies.

What to do

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 in between feeds. This is usually cooled boiled water. Your healthcare provider will advise you if you need an oral rehydration solution.	Offer your child small sips of cool fluid every few minutes. Water, clear soup, or watered-down fruit juice (1 part juice and 5 parts water) are good options. If your child doesn’t want to drink, offer ice, frozen diluted fruit juice or frozen canned peach slices to suck. Use a novelty straw or try a timer to encourage them to have few sips every few minutes. If vomiting lasts more than 24 hours, an oral rehydration solution such Gastrolyte or Pedialyte can be used. Try freezing the rehydration drink into ice-blocks 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 in between feeds. This is usually cooled boiled water. Your healthcare provider will advise you if you need an oral rehydration solution.

Offer your child small sips of cool fluid every few minutes. Water, clear soup, or watered-down fruit juice (1 part juice and 5 parts water) are good options.
If your child doesn’t want to drink, offer ice, frozen diluted fruit juice or frozen canned peach slices to suck. Use a novelty straw or try a timer to encourage them to have few sips every few minutes.
If vomiting lasts more than 24 hours, an oral rehydration solution such Gastrolyte or Pedialyte can be used. Try freezing the rehydration drink into ice-blocks if your child doesn’t like the taste.

Image credit: Canva

Your child probably won't feel like eating when they are vomiting. If your child is hungry, let them eat whatever they want. Otherwise, don’t worry about eating until they ask for food.

Young babies

Any baby under the age of 6 months with vomiting should be seen by a healthcare provider – babies become dehydrated and unwell quickly.

Older children

Urgent appointment

For older children with vomiting, ask for an urgent appointment with your healthcare provider if you notice:

Signs of dehydration such as:
- a dry mouth and tongue
- sunken eyes
- cold hands and feet
- unusual sleepiness or lack of energy
- fewer wet nappies or your child is not passing as much urine as usual.
Blood or bile (dark green colour) in their vomit.
Severe tummy pain or a swollen tummy (puku).
The vomiting continues to get worse after 48 hours.
Weight loss.
Your child doesn't want to move their neck, has a rash or doesn't want to look at light.
Your child's skin colour or whites of the eyes have become yellow.