Causes

• Food poisoning or food allergy can cause vomiting.
• Hard coughing can cause vomiting, especially if a child has reflux.
• Viral gastroenteritis, commonly called 'gastro', is one of the most common reasons for acute vomiting in children.
• Infections such as a cold or urinary tract infection can also cause vomiting.
• Some children are prone to motion sickness and vomit when they’re in a car or pram.
• Vomiting can also be a sign of other, more complicated medical conditions such as appendicitis or an obstruction.

Other medical conditions which cause vomiting are as follows:

• Urinary tract infections - Vomiting can be a sign of a urinary tract infection (UTI) in children. The symptoms of UTIs in children are often vague but can include fever, tiredness, being irritable, pain when weeing, urinating less and smelly urine.
• Appendicitis - Appendicitis causes pain around the belly button (navel) which then moves to the lower right side of the abdomen and becomes sharper. A child with appendicitis may complain of worsening tummy pain, lose their appetite, vomit, feel uncomfortable when sitting upright or standing up, and experience pain when moving.
• Intussusception - Children with intussusception may have intermittent severe pain causing crying and distress. They may have bleeding from the bottom, vomiting, or be lethargic or listless either all the time or in waves. In between the episodes, the child may seem relatively well.
• Meningitis - Meningitis is an infection and swelling of the membrane that covers the brain and spinal cord, usually from a bacterial or viral infection. Meningitis can cause symptoms such as vomiting, fever, headache, a stiff neck and avoidance of bright lights (photophobia). There may be a skin rash that consists of small red or purple spots that don't turn white when you press on them.

Symptoms

• Nausea (feeling sick and feeling that you are about to vomit)
• Abdominal pain.
• Diarrhoea.
• Fever.
• Headache.
• Coughing or breathing problems.
• Children can projectile vomit. Projectile vomiting is when they vomit out of their mouth so forcefully that it can travel over a metre. A child who projectile vomits should be taken straight to a hospital's emergency department.

When should I see a doctor?

• Blood in the vomit or in the stool (poo).
• High fever.
• Vomiting that isn’t stopping.
• Swollen or tender abdomen.
• Stiff neck - with or without photophobia (pain when looking at bright lights).
• Green-coloured vomit.
• Vomiting early in the morning.
• Projectile vomiting (where the vomit is ejected some distance).
• Bulging fontanelle in a baby.
• They can't keep fluids down.
• Signs of dehydration, such as fewer wet nappies, darker coloured urine, or dry lips and mouth.

How is vomiting diagnosed in children?

Tests that may help determine the cause of the vomiting include:

• Blood tests.
• Urine tests.
• X-ray.
• Ultrasound.
• Lumbar puncture.

Treatment

• If a child vomits, offer him a drink after each time. You can also offer them an oral rehydration solution or water for the first 12 hours. Give older children small amounts of clear fluids to drink often - about every 15 minutes. Oral rehydration solutions are strongly recommended for any child with frequent diarrhoea or vomiting. Oral rehydration solution can be chilled or made into ice blocks for a child to suck if they do not want to drink it. Don't give your child undiluted drinks high in sugar, such as sports drinks which can make diarrhoea or dehydration worse. Give a homemade ORS solution:

1. Clean Water - 1 litre.
2. Sugar - 30 gms.
3. Salt - 2 gms.
4. Stir the mixture till the sugar dissolves.

• Children with gastroenteritis may refuse solid food, but it’s good for them to return to their normal diet as soon as possible, as long as they are not dehydrated or vomiting.
• Do NOT give children anti-diarrhoeal medicines or anti-vomiting medicines (antiemetics) — they may be harmful.
• Make sure your child rests.
• Don't send them to nursery, daycare or school until they have not had a loose bowel motion for 24 hours.
• Whatever the cause of vomiting, treatment needs to ensure that a child doesn’t develop dehydration because of the fluids lost when vomiting.
• If your child becomes dehydrated they may need to go to hospital for rehydration via a nasogastric tube, which goes down their nose into their stomach, or intravenously on a drip.
• Anti-vomiting medicines (antiemetics) are not generally recommended in children and may be harmful.
• Surgery is usually needed for conditions such as appendicitis, bowel obstruction, and pyloric stenosis, where there are blockages or problems in the digestive system.
• Meningitis is treated in the hospital. Treatment depends on how unwell your child is. Bacterial meningitis is treated with antibiotics. Your child may need steroids to reduce swelling on the brain. Viral meningitis is not helped by antibiotics.
• Diabetic ketoacidosis will need to be treated in the hospital. This involves safely reversing any dehydration, stabilising blood sugar levels with insulin and closely monitoring your child
• Infections, such as urinary tract infections, are usually treated with antibiotics.