Vomiting in Toddlers

It is undoubtedly distressing for any parent to watch their toddler vomit often. This worry can escalate very quickly if you notice that your child tends to vomit quite often and you cannot identify the reason. While you may not be able to understand the reason at the onset, a closer look may help reveal the reason.

Causes

Toddlers are sensitive and are still building their immunity and hence may feel nauseated and end up vomiting for various reasons. Here are a few causes of vomiting in toddlers.

• Stomach infection: Stomach flu or viral gastroenteritis is one of the most common stomach infections that can cause vomiting in children. This stomach bug may cause painful cramps in the abdominal cavity which can lead your little one to regurgitate and vomit. Vomiting caused by stomach infection may be accompanied by diarrhoea, cramps, nausea and fever. The dehydration from diarrhoea may even cause mild headaches.

• Intestinal infection: Pathogens and bacteria like salmonella and staphylococcus can lead to infections which can cause your toddler to vomit. An intestinal infection may have symptoms like abdominal cramps, fever and diarrhoea.

• A pediatric hernia: When the small or the large intestine slips out of the abdominal cavity, it causes a hernia. This can cause discomfort and even increase the risk of infections. Toddlers may be prone to two kinds of hernias, inguinal hernia and umbilical hernia. If the bowel shifts to the inguinal canal, it can cause a large bump near the groin area, causing an inguinal hernia. An umbilical hernia is caused when the small intestine slips of a damaged abdominal wall behind the navel. These hernias exert pressure on the abdominal cavity and cause the toddler to throw up.

• Ingestion of poisonous substance: Since toddlers have a common habit of putting things in their mouth, it is possible that they ingest toxic substances. This can irritate the lining of their stomach and make the muscles contract, causing your toddler to vomit. He may also have nausea or experience some pain in the abdomen as a result.

• Food allergies: If your child tends to vomit after eating a particular food, it may be due to an allergy. Vomiting is one out of the other symptoms of a food allergy. Other symptoms could include swelling of the lips and eyelids, abdominal pain, skin hives, itching, etc. If your toddler throws up white chunks of milk, he may be lactose intolerant. This is when the body does not enough lactase enzymes to digest milk.

• Acid and bile reflux: When the oesophageal sphincter that separates the stomach and the oesophagus opens up, it causes some of the contents of the stomach along with the acid to move into the oesophagus. This can cause vomiting and nausea due to the irritation. On the other hand, when the pyloric valve which is between the small intestine and the stomach tends to malfunction, bile from the small intestine moves into the stomach. This irritates the lining of the stomach making it contract and expel the bile, a greenish-yellow fluid, like vomit.

• Swallowing air and overeating: If your toddler has eaten more than what his stomach can hold or if he has swallowed during feeding, he may throw up as his stomach is full to the brim. Swallowing air may be a result of the wrong positioning of the nipple in the mouth.

• Indigestion: If you toddlers food hasn’t digested well, he may throw up the undigested food that has accumulated in his stomach. Poor digestion may be caused due to overeating, eating too fast, spicy or greasy food.

• Medication: Some medications, especially when taken on an empty stomach can cause your toddler to vomit.

• Motion sickness: A constant shift in the equilibrium can cause your toddler’s inner balance to feel disoriented. This can be observed after a roller coaster ride. The inner ear, which manages the body balance, may send erratic distress signals to the brain due to this shift in balance. This further leads to the brain sending nervous distress signals to the muscles in the stomach causing your toddler to vomit. Dizziness and headaches can also create the same effect.

• Ear infections: Ear infections like labyrinthitis can make the inner ear send erratic signals to the brain, similar to that of motion sickness and vertigo. Your toddler may feel dizzy, face problems balancing and have severe nausea.

• Pneumonia: Bacterial or viral infections inflame the alveoli in the lungs leading to pneumonia. While breathing difficulties and cough are common symptoms, the toddler may also have vomiting which is triggered by constant coughing. Lack of appetite caused due to the infection may also cause the toddler to throw up every time he eats something.

• Other infections and diseases: Vomiting is the symptom of several infections and diseases including septicaemia and meningitis, along with other symptoms like fever, body pain, headache, etc.

• Rumination syndrome: This is a rare case when the food regurgitates without any trouble or pain. The toddler will not have any discomfort or heartburn during this. It is also interesting to note that during rumination the food that is regurgitated is fresh and the toddler will usually chew and swallow it back.

• Appendicitis: Appendicitis is rare in toddlers and usually occurs in kids between the ages of 10 and 20. Infection in the appendix can cause nausea and lead to vomiting. It can even cause severe pain in the abdomen, low fever and loss of appetite. The stomach muscles move in an unusual fashion as the infection tends to send impulses of pain throughout the abdominal cavity. This can lead to nausea and vomiting.

If you notice your toddler vomiting at night it can be due to these and other reasons like sleeping immediately after dinner, sinus problems, severe cough or accumulation of mucus in the tummy at night, etc. In rare cases, it may even be indicative of a tumour. Hence, it is advisable to consult a doctor if it persists.

What is Dry Heaving?

Dry heaving is when your toddler’s muscles in the abdomen and the mouth contract just like during vomiting, however, he does not essentially vomit anything. It is also called as retching, and it may happen after a bout of vomiting or if your toddler is feeling nauseated. It may even be a sign of stress and discomfort.

Is It Okay to Give Toddler Medicines after Vomiting?

Do not give your toddler any prescription or over the counter medicine unless a doctor has recommended it. Do not give medication that contains aspirin to your child as it may lead to Reye’s syndrome that affects that baby’s brain, heart and liver.

How to Make Your Toddler Feel Better?

If your toddler is nauseated and feels like vomiting, here are a few things you can do to help him feel better and ease the discomfort.

1. Don’t force him to eat: If your toddler does not want to eat anything after vomiting constantly, do not force him to eat. It is all right if he skips a meal to soothe his stomach. Also, feeding him solid food may further distress his stomach and cause him discomfort.

2. Give him plenty of fluids: Vomiting can cause the body to dehydrate very fast, even more so if it is accompanied by diarrhoea. He will have also lost electrolytes like sodium and potassium because of vomiting. In order to rehydrate him, you will need to provide him small sips of oral rehydration salts (ORS) dissolved in water. This will also provide him with enough calories to sustain him until the time he can eat solid food. Do not give him any milk or juice as it may be difficult to digest.

3. Allow him to rest: Constant vomiting can make your toddler tired, and he needs adequate rest to gain his energy back. Proper rest will also give his body the time to fight the infection that may have led to the vomiting.

4. Follow the course of medicines prescribed by the doctor: Your doctor will give him a course of different drugs. Follow the prescription to ensure that the infection doesn’t return.

What Should You Feed Your Toddler after Vomiting?

After vomiting your little one would have expelled the nutrients he had consumed. He may even be unwilling to eat immediately after vomiting because of that unpleasant experience. Here are things to do to ensure that your toddler is not drained out of energy.

1. Feed him water and electrolytes: For a few hours after your toddler vomits, you will need to give him enough fluids and electrolytes. Do not give him any solid food as it could make his condition even worse.

2. Start a liquid diet: Starting your toddler on a liquid diet once he feels better is best. You can give him some vegetable or chicken stock with little salt and no condiments. Rice stock is also a good option. However, avoid lentil stock as some lentils may be hard to digest. You can even give him some tender coconut water as it is rich in amino acids and minerals.

3. Provide him bland solid food: Simple mashed rice and vegetable or chicken stock can be given to your child once he recovers more. Ensure that you do not give him any high fibre vegetables that are hard to digest. You can even try blending the vegetables and strain them to make soups that are easy to digest. Wait for eight hours after your child has vomited to start on solid food.

4. Give him regular food: Once your toddler has recovered completely or after 24 hours since he last vomited, you can give him regular food. You can give him milk in small quantities paired with bread or other foods. If he responds well to the diet, you can continue to give him regular food.

Home Remedies for Vomiting in Toddlers

Below are some home remedies that can help soothe your toddler after vomiting.

• Clear fluids like broth or water can be a great option to rehydrate your child. Electrolyte solution like ORS can also be helpful to supplement the lost nutrients. Ginger ale or lukewarm soda can be given in small quantities once it is flat. You will need to stir it to dissolve some of the bubbles as carbonation may make things worse.

• Tender coconut water is packed with nutrients and can help sustain your child on a liquid diet.

• Chamomile or peppermint tea can soothe the stomach. You can give your child small amount of tea twice or thrice if he can keep it down. Always give lukewarm tea to prevent burns.

• Once your toddler can successfully keep his liquid diet down, you can give him some toast or crackers. As he recovers, you can begin to give him some bland, easily-digestible food like vegetable stock and mashed rice. Once he completely recovers, gradually starts him on regular food again.

When Can Your Toddlers Consume Solids Again?

Most people say that you wait for at least 24 hours after your child has vomited to give him solid food. If your child does not vomit in the between and responds well to the liquid diet, you can slowly introduce easily digestible solid food to him.

Precautions to Prevent Vomiting

In order to prevent your toddler from vomiting due to external triggers, you can follow a few precautions.

1. Ensure that the food is clean and hygienic: Keep your kitchen clean. Sterilize the utensils that you use to prepare and serve food to your toddler. This is one way to prevent infection-causing bacteria and virus.

2. Reduce food that can cause indigestion: Certain foods like chocolates, citrus fruits and processed foods can lead to acid reflux in your child. If your toddler has experienced acid reflux before, it is best to steer clear of these food items. Also, teach your toddler to eat slowly and chew his food properly before swallowing to prevent indigestion.

3. Learn the side-effects of medicines: If your child is on medications, you will need to enquire about any side effects that these medicines may cause. Certain medications can cause vomiting especially if taken on an empty stomach.

4. Keep track of your toddler’ allergies: If you are aware of any food allergies that your toddler has, take all the necessary measures to prevent him from eating that particular food. Also, check the ingredients of all packaged food items to ensure that there are no ingredients that your child may be allergic to.

5. Stay away from situations that can lead to motion sickness: If your child is prone to motion sickness, avoid taking him on roller coaster rides or travelling through sharp curves, etc., which can trigger vertigo and make him throw up.

6. Hydrate your toddler: Vomiting paired with diarrhoea can decrease the water reserves of the body. Hence, it is important that you provide him with enough fluids to keep him hydrated.

What if a Toddler has Swallowed something Poisonous?

If your toddler begins to vomit after ingesting a poisonous substance, you will need to call a doctor immediately to ask for the best course of action. If you can identify the substance that he has ingested, do make a note of it and tell the doctor exactly what it is. The doctor will then be able to tell you what you need to do depending on what was ingested.

When to Consult a Doctor?

Vomiting can be an indicator of something potentially serious. In the following cases, always consult a doctor to get the right medical help for your toddler.

• You notice blood in the vomit: Blood in your toddler’s vomit can indicate a lot of serious issues like a severe infection in the stomach, tear or bruise in the oesophageal lining caused by acid reflux, inflamed small intestine, etc. In such cases, you must take your toddler to the doctor as soon as possible.

• Severe diarrhea and high fever with vomiting: Diarrhoea paired with vomiting can quickly dehydrate your child. The condition escalate if your child has a high fever. This warrants a visit to the doctor to prevent any further complications.

• Vomit is green or black colored: A bile reflux can make your toddler’s vomit appear green. This could also indicate that your toddler may have an ulcer in the intestine or a severe infection. On the other hand, a dark brown or black coloured vomit can indicate blood clots caused by internal bleeding. This could be because of deficiency of Vitamin K or due to milk allergies.

• Swollen abdomen: If your toddler’s abdomen is swollen it can indicate a serious infection or fluid retention, both cases require medical intervention.

• Weak pulse and fatigue: If your toddler seems disoriented and pees fewer in the day it may be a sign that he is dehydrated due to loss or water and electrolytes.

Proper hygiene and healthy food is a great way to reduce the risk of vomiting in children. However, if other conditions cause your toddler to vomit often, it is recommended that you seek medical attention.