GUIDANCE FOR PARENTS ON MANAGING CHILDHOOD VOMITING AT HOME

🌦 During seasonal changes, children are more susceptible to respiratory illnesses and digestive disturbances. Among these symptoms, vomiting can be uncomfortable for both children and parents. Vomiting may lead to dehydration and loss of electrolytes, so ensuring proper fluid replacement is essential. 

👩🏻‍⚕️ The following article is written by MSc, MD Lê Thị Kim Dung to help parents manage vomiting at home and recognize key warning signs for timely medical consultation. 

1️⃣ What causes vomiting in children? 

▶️ Vomiting is a natural way for the body to expel unwanted substances. In children, the most common causes include: 

▪️ Viral infections such as gastroenteritis (“stomach flu”) 
▪️ Food poisoning or allergies 
▪️ Motion sickness during travel 
▪️ Overeating or eating too quickly 
▪️ High fever or persistent cough 
▪️ Stress or anxiety, especially before school or events 
▪️ Underlying conditions such as acid reflux or migraines (less common) 

‼️ Although most episodes of vomiting are short-lived and not serious, monitoring for dehydration and other symptoms is very important. 

2️⃣ What should parents do when their child vomits? 

Here are some home care measures and tips to try when your child begins vomiting: 

▶️ Start with small sips of fluids 

Vomiting can cause rapid dehydration, making fluid replacement critical. However, dehydrated children often want to drink quickly in large amounts, which may worsen vomiting. 

🔴 How to give fluids: 

Offer fluids via an age-appropriate bottle or cup. If the child cannot drink from a cup or bottle, use a medicine cup, syringe, or teaspoon. 

Which fluids to give: 

🔸 For breastfed infants: Reduce the volume per feed: 
▪️ If the child vomits once, breastfeed from one side every 1–2 hours. 
▪️ If vomiting occurs more than once, feed for 5 minutes every 30–60 minutes. 
▪️ If vomiting persists, offer expressed breast milk 1–2 teaspoons every 5 minutes. 
▪️ After 4 hours without vomiting, resume normal breastfeeding, starting with small feeds of 5 minutes every 30 minutes and gradually increasing according to the child’s tolerance. 

🔸 For infants fed expressed breast milk via bottle: Reduce the volume per feed: 
▪️ If vomiting occurs once, give half the usual amount every 1–2 hours. 
▪️ If vomiting occurs more than once within 2 hours, feed every 30–60 minutes. 
▪️ If vomiting persists, give 1–2 teaspoons every 5 minutes. If milk is not tolerated, switch to an oral rehydration solution (ORS). 
▪️ After 4 hours without vomiting, resume normal feeding, starting small and gradually increasing according to tolerance. 

🔸 For formula-fed infants: Provide an oral rehydration solution (ORS), a special electrolyte solution to prevent dehydration. Avoid plain water. 
▪️ If vomiting occurs multiple times, continue ORS over 8 hours. 
▫️ Give 1–2 teaspoons every 5 minutes. 
▫️ After 4 hours without vomiting, double the amount. 
▪️ After 8 hours without vomiting, resume normal formula feeding. 

🔸 For children over 1 year old: Use an oral rehydration solution (ORS). Start with small sips. Avoid fruit juices and carbonated drinks, as they may worsen nausea. Tip: initially give 1 teaspoon ORS every 5–10 minutes. When vomiting decreases, gradually increase the volume over 3–4 hours. 

‼️ Note: Be cautious with commercial sports drinks. They may replace electrolytes but contain high sugar, which can worsen diarrhea. Consult a doctor before using any electrolyte solution other than ORS. 

🔴 Diet: 

🔸 After 8 hours without vomiting, offer bland foods: 
✔️ Plain rice, toast, or crackers 
✔️ Mashed banana 
✔️ Applesauce 
✔️ Steamed carrots or boiled potatoes 

❌ Avoid milk, fatty foods, and spicy foods for at least 24 hours after vomiting. For young children, give small, frequent feeds. If vomiting recurs, wait 20–30 minutes before feeding again.