Instructions

• Instructions for new users

Call Your Doctor Now If:

• Your child looks or acts very sick
• Difficult to awaken, confused when awake or severe headache
• You suspect poisoning with a plant, medicine, or other chemical
• Signs of dehydration (e.g. very dry mouth, no tears and no urine in > 8 hours)
• Blood in the vomit that's not from a nosebleed
• Green bile in the vomit
• Abdominal pain is also present (EXCEPTION: abdominal pain or crying just before and relieved by vomiting is quite common)
• Fever > 105°F (40.6°C)
• Age < 12 weeks old with fever > 100.4°F (38°C) rectally
• Age < 12 weeks with vomiting 2 or more times
• Age < 12 months old who has vomited clear fluids 3 or more times and also has watery diarrhea
• High-risk child (e.g. diabetes mellitus, abdominal injury)
• Vomiting an essential medicine

Call Your Doctor Within 24 Hours If:

• You think your child needs to be seen
• Has vomited > 24 hours
• Fever present > 3 days

Call Your Doctor During Weekday Hours If:

• You have other questions or concerns
• Vomiting is a recurrent problem

Home Care (Read "Call Your Doctor…" first):

Sleep

Help your child go to sleep (Reason: sleep often empties the stomach and relieves the need to vomit). Your child doesn't have to drink anything if he feels nauseated.

For Bottlefed Infants Offer Oral Rehydration Solution (ORS) for 8 Hours

• For vomiting once, offer ½ strength formula for 2 feedings, then regular formula
• For vomiting 2 or more times, offer ORS (Infalyte, KaoLectrolyte or Pedialyte)
• If ORS not available, use formula. Spoon feed small amounts: 1-2 teaspoons (5-10 mL) every 5 minutes
• After 4 hours without vomiting, increase the amount gradually
• After 8 hours without vomiting, return to regular formula. For infants > 4 months old, also return to cereal, strained bananas, etc. Normal diet OK in 24-48 hours

For Breastfed Infants, Reduce the Amount Per Feeding

• If vomits once, wait 1 hour, then nurse 1 side (to limit amount of feeding)
• If vomits twice, nurse 1 side every 1 to 2 hours
• If vomits > 2 times, nurse for 4 to 5 minutes every 30 to 60 minutes
• After 8 hours without vomiting, return to regular breastfeeding

For Older Children (>1 Year Old) Small Amounts of Clear Fluids For 8 Hours

• Water or ice chips are best for vomiting in older children. (EXCEPTION: severe diarrhea). (Reason: water is directly absorbed across the stomach wall)
• Give small amounts: 1 tablespoon (10-15 mL) every 5 minutes
• Other options: ½ strength flat lemon-lime soda, Popsicles or ORS frozen pops
• After 4 hours without vomiting, increase the amount gradually
• For severe vomiting, rest the stomach completely for 2 hours, then start over with smaller amounts
• After 8 hours without vomiting, add solids:
  • Limit solids to bland foods for 24 hours
  • Start with saltine crackers, white bread, cereals, rice, mashed potatoes, etc.
  • Normal diet OK in 24-48 hours

Avoid Medicines

Discontinue all nonessential medicines for 8 hours. (Reason: usually make vomiting worse). Call if vomiting an essential medicine.

Contagiousness

Your child can return to day care or school after vomiting and fever are gone.

Expected Course

Vomiting from viral gastritis usually stops in 12 to 24 hours. If diarrhea is present, it usually continues for several days.

Call Your Doctor If:

• Vomiting persists > 24 hours
• Signs of dehydration
• Your child becomes worse or develops any of the "Call Your Doctor…" symptoms