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Nausea and Vomiting, Age 11 and Younger

Topic Overview

Vomiting occurs when a child's stomach contents are forced up the esophagus and out of the mouth. Although nausea may accompany vomiting in adults and older children, children younger than age 3 are usually not able to tell you if they are having nausea. Most of the time vomiting is not serious. Home treatment will often ease your child's discomfort.

Vomiting in a baby should not be confused with spitting up. Vomiting is forceful and repeated. Spitting up may seem forceful but it usually occurs shortly after feeding, is effortless, and causes no discomfort.

Causes of vomiting

A baby may spit up for no reason at all. Overfeeding, not burping your baby after feeding, intolerance to milk or formula, and exposure to tobacco smoke are other reasons why your baby may spit up.

Most vomiting in children is caused by a viral stomach illness (gastroenteritis). A child with a stomach illness also may have other symptoms, such as diarrhea, fever, and stomach cramps. With home treatment, the vomiting usually will stop within 12 hours. Diarrhea may last for a few days or more.

Rotavirus is a virus that can cause severe vomiting and diarrhea. Rotavirus vaccineRotavirus vaccine(What is a PDF document?) helps protect against rotavirus disease.

Vomiting can also be caused by an infection in another part of the body, such as strep throat, pneumonia, or a urinary tract infection. In rare cases, vomiting can be a symptom of a serious condition, such as a blockage of the digestive tract (pyloric stenosis), an infection (meningitis) of the fluid (cerebrospinal fluid) and tissues (meninges) that surround the brain and spinal cord, or Reye syndrome.

When a toddler vomits, it is important to make sure he or she has not swallowed medicines, household liquids, or other poisons. Look around the house for empty containers and spills. There may be pills in your child's vomit, or the vomit may have an unusual appearance, color, or odor. For more information, see the topic Poisoning.

A child who falls down and forcefully hits his or her head or belly may vomit because of an injury to those areas. Check your child's body for bruises and other injuries.

Treatment

Babies and children younger than 1 year old need special attention if they continue to vomit. They can quickly become dehydrated. It is important to replace lost fluids when your child is vomiting. Watch your child carefully, and pay close attention to the amount of fluid he or she is able to drink. Look for early symptoms of dehydration:

  • The mouth and eyes may be drier than usual.
  • The urine may be less than usual.
  • He or she may feel cranky, tired, or dizzy.

Also, be sure to notice the color of the vomit, and count the number of times your child vomits. If your child vomits so frequently that you can't get him or her to drink or vomits every time he or she takes a drink, the risk of dehydration is greater.

Check your child's symptoms to decide if and when your child should see a doctor.

Check Your Symptoms

Is your child nauseated or vomiting?
Nauseated means you feel sick to your stomach, like you are going to vomit.
Yes
Nausea or vomiting
No
Nausea or vomiting
How old are you?
Less than 3 months
Less than 3 months
3 to 11 months
3 to 11 months
12 months to 3 years
12 months to 3 years
4 to 11 years
4 to 11 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Does your child have moderate to severe belly pain?
Yes
Abdominal pain
No
Abdominal pain
Has your child had a head injury in the past 24 hours?
Yes
Head injury in past 24 hours
No
Head injury in past 24 hours
Has your child swallowed or inhaled something that might be poisonous?
Yes
Ingested known or suspected poison
No
Ingested known or suspected poison
Do you think your baby might be very sick?
A sick baby probably will not be acting normally. For example, the baby may be much fussier than usual or not want to eat.
Yes
Baby might be very sick
No
Baby might be very sick
How sick do you think your baby is?
Extremely sick
Baby is very sick (limp and not responsive)
Sick
Baby is sick (sleepier than usual, not eating or drinking like usual)
Do you think your baby may be dehydrated?
Yes
May be dehydrated
No
May be dehydrated
Are the symptoms severe, moderate, or mild?
Severe
Severe dehydration
Moderate
Moderate dehydration
Mild
Mild dehydration
Do you think your child may be dehydrated?
It can be harder to tell in a baby or young child than it is in an older child.
Yes
May be dehydrated
No
May be dehydrated
Are the symptoms severe, moderate, or mild?
Severe
Severe dehydration
Moderate
Moderate dehydration
Mild
Mild dehydration
Is your child having trouble drinking enough to replace the fluids he or she has lost?
Little sips of fluid usually are not enough. The child needs to be able to take in and keep down plenty of fluids.
Yes
Unable to drink enough fluids
No
Able to drink enough fluids
Does your child have symptoms of a serious illness?
Yes
Symptoms of serious illness
No
Symptoms of serious illness
Do you think your baby has a fever?
Yes
Fever
No
Fever
Did you take a rectal temperature?
Taking a rectal temperature is the only way to be sure that a baby this age does not have a fever. If you don't know the rectal temperature, it's safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious.
Yes
Rectal temperature taken
No
Rectal temperature taken
Is it 100.4°F (38°C) or higher?
Yes
Temperature at least 100.4°F (38°C)
No
Temperature at least 100.4°F (38°C)
Within the past week, has your child had an injury to the abdomen, like a blow to the belly or a hard fall?
Yes
Abdominal injury within past week
No
Abdominal injury within past week
Do you think the nausea or vomiting may be caused by an injury or by abuse?
Yes
Nausea or vomiting may be caused by injury or abuse
No
Nausea or vomiting may be caused by injury or abuse
Do you think your child has a fever?
Yes
Fever
No
Fever
Did you take your child's temperature?
Yes
Temperature taken
No
Temperature taken
How high is the fever? The answer may depend on how you took the temperature.
High: 104°F (40°C) or higher, oral
High fever: 104°F (40°C) or higher, oral
Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Mild: 100.3°F (37.9°C) or lower, oral
Mild fever: 100.3°F (37.9°C) or lower, oral
How high do you think the fever is?
High
Feels fever is high
Moderate
Feels fever is moderate
Mild or low
Feels fever is mild
How long has your child had a fever?
Less than 2 days (48 hours)
Fever for less than 2 days
From 2 days to less than 1 week
Fever for more than 2 days and less than 1 week
1 week or longer
Fever for 1 week or more
Does your child have a health problem or take medicine that weakens his or her immune system?
Yes
Disease or medicine that causes immune system problems
No
Disease or medicine that causes immune system problems
Does your child have shaking chills or very heavy sweating?
Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off the child or soaking through his or her clothes.
Yes
Shaking chills or heavy sweating
No
Shaking chills or heavy sweating
Has there been any blood, yellow or green liquid (bile), or what looks like coffee grounds in the vomit?
Sometimes a food (like yellow squash or green peas) can be the reason for the vomit's color. But unless food is the obvious cause, vomit that is yellow, green, or bloody may be a sign of a serious medical problem.
Yes
Blood or yellow or green liquid (bile) in vomit
No
Blood or yellow or green liquid (bile) in vomit
Has your baby vomited after 2 feedings in a row?
Vomiting is not the same as spitting up. Spitting up usually occurs right after eating, happens easily without any effort by the child, and is not forceful or painful like vomiting can be.
Yes
Vomited after 2 feedings in a row
No
Vomited after 2 feedings in a row
Has your child vomited?
Yes
Vomiting
No
Vomiting
Has there been any blood, yellow or green liquid (bile), or what looks like coffee grounds in the vomit?
Sometimes a food (like yellow squash or green peas) can be the reason for the vomit's color. But unless food is the obvious cause, vomit that is yellow, green, or bloody may be a sign of a serious medical problem.
Yes
Blood or yellow or green liquid (bile) in vomit
No
Blood or yellow or green liquid (bile) in vomit
How much blood or bile has your child vomited?
Vomit is mostly blood or bile, or contains what looks like coffee grounds
Vomit is mostly blood or bile, or contains material that looks like coffee grounds
Streaks of blood or a small amount of bile
Streaks of blood or small amount of bile in vomit
Is your child vomiting all the time, again and again, or is your child vomiting just now and then?
How often the child vomits is important. Repeated vomiting is more serious than vomiting that occurs now and then.
All the time
Repeated vomiting
Now and then
Occasional vomiting
Has your child been vomiting for more than 4 hours?
Yes
Vomiting for more than 4 hours
No
Vomiting for more than 4 hours
Has your child been vomiting for more than 8 hours?
Yes
Vomiting for more than 8 hours
No
Vomiting for more than 8 hours
Has the vomiting gone on for more than 3 days?
Yes
Vomiting for more than 3 days
No
Vomiting for more than 3 days
Has the vomiting gone on for more than 1 week?
Yes
Vomiting for more than 1 week
No
Vomiting for more than 1 week
Is your child starting to vomit more often, or is the vomiting getting more severe?
Yes
Occasional vomiting is becoming more frequent or severe
No
Occasional vomiting is becoming more frequent or severe
Does your child have diabetes?
Yes
Diabetes
No
Diabetes
Is your child's diabetes getting out of control because your child is sick?
Yes
Diabetes is affected by illness
No
Diabetes is affected by illness
Do you and your child's doctor have a plan for what to do when your child is sick?
Yes
Diabetes illness plan
No
Diabetes illness plan
Is the plan helping get your child's blood sugar under control?
Yes
Diabetes illness plan working
No
Diabetes illness plan not working
How fast is it getting out of control?
Quickly (over several hours)
Blood sugar quickly worsening
Slowly (over days)
Blood sugar slowly worsening
Has your baby been vomiting for more than 2 days?
Yes
Vomiting for more than 2 days
No
Vomiting for more than 2 days
Has your child vomited after 2 or more feedings or meals in a row?
Yes
Vomited after 2 or more feedings/meals in a row
No
Vomited after 2 or more feedings/meals in a row
Does your child spit up often?
Spitting up is not the same as vomiting. It usually occurs right after eating, happens easily without any effort by the child, and is not forceful or painful like vomiting can be.
Yes
Problems spitting up
No
Problems spitting up
Has your child been spitting up more than usual?
This can mean more often than usual or larger amounts than usual.
Yes
Spitting up is increased in amount or more frequent
No
Spitting up is increased in amount or more frequent
Does spitting up occur with other symptoms, such as diarrhea, constipation, or fussiness?
Yes
Spitting up occurs with other symptoms
No
Spitting up occurs with other symptoms
Has your child been spitting up for more than 1 month?
Yes
Spitting up for more than 1 month
No
Spitting up for more than 1 month
Do you think that a medicine could be causing the nausea or vomiting?
Think about whether the nausea or vomiting started after you began using a new medicine or a higher dose of a medicine.
Yes
Medicine may be causing nausea or vomiting
No
Medicine may be causing nausea or vomiting
Is your baby colicky?
Yes
Colicky
No
Colicky
Poisoning
Head Injury, Age 4 and Older
Head Injury, Age 3 and Younger
Abdominal Pain, Age 11 and Younger
Nausea and Vomiting, Age 12 and Older

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Colic is an extreme type of crying in a baby between 3 weeks and 3 months of age. All babies cry, but a colicky baby will cry for hours at a time, no matter what you do.

During a crying episode, a colicky baby may cry loudly and continuously and be hard to comfort. The baby may get red in the face, clench the fists, and arch his or her back or pull the legs up to the belly.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

A baby that is extremely sick:

  • May be limp and floppy like a rag doll.
  • May not respond at all to being held, touched, or talked to.
  • May be hard to wake up.

A baby that is sick (but not extremely sick):

  • May be sleepier than usual.
  • May not eat or drink as much as usual.

It is easy for your diabetes to become out of control when you are sick. Because of an illness:

  • Your blood sugar may be too high or too low.
  • You may not be able take your diabetes medicine (if you are vomiting or having trouble keeping food or fluids down).
  • You may not know how to adjust the timing or dose of your diabetes medicine.
  • You may not be eating enough or drinking enough fluids.

An illness plan for people with diabetes usually covers things like:

  • How often to test blood sugar and what the target range is.
  • Whether and how to adjust the dose and timing of insulin or other diabetes medicines.
  • What to do if you have trouble keeping food or fluids down.
  • When to call your doctor.

The plan is designed to help keep your diabetes in control even though you are sick. When you have diabetes, even a minor illness can cause problems.

Symptoms of serious illness may include:

  • A severe headache.
  • A stiff neck.
  • Mental changes, such as feeling confused or much less alert.
  • Extreme fatigue (to the point where it's hard for you to function).
  • Shaking chills.

Symptoms of serious illness in a baby may include the following:

  • The baby is limp and floppy like a rag doll.
  • The baby doesn't respond at all to being held, touched, or talked to.
  • The baby is hard to wake up.

Many nonprescription and prescription medicines can cause nausea or vomiting. A few examples are:

  • Antibiotics.
  • Antidepressants.
  • Aspirin, ibuprofen (such as Advil or Motrin), and naproxen (such as Aleve).
  • Medicines used to treat cancer (chemotherapy).
  • Narcotic pain medicines.
  • Vitamins and mineral supplements, such as iron.

Starting a new medicine or increasing the dose can cause nausea and vomiting. Nausea and vomiting also may mean that there is too much medicine in your body, even if you took it properly.

Severe dehydration means:

  • The child's mouth and eyes may be extremely dry.
  • The child may pass little or no urine for 12 or more hours.
  • The child may not seem alert or able to think clearly.
  • The child may be too weak or dizzy to stand.
  • The child may pass out.

Moderate dehydration means:

  • The child may be a lot more thirsty than usual.
  • The child's mouth and eyes may be drier than usual.
  • The child may pass little or no urine for 8 or more hours.
  • The child may feel dizzy when he or she stands or sits up.

Mild dehydration means:

  • The child may be more thirsty than usual.
  • The child may pass less urine than usual.

Severe dehydration means:

  • The baby may be very sleepy and hard to wake up.
  • The baby may have a very dry mouth and very dry eyes (no tears).
  • The baby may have no wet diapers in 12 or more hours.

Moderate dehydration means:

  • The baby may have no wet diapers in 6 hours.
  • The baby may have a dry mouth and dry eyes (fewer tears than usual).

Mild dehydration means:

  • The baby may pass a little less urine than usual.

You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For example:

  • You may feel tired and edgy (mild dehydration), or you may feel weak, not alert, and not able to think clearly (severe dehydration).
  • You may pass less urine than usual (mild dehydration), or you may not be passing urine at all (severe dehydration).

Babies can quickly get dehydrated when they lose fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For example:

  • The baby may be fussy or cranky (mild dehydration), or the baby may be very sleepy and hard to wake up (severe dehydration).
  • The baby may have a little less urine than usual (mild dehydration), or the baby may not be urinating at all (severe dehydration).

Temperature varies a little depending on how you measure it. For children up to 11 years old, here are the ranges for high, moderate, and mild according to how you took the temperature.

Oral (by mouth), ear, or rectal temperature

  • High: 104°F (40°C) and higher
  • Moderate: 100.4°F (38°C) to 103.9°F (39.9°C)
  • Mild: 100.3°F (37.9°C) and lower

Armpit (axillary) temperature

  • High: 103°F (39.5°C) and higher
  • Moderate: 99.4°F (37.4°C) to 102.9°F (39.4°C)
  • Mild: 99.3°F (37.3°C) and lower

Note: For children under 5 years old, rectal temperatures are the most accurate.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:

  • Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
  • Steroid medicines, which are used to treat a variety of conditions.
  • Medicines taken after organ transplant.
  • Chemotherapy and radiation therapy for cancer.
  • Not having a spleen.

If you're not sure if a child's fever is high, moderate, or mild, think about these issues:

With a high fever:

  • The child feels very hot.
  • It is likely one of the highest fevers the child has ever had.

With a moderate fever:

  • The child feels warm or hot.
  • You are sure the child has a fever.

With a mild fever:

  • The child may feel a little warm.
  • You think the child might have a fever, but you're not sure.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Repeated vomiting: The child vomits nearly every time he or she tries to drink something. This type of vomiting makes it impossible to keep down any fluids or solid food, which greatly increases the chance of becoming dehydrated. The child has an even greater chance of dehydration if he or she also has diarrhea.

Occasional vomiting: Some young children vomit every once in a while for no clear reason. This usually does not increase the risk of dehydration or other problems as long as the child can keep down fluids between vomiting. The more time that passes between episodes of vomiting, the less serious it probably is. But if the vomiting continues, it may be important to find the cause.

Home Treatment

Newborns and babies younger than 1 year of age

Don't wait until you see signs of dehydration in your baby. These signs include your baby being thirstier than usual and having less urine than usual.

  • If you breast-feed your baby, nurse him or her more often. Offer each breast to your baby for 1 to 2 minutes every 10 minutes.
  • If you use a bottle to feed your baby, increase the number of feedings to make up for lost fluids. The amount of extra fluid your baby needs depends on your baby's age and size. For example, a newborn may need as little as 1 fl oz (30 mL) at each extra feeding, while a 12-month-old baby may need as much as 3 fl oz (90 mL) at each extra feeding.
  • Ask your doctor if you need to use an oral rehydration solution (ORS) if your baby still isn't getting enough fluids from formula or the breast. The amount of ORS your baby needs depends on your baby's age and size. You can give the ORS in a dropper, spoon, or bottle.
  • If your baby has started eating cereal, you may replace lost fluids with cereal. You also may feed your baby strained bananas and mashed potatoes if your child has had these foods before.

Children ages 1 through 11

  • Make sure your child is drinking often. Frequent, small amounts work best.
  • Allow your child to drink as much fluid as he or she wants. Encourage your child to drink extra fluids or suck on flavored ice pops, such as Popsicles. Note: Do not give your child fruit juice or soda pop. Fruit juice and soda pop contain too much sugar and not enough of the essential minerals (electrolytes) that are being lost. Diet soda pop lacks calories that your child needs.
  • Cereal mixed with milk or water may also be used to replace lost fluids.
  • If your child still is not getting enough fluids, you can try an oral rehydration solution (ORS).
  • Gradually start to offer your child regular foods after 6 hours with no vomiting.
    • Offer your child solid foods if he or she was eating solids before. Offer crackers, toast, broths, mild soups, mashed potatoes, rice, and breads to your older child.
    • Avoid high-fiber foods, such as beans, and foods with a lot of sugar, such as candy or ice cream.

For older children

After talking to your child's doctor, you may give your older child an over-the-counter antinausea medicine, such as meclizine (Antivert or Bonine) or dimenhydrinate (Dramamine). Follow the package instructions carefully.

If your child also has diarrhea, try home treatment for diarrhea.

Symptoms to watch for during home treatment

Call your child's doctor if any of the following occur during home treatment:

  • Dehydration develops. Signs include your child being thirstier than usual and having less urine than usual.
  • Your child's vomiting returns or becomes severe.
  • Blood or yellow or green liquid (bile) is present in your child's vomit.
  • Your child's vomiting does not get better.
  • Your child's symptoms become more severe or frequent.

Prevention

Babies

It is normal for babies to spit up after a feeding. Vomiting after a single feeding may happen sometimes and does not mean your baby has a problem. Repeated vomiting after feedings is more of a concern. The following tips may help your baby spit up less often. If this advice does not help, talk with your doctor.

  • Feed your baby smaller amounts at each feeding.
  • Feed your baby slowly.
  • Hold your baby during feedings.
    • Do not prop your baby's bottle.
    • Do not place your baby in an infant seat during feedings.
  • Try a new type of bottle or use a nipple with a smaller opening to reduce air intake.
  • Limit active and rough play after feedings.
  • Try putting your baby in different positions during and after feeding.
  • Burp your baby frequently during feedings.
  • Consider talking to your doctor about starting your baby on hypoallergenic formula. About 1% of babies who spit up are allergic to milk protein.
  • Do not add cereal to formula without first consulting your child's doctor.
  • Do not smoke when you are feeding your baby. Children who are exposed to tobacco smoke are more likely to develop illnesses that cause vomiting. If you smoke, quit. If you can't quit, do not smoke when you are holding or feeding your baby or when you are in the house or the car. For more information, see the topic Quitting Smoking.
  • Consider getting your child the rotavirus vaccine.rotavirus vaccine.(What is a PDF document?)

Toddlers

  • Limit active and rough play after feedings.
  • Teach your children how to wash their hands well, especially if there is an illness in the house.

If you use child care, talk to the caregivers about their program or policies for sick children.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your child's condition by being prepared to answer the following questions:

  • Did you have problems during your pregnancy or with the delivery of this child?
  • What do you think might be causing your baby's vomiting?
  • Has your child been exposed to someone with a similar illness?
  • How long has the vomiting been going on?
  • Does your child have any other symptoms, such as fever, belly pain, or diarrhea?
  • Has your child had a recent fall or injury?
  • How many times has your child vomited? How much fluid is lost each time?
  • Is your child able to hold down fluids?
  • What does the vomit look like?
    • Is there any blood or yellow or green liquid (bile) in the vomit?
    • Did you find any unusual liquids or pills in the vomit?
  • What does the vomit smell like?
  • What prescription or nonprescription medicines are in your home?
  • Did your child's symptoms start after eating at a restaurant? Has anyone else who ate there with you become ill?
  • Has your child recently eaten raw or undercooked seafood?
  • Do you think your child may have eaten any contaminated food?
  • Has your child recently visited a foreign country?
  • Has your child recently drunk water from a lake, stream, or private well?
  • Has your child had any known exposure to toxic materials, chemicals, or fumes?
  • Does your child have any health risks?

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Current as of June 4, 2014

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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