Vomiting In Normal Children
Quite a few small infants as well as older children
vomit once or more during the course of the day but remain
otherwise well. It seems that they have a rather more sensitive
vomiting centre in the brain. They vomit even if they seem to
have no other problem. They vomit if they are excited, unhappy, fearful or because of any illness. The vomiting becomes
less frequent as these children grow and then stops without
any special treatment.
Parents must not show undue anxiety when the child vomits. This may make matters worse.
A typical scene is witnessed when a child is getting late for his school
bus and his mother wants him to finish his glass of milk. He
tries to gulp it in a hurry and brings most of it up. Giving
solids before the child is ready for them, or forced feeding in
children are other common causes. The child should never be forced to
eat or drink in such situations. Older children should be
put to bed early at night so that they get up well in advance,
before the school bus arrives. If the child hates to drink milk
in the morning, do not insist that he has it.
Even if there is enough time, an occasional child does
not want to eat anything in the morning. In general, I would
like children not to go to school on an empty stomach. I
would suggest offering the child some fruit or fruit juice. If
he refuses that, give him some healthy snacks (fresh
fruits, dry fruits, nuts, or a sandwich made with whole wheat bread)
to take to school for his short recess.
Some infants swallow a lot of air while feeding and
bring out milk quite often after a feed. Some are helped by
burping. Others vomit as soon as they are lifted up to be burped. Check the position of these babies at the breast so that
they have enough of the areola (the dark portion of the
breast behind the nipple) in their mouth.
If bottle-fed, change over to cup feeding (which is
better than spoon feeding). If you must bottle-feed, check that
the hole in the nipple is not too small.
Some babies bring up curds after each feed or after some
of the feeds. They are otherwise well — thriving, active
and passing urine normally. This is called possetting and is normal. Nothing should be attempted to set it right.
Maybe you can buy some more bibs!
However, consult your doctor if your child is dehydrated following vomiting. He may like to
treat the cause and
give intravenous fluids if required.
A dehydrated child looks sick and passes too little,
dark urine. You should be equally concerned if he shows lack
of alertness or behaves as if he were not fully conscious.
This could be due to meningitis.
Three Common Causes Needing Attention
- Obstruction of the intestinal tract due to surgical conditions
- Head injury
Obstruction Of The Intestinal Tract Due To Surgical Conditions
Consider the possibility of an intestinal obstruction if
a small baby brings up green vomit. Do not give this child
anything to eat or drink and take him to your doctor. Such children
may also have distension of the abdomen and dehydration.
In a condition called pyloric stenosis, the child may
present with white projectile vomiting and failure to gain
An intussusception and appendicitis discussed under
Abdominal Pain are
also to be kept in mind.
An infection of the stomach and intestine (gastroenteritis) is the commonest infection
resulting in diarrhoea and
vomiting. This is discussed at length in the chapter on Home Remedies.
Suspect hepatitis (see Hepatitis)
if your toddler or older child has developed marked loss of appetite and passes
high coloured urine.
A small baby who stops taking his feeds, vomits and
looks unwell may have septicaemia — a serious type of
infection. It may or may not be accompanied by fever.
An infant showing the above symptoms with a bulging soft spot (anterior fontanelle) on the
head, with or without stiffness of the neck, may have meningitis, needing
urgent treatment (see Meningitis).
Children with whooping cough also tend to vomit after a severe bout of coughing. Ear and
urinary infection may
also be associated with vomiting.
Seasonal vomiting, probably due to a viral infection,
may affect a large number of children in a city. These
children do not have any of the serious features mentioned above and settle down
with symptomatic treatment of the vomiting
in 2 to 3 days.
Some other causes of vomiting are poisoning, travel sickness, gastro-oesophageal reflux and
migraine. Some children with allergy to artificial milk can get a
severe attack of vomiting with even small intake of milk. Many drugs,
like antibiotics and drugs for diarrhoea and other illnesses,
may cause vomiting.
One vomit after a head injury in a child who is
otherwise well can be ignored. But the doctor must be consulted if the
child continues to vomit.
Blood In Vomit
Some children bring out a streak of blood with a
forceful vomit. This need not cause undue anxiety. But if it
becomes a common feature, your doctor would consider the
possibility of conditions like hiatus hernia. Of course, if bleeding is
also noticed from other sites, a bleeding disorder has to be
kept in mind.
TREATMENT: Treatment depends upon the cause. No drug for vomiting should be given without the advice of
your doctor. If your doctor decides to give a medicine to
check vomiting, do not give anything by mouth for an hour. By
then, the drug will have started acting and you can give small amounts of a drink or the child’s favourite fruit or
food. Do not give too much at a time. Give small amounts but offer
them at frequent intervals.
A child may occasionally get a peculiar side effect due
to the commonly used drugs for vomiting. He may roll his
eyes upwards and his whole body may go into tonic spasms. Fortunately, almost all cases recover after the drug is
stopped. Some patients are given another medicine to counteract the effect of the earlier drug.
7 March, 2016