Most vom­it­ing is caused by a viral infec­tion of the gas­troin­testi­nal tract (stom­ach flu) or after hav­ing eat­en some­thing that upsets the diges­tive tract. The most sev­er vom­it­ing usu­al­ly stops with­in six to 24 hours, but chil­dren can vom­it inter­mit­tent­ly for three to five days. Dietary changes usu­al­ly speed up recov­ery, but the main goal is to pre­vent dehydration.

Do not offer any­thing by mouth until the first episode of vom­it­ing ceas­es. This may last one to two hours, or until the stom­ach is emp­ty. After the ini­tial episode of vom­it­ing stops, wait about 30 – 60 min­utes and then slow­ly start with clear liq­uids for the next eight hours. For infants, use elec­trolyte solu­tions like Pedi­alyte™, Kao-elec­trolyte™ or Resol™. In old­er chil­dren, you may use flat soft drinks (colas, gin­ger ale or lemon-lime), Kool-Aid™, Gatorade™, pop­si­cles or weak tea. Avoid diet sodas.

Start with one tea­spoon at a time (for infants) or one table­spoon (for old­er chil­dren) of clear liq­uids every 10 to 15 min­utes. If tol­er­at­ed, then increase to two spoon­fuls every 10 min­utes for the next hour, then three the fol­low­ing hour, etc. If your child vom­its dur­ing the process, wait 30 to 60 min­utes and start over with one spoon­ful. If vom­it­ing occurs dur­ing the night, allow the child to sleep and start liq­uids slow­ly the next morning.

For the next eight hours, in addi­tion to clear flu­ids, you may intro­duce bland foods like saltines, toast, clear soups, rice and mashed pota­toes. Most chil­dren can return to a nor­mal diet after 24 hours or when their appetite returns.

For breast-fed babies, after the ini­tial vom­it­ing stops, try breast feed­ing small­er amounts than usu­al, more fre­quent­ly and lim­it the baby to only one breast at a feed­ing. If vom­it­ing con­tin­ues then put the baby on Pedi­alyte or Kao-elec­trolyte for eight hours as out­lined above. After­wards, resume breast feed­ing with small­er, more fre­quent feed­ings for the next eight hours.