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Vomiting Management in Children

See also
1. Breast Feeding with Infant Vomiting
2. Vomiting in Children
3. Triage of Children with Vomiting
4. Vomiting Causes in Children
Management: First 8 hours after Vomiting
1. Avoid solid foods and medications for 8 hours
2. Keep child comfortable by lowering fever
  1. Cool compresses to forehead
  2. Tylenol Suppository
3. Sweet drink for first hour (1-2 tsp every 20 minutes)
  1. Corn or coke syrup
  2. Honey (if age >1 year old)
4. Clear fluids (see-through) after the first hour
  1. Fluids
    1. Pedialyte
    2. Gatorade
    3. Ginger ale or 7-Up (stir until bubbles dissipate)
    4. Ice chips for children older than 3 years old
  2. Amounts
    1. Start 1 teaspoon to 1 tablespoon every 20 minutes
    2. Double amount of fluid every hour
  3. Repeat Vomiting management
    1. Rest stomach for one hour
    2. Restart fluid amount at 1 teaspoon to 1 tablespoon
  4. Pitfalls
    1. Avoid allowing children to drink ad lib
    2. Risk of repeat Vomiting from drinking too rapidly
Management: After 8 hours of no Vomiting
1. Gradually transition to normal diet
  1. Infant
    1. Bananas
    2. Rice Cereal
    3. Applesauce
  2. Children
    1. Toast
    2. Soda crackers
    3. Honey on bread
    4. Bland soups (chicken with stars)
    5. Rice
    6. Mashed potatoes
2. Normal diet may be resumed after 24 hours
3. Medications should be given after meals
Management: Antiemetics
1. General
  1. Avoid if possible
  2. Administer only in clinic or emergency room
  3. Not effective in stopping childhood Viral Vomiting
2. Indications
  1. Drug intoxication
  2. Antineoplastic medications (Chemotherapy)
  3. Radiation Therapy
  4. Increased Intracranial Pressure
3. Adverse effects
  1. Lethargy
  2. Extrapyramidal Side Effects
  3. Possible Reye's Syndrome association

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.