Parent’s Guide: Vomiting & Diarrhea

🚩Is it Serious? (The “Red Flags”)

Most vomiting is viral, but you must rule out serious causes immediately.

Sign: Forceful, projectile vomiting that shoots across the room.

Behavior: The baby is immediately hungry afterwards (“Hungry Vomiter”).

Action: This is a blockage at the bottom of the stomach requiring surgery. Call the doctor immediately.

If vomit contains blood or bile (bright green), seek care immediately.

Stomach pain that exists even when not vomiting (could indicate appendicitis).

Vomiting after a fall or head hit requires urgent evaluation.

Age: Baby is < 12 weeks and has vomited 2+ times.
Dehydration: No urine > 8 hours, no tears, dry mouth.
Appearance: Blood or Green Bile in vomit.
Pain: Severe stomach pain when not vomiting.
Duration: Vomiting everything for > 8 hours despite using the “small sips” method.
Underlying Condition: Child has Diabetes, head injury, or weak immune system.

The younger the child, the faster they dehydrate. You must monitor their hydration status closely.

⚠️ Signs of Dehydration (Call Doctor Now):

The stomach cannot handle large amounts of fluid. The key is small amounts, frequently.

Do Not Stop: Continue breastfeeding but reduce the time.
Technique: Nurse for 4-5 minutes every 30 to 60 minutes.
If Vomiting Continues: Switch to pumped milk via spoon/syringe (1–2 teaspoons every 5 minutes).

First Vomit: Offer regular formula in smaller amounts.
Repeated Vomiting: Switch to Oral Rehydration Solution (ORS) like Pedialyte for 8 hours.
Technique: Give 1–2 teaspoons (5–10 mL) every 5 minutes. After an hour, advance to 1 Tablespoon every 15 minutes.
Goal: After 4 hours without vomiting, slowly return to formula.

Fluids:
- Vomiting Alone: Water or ice chips are fine.
- Vomiting + Diarrhea: Use Pedialyte or Half-Strength Gatorade (half water/half Gatorade). Avoid juice or soda (makes diarrhea worse).
Technique: Offer 1 Tablespoon every 5 minutes.
Solids: Stop all solid foods for 8 hours. Restart with bland, starchy foods (crackers, bread, rice) once vomiting stops.

⛔ No OTC Drugs: Stop giving over-the-counter medicines for 8 hours; they can irritate the stomach.
⛔ No Ibuprofen: Ibuprofen (Advil/Motrin) upsets the stomach. Use Acetaminophen (Tylenol) suppositories only if there is a high fever.
Sleep Helps: Sleep often empties the stomach and resets the nausea. Let the child sleep.