Vomiting With Diarrhea  
Back to Index

 
          
This Care Guide Covers:

  • Vomiting and diarrhea that occurs together. (Exception: If vomiting is done, use the Diarrhea guide)
  • Vomiting is the forceful emptying (throwing up) of what is in the stomach
  • It's normal for nausea (upset stomach) to come before each bout of vomiting
  • Diarrhea means 2 or more watery or very loose stools. (Reason: 1 loose stool can be normal.)

If not, see these topics
When to Call Your Doctor

Call 911 Now (your child may need an ambulance) If
  • Can't wake up
  • Not moving or too weak to stand
  • You think your child is having a life-threatening emergency
Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Hard to wake up
  • Acts or talks confused
  • Dehydration suspected. (No urine in over 8 hours, dark urine, very dry mouth and no tears)
  • Blood in the stool
  • Blood in the vomit that's not from a nosebleed
  • Bile (green color) in the vomit (Exception: Stomach juice which is yellow)
  • Stomach pain when not vomiting. (Exception: Stomach pain or crying just before vomiting is quite common)
  • Appendicitis suspected. (pain low on right side, won't jump, wants to lie still)
  • Poisoning suspected
  • Age under 12 weeks old with vomiting 2 or more times. (Exception: normal spitting up)
  • Age under 12 months old and vomited Pedialyte 3 or more times
  • Getting Pedialyte (or clear fluids) and vomits all of it for more than 8 hours
  • Weak immune system. (Such as sickle cell disease, HIV, cancer, organ transplant, taking oral steroids)
  • Vomiting a prescription medicine
  • Fever over 104° F (40° C)
  • Age under 12 weeks old with fever. (Caution: Do NOT give your baby any fever medicine before being seen.)
  • You think your child needs to be seen urgently
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen, but not urgently
  • Has vomited for more than 24 hours
  • Fever lasts more than 3 days
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Vomiting is a frequent problem
Parent Care at Home If
  • Mild or moderate vomiting with diarrhea
Causes & Health Information

Causes

Vomiting Scale

Diarrhea Scale

Dehydration: How to Know

Return to School

CARE ADVICE FOR VOMITING WITH DIARRHEA

  1. What You Should Know:
    • Most vomiting is caused by a viral infection of the stomach. Sometimes, mild food poisoning is the cause.
    • Throwing up is the body's way of protecting the lower intestines.
    • Diarrhea is the body's way of getting rid of the germs.
    • When vomiting and diarrhea occur together, treat the vomiting. Don't do anything special for the diarrhea.
    • Here is some care advice that should help.
  2. For Bottlefed Babies, Offer Oral Rehydration Solution (ORS) for 8 Hours:
    • ORS is a special fluid that can help your child stay hydrated. You can use Pedialyte or the store brand of ORS. It can be bought in food or drug stores.
    • If vomits once, keep on regular formula.
    • For more than once, offer ORS for 8 hours. If you don't have ORS, use formula.
    • Spoon or syringe feed small amounts. Give 1-2 teaspoons (5-10 ml) every 5 minutes.
    • After 4 hours without throwing up, double the amount.
    • Return to Formula. After 8 hours without throwing up, go back to regular formula.
    • Return to Solid Foods. If over 4 months old and after 8 hours without vomiting, add solids. Start with cereals. Then, slowly add other baby foods.
    • Return to normal diet in 24-48 hours.
  3. For Breastfed Babies, Reduce the Amount Per Feeding:
    • If vomits once, nurse 1 side every 1 to 2 hours.
    • If more than once, nurse for 5 minutes every 30 to 60 minutes. After 4 hours without throwing up, go back to regular nursing.
    • If continues to vomit, switch to ORS (such as Pedialyte). Do this for 4 hours.
    • Spoon or syringe feed small amounts of ORS. Give 1-2 teaspoons (5-10 ml) every 5 minutes.
    • After 4 hours without throwing up, return to regular feeding at the breast. Start with small feedings of 5 minutes every 30 minutes. As your baby keeps down the smaller amounts, slowly give more.
  4. For Older Children (over 1 Year Old), Offer Small Amounts of Clear Fluids For 8 Hours:
    • ORS. Vomiting with watery diarrhea needs ORS (such as Pedialyte). If refuses ORS, use half- strength Gatorade.
    • Give small amounts. Use 2-3 teaspoons (10-15 ml) every 5 minutes.
    • After 4 hours without throwing up, increase the amount.
    • After 8 hours without throwing up, go back to regular fluids.
    • Return to Solid Foods. After 8 hours without vomiting, add solid food.
      • Limit solids to bland foods. Starchy foods are easiest to digest.
      • Start with crackers, bread, cereals, rice, mashed potatoes, noodles.
      • Return to normal diet in 24-48 hours.
  5. Do Not Give Medicines:
    • Stop using any drug that is over-the-counter for 8 hours. Reason: Some of these can make vomiting worse.
    • Fever: Mild fevers don't need to be treated with any drugs. For higher fevers, you can use an acetaminophen (Tylenol) suppository. This is a form of the drug you put in the rectum. Ask a pharmacist for help finding this product. Do not use ibuprofen. It can upset the stomach.
    • Call your doctor if: Your child vomits a drug ordered by your doctor.
  6. Return to School:
    • Your child can return to school after the vomiting and fever are gone.
  7. What to Expect:
    • Moderate vomiting usually stops in 12 to 24 hours.
    • Mild vomiting (1-2 times per day) with diarrhea may last a little longer. It can continue off and on for up to a week.
  8. Call Your Doctor If:
    • Vomits all clear fluids for more than 8 hours
    • Vomiting lasts more than 24 hours
    • Signs of dehydration occur
    • Diarrhea becomes severe
    • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/1/2012

Last Revised: 1/13/2013

Content Set: Child Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.