The main cause of toddler vomiting is gastroenteritis. This is a stomach virus that usually goes away in 24 hours. It is also known as the 24 hour bug. There is no known reason why or how one picks it up but being a virus it can be contagious.
Food poisoning is a major cause of vomiting for any age group. Especially in hot weather it’s best to avoid any food that has been sitting around on hot plates in the take away store or on the counter. When food goes off our body nature instinct is to reject it. It does this best via mouth or bowels. Food hygiene is essential in preventing such events from occurring.
Toddler vomiting can also be known as posseting or reflux. This is when a child can vomit their feed after consumption. It can be a regular occurrence. This is mainly due to the fact that the valve between their stomach and oesophagus is weak. Posseting is more common and of less concern. This is when milk feed is regurgitated after a feed with little sign of discomfort or pain. This tends to go away once a child is on solids as the toddler matures so does the valve.
Reflux is when stomach acid may leak into oesophagus along with the milk and cause inflammation and discomfort. Many babies have what doctors called “silent reflux” as there is no regurgitation of milk or stomach acid out of the child’s mouth. This acid or milk usually only go up as far as the oesophagus or throat. Reflux does cause discomfort to the toddler and may disrupt their feed and even their sleep. A simple sign could be the child crying during or after a feed. They may arch their backs kick or throw their arms around. This is definitely not a comfortable happy toddler.
Whether it is gastroenteritis or food poisoning the main treatment is the same, fluid hydration. Electrolyte supplementation is recommended for all ages as this will prevent dehydration. Most parents think it’s important to stop the vomiting but it’s the effect of vomiting that medical professions are more worried about. When a toddler vomits, they lose a lot of fluid and sweat or may even have a fever. This will lead to dehydration in the child and the worse consequence is the child requiring an IV drip in the hospital. As parents and careers the main objective is to make sure the child is well hydrated.
Electrolyte supplements come in ready prepared liquids, powdered sachets which need to be mixed in water and ice blocks. Pick whatever works best.
It is always best to avoid tap water for children under the age of one. Cooled down boiled water is best for this age group as their bowels have not gained the acidophilus culture it requires to protect themselves against nasty invasions.
When electrolyte supplements are not available you can mix 2 teaspoons of glucose powder with 240ml water or 30ml of cordial in 180ml water.
Small sips of fluid will better hydrate the child than big gulps as gulping may trigger more vomiting.
It is best to avoid any dairy or fatty food once vomiting settles for 24 hours. Slowly re-introduce starch foods like rice, pasta, potato and bread.
Posseting or Reflux does NOT require electrolyte supplements.
Posseting does not cause any discomfort to the child and involves milk being brought up after a feed. This usually settles around 6 months old but may vary from child to child. It is of no concern if the child appears happy, alert, is putting weight on and is full after the feed.
The best prevention mechanism a parent can do in this situation is to ensure the child has a bib on after the feed. Try to hold the child in an upright position while feeding and have child continue sitting semi-upright for up to 15mins after a feed to help settle the milk.
Try to change the child’s nappy prior to a feed. When changing the child’s nappy place the child on their side rather than elevate their legs when wiping their bottoms. This will ensure no extra pressure is place on the stomach which reduces stomach acid forced up the oesophagus.
Reflux preventions involve the same advice as Posseting along with possible medical treatment. Your doctor may advise you to try thickening your toddler’s feed with a food thickener. Alternatively prescription medications that may reduce the acid produced in the stomach of your toddler or medication that may help empty the stomach and tighten the valve at the top of the stomach may be tried. Discuss appropriate requirements for your toddler with your family doctor.
When to Refer Toddler Vomiting to the Doctor
- If the toddler can’t stop vomiting and is not keeping any fluid or solids down.
- If there is red blood or green tinge to the vomit
- If the toddler is hard to wake when asleep or look limp
- If the toddler has sunken eyes
- If the toddler’s mouth or tongue feels dry
- If the toddler goes 6 hours without a wet nappy or toilet visit
- If the toddler is irritable and can’t be consoled
- If the toddler has a fever that won’t go down with medication
Referral to Doctor when Child is Posseting and has the above signs or :
- if the child is not putting on weight or is losing weight
- if there is a recurrent cough
- if the child is constantly unsettled or crying or resisting feeds