Vomiting: How to Care for Your Infant

Vomiting in infants usually isn't serious. It's important to keep your baby hydrated while the vomiting lasts, though, which usually is about 24 hours. Vomiting can happen for many reasons, like illnesses, formula allergies, reflux, or in rare cases, a blockage in the intestines. But most of the time, vomiting in babies and kids is due to gastroenteritis. Gastroenteritis usually happens because a virus infects the stomach and intestines. Children with gastroenteritis also might have diarrhea and a fever.

Do NOT give your baby:

• plain water, sports drinks, soda, or full-strength (undiluted) juice

• medicines for nausea, diarrhea, or vomiting, unless told to by the health care provider

For breastfed infants:

• Continue breastfeeding unless the health care provider tells you otherwise.

• Try breastfeeding more often, but for shorter amounts of time (5–10 minutes every 1–2 hours). You can breastfeed normally if your baby goes 8 hours without vomiting.

• If your infant is still vomiting the smaller amounts of breast milk, see the information below about using an oral electrolyte solution and call your health care provider.

• After your infant has been on oral electrolyte solution for 8 hours without vomiting, breastfeed for 5–10 minutes every 2 hours and slowly work up to your normal feeding schedule.

For formula-fed infants:

• Don't give your infant any formula for now.

• Follow the instructions below to give your infant an oral electrolyte solution.

• After your infant has been on oral electrolyte solution for 8 hours without vomiting, give ½–1 ounces of formula every 2 hours and slowly work up to your normal feeding schedule.

Oral electrolyte solution instructions:

• Give an oral electrolyte solution to help your child stay hydrated. This solution is a special liquid with the right amount of water and electrolytes (sodium and potassium) for babies and kids. Brand names include Pedialyte® and Enfalyte®, and many stores also have a store brand. You can buy it at drugstores or supermarkets without a prescription.

Here's what to do:

• Give your baby small amounts of the oral electrolyte solution every few minutes. You can use an oral syringe, a medicine cup, or a kitchen spoon. 

• Start with 5–10 ml of oral electrolyte solution.

• After 1 hour, if your baby is doing well, increase the amount a little bit and give 15–20 ml.

• Continue to give this amount every few minutes for the next hour or two until your child is peeing as usual.

• If your child vomits again, start this process over. 

• Don't keep your infant on oral electrolyte solution for more than 24 hours.

For all babies:

• If your baby already eats solids and hasn't vomited in 8 hours, offer small amounts of bland foods, such as cereal, crackers, applesauce, or bananas. After 24 hours without vomiting, go back to your baby's regular diet.

• Wash your hands well and often. Viruses that cause vomiting are contagious and can spread from person to person.

• Keep your baby out of child care until he or she hasn't vomited for 24 hours.

Your baby:

• continues to vomit for more than 12 hours

• needs electrolyte solution for more than 24 hours

• is crying a lot and can't be calmed down

• seems to have belly pain or other pain

• has a fever

• has a hard, firm belly

• has forceful vomiting immediately with every feeding

Your baby:

• appears to be dehydrated; signs include a dry or sticky mouth, crying with few or no tears, more than 4 to 6 hours without a wet diaper, sunken eyes or soft spot on the head, decreased alertness, rapid breathing, and/or severe sleepiness

• has vomit that's bright green, red, or brown

• has a soft spot on the head that's bulging out

• is very tired and hard to wake up

Is spitting up the same as vomiting? No. Spitting up is when there is an easy flow of liquid out of a baby's mouth, often with a burp. Spitting up doesn't cause discomfort. Vomiting is when a baby throws up liquid or solids forcefully. Vomiting is uncomfortable and often happens a few times.

Does my child need an antibiotic for gastroenteritis? No, your child doesn't need an antibiotic. The health care provider believes a virus caused your child's illness and antibiotics don't work against viruses. Viral illnesses usually go away on their own without special medicines. Help your child feel comfortable and stay hydrated while the infection gets better.