Vomiting and Diarrhea

Article Translations: (Spanish) (Hmong)

What are they? 

Vomiting (throwing up) and diarrhea (a sudden increase in the number and looseness of stools or bowel movements) are symptoms that are present in many illnesses, including non-infectious ones. Commonly, they may be caused by a virus or bacteria (germ) in food or by food that "disagrees" with the stomach (too spicy, too rich, or new foods). Vomiting can also be caused by a blockage in the bowel (intestines). 

Vomiting usually stops in 6 to 24 hours. With a viral illness, diarrhea often starts 8 to 12 hours after the start of vomiting and may continue for 5 to 7 days. 

Vomiting and diarrhea can cause dehydration (getting "dried out"), which can be dangerous. The younger the child, the more quickly dehydration can happen.  

How should I care for my child? 

Watch for signs of dehydration. If your child shows signs of dehydration, call their doctor. 

Signs of mild to moderate dehydration: 

• no urine (or wet diaper) for 8 hours 
• dry lips 
• the inside of their mouth is dry and sticky 

Signs of severe dehydration: 

• no tears when crying 
• the inside of the mouth is very dry (no saliva) 
• eyes seem sunken 
• weight loss 
• listless (has little energy) 
• hard to awaken 
• confused 
• weakness (hard to sit up or walk, floppy) 

What is the home treatment for a child without dehydration?

Give liquids to replace the fluid lost by vomiting and/or diarrhea. If your baby is younger than 3 months, call your clinic or on-call service to decide how serious the problem is, and whether you should have your baby seen by the doctor. 

Best liquids to use: 

Breast-fed infants who have only vomited 1 or 2 times should continue nursing. You may need to nurse for a shorter time on each breast and feed more often. If vomiting occurs 3 or more times, stop nursing and give an oral rehydration solution (such as Pedialyte® or another brand) as instructed below. 

Pump your milk if unable to nurse and store it in the freezer to give to your baby later. As soon as your baby is able to keep liquids down, go back to your usual nursing schedule. (Note: It is okay to nurse even if you are sick—your milk has antibodies that may help your baby heal faster.) 

For formula-fed infants, give an oral rehydration solution such as Pedialyte® (you can buy them at some grocery stores and most drug stores without a prescription). Give 1 to 2 ounces (30 to 60 milliliters) every 10 to 15 minutes. If your baby cannot keep this amount down, try less (1 to 2 teaspoons) and give it more often. If your baby cannot keep these small amounts down, call the clinic. 

If your baby does keep the liquid down, slowly increase the amount and the time between each feeding. Double the amount in each feeding every hour. Continue frequent feedings until your baby can keep a normal amount down. 

A common mistake is to give too much liquid, rather than slowly increasing the amount. This can lead to more vomiting. 

Some infants older than 6 months refuse the oral rehydration solution. In that case, continue small amounts of their regular liquids (except fruit juices). Start giving 1 or 2 ounces per feeding and feed more often. Do not give plain water. 

It may not help to change formulas, but your doctor or nurse practitioner may suggest a trial. 

Avoid fluids high in sugar and sweeteners such as fruit juices, soda, gelatin (Jell-O® or another brand) or diet drinks, because the type of sugar in them can make symptoms worse. Adult sport drinks have a different balance of salt and sugar and other electrolytes than what young children need. However, these work well for older children. 

For older children, or those who do not take the oral rehydration solution, you can use: 

• flavored Pedialyte®, especially the frozen form 
• small amounts of their usual fluids 

Add solid foods as soon as the vomiting improves. Give your infant’s or child's regular foods as tolerated, but in smaller amounts and more often than usual meals. Don’t give medicines for diarrhea or vomiting unless your doctor recommends it. 

Adding Foods: 

Infants: Give baby food as tolerated. 

Toddlers and older children—start with: 

• applesauce, bananas 
• cooked carrots 
• complex carbohydrates, such as cereal, potatoes, rice, yogurt 
• lean meats such as chicken, turkey 
• other fruits and vegetables as tolerated 
• avoid fatty or greasy foods (fried foods, bacon, sausage), as they are harder to digest and may increase symptoms 

Give larger amounts as tolerated. Children can often be back on their regular diet within 24 hours after vomiting stops. 

How can I prevent the spread of diarrhea and vomiting? 

Make sure everyone in the family washes their hands well after using the toilet and changing diapers, and before preparing or eating food.  Wash your baby’s or toddler’s hands often to prevent them from spreading germs to people or objects around the house. 

What can I do to keep my child comfortable? 

Diarrhea can cause the skin to become very sore. A diaper rash can develop. If a diaper rash does develop, you may use barrier creams. Call your doctor if there are concerns.  

Using extra-absorbent diapers with snug (but not too tight) leg bands, plastic pants, or cloth diapers inside disposable diapers may cut down on some of the clean-up. These methods help with the mess, but they may make it hard to know when there is stool against the skin. Be sure to change diapers more often than usual. 

Encourage older children to clean themselves well after every stool. You may need to help them more than usual while diarrhea is present. Rinsing with a squirt bottle of warm water and patting dry may decrease discomfort and improve cleaning. 

When should I call the clinic? 

Call if your child: 

• has signs of mild to moderate dehydration (see above) 
• refuses to drink 
• is less than 12 months old and vomits clear liquid drinks 3 or more times 
• vomits for more than 8 hours 
• is unable to progress to solid foods within 24 hours 
• has diarrhea that becomes worse or does not improve after 48 hours (2 days) 
• has blood, mucus, or pus appear in the diarrhea 
• has a few loose or mushy stools per day for longer than 2 weeks 
• is an older infant or child and has a fever above 104° F 
• has dizziness when standing up  
• is vomiting and has diabetes 
• takes daily medicines 
• has had recent abdominal surgery or injury 

When should I go to the Emergency Room? 

Bring your child to the Emergency Room if your child: 

• has signs of severe dehydration (see above) 
• is a baby younger than 2 months and has a fever 100.4° F or above rectally 
• has a constant severe stomachache, stiff neck, or headache 
• has vomit that looks like coffee grounds 
• has vomit that is red or green, and food given just before was not the same color 
• vomits like "water shooting straight out of a hose" 

Questions? 

This sheet is not specific to your child but provides general information.  If you have any questions, please call the clinic. 

Reviewed 2/2024 

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