Vomiting In Toddlers: Causes And Preventive Steps

Vomiting In Toddlers

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It happens once, then twice and soon he is throwing up randomly at any time. Vomiting in toddlers is quite unsettling for the parents and things worsen when it occurs quite frequently. There are numerous reasons why your little one throws up – from gastroenteritis to motion-sickness. The reason may not seem apparent, but when you look closely, the real cause could be right in front of you. MomJunction helps you identify the cause and then take remedial measures. We also tell you what you can do to prevent such situation.

15 Causes Of Vomiting In Toddlers

Your baby can feel nauseated and eventually vomit, due to several reasons. Here are the most common reasons why toddlers may vomit:

1. Stomach infection:

Stomach infection is the leading cause of vomiting in toddlers, and among a plethora of stomach infections, viral gastroenteritis is the most common.

Viral gastroenteritis is also known as stomach flu and stomach bug. The infection causes severe stomach cramps resulting in excruciating pain in the abdominal cavity, which can make the toddler regurgitate the stomach contents and throw up. It may cause the body temperature to rise, leading to fever with vomiting in toddlers. Fever is not always prevalent, though.

Symptoms: Vomiting could be accompanied by diarrhea, abdominal cramps, nausea, and fever. Diarrhea may cause dehydration that could lead to a headache.

2. Intestinal infection:

Your toddler may throw up when his intestines contract an infection. There are numerous pathogens, bacteria, and viruses that can infect intestines and vomiting is a symptom of their existence. Infections caused by bacteria such as salmonella and staphylococcus cause vomiting and diarrhea (1). Your tot may or may not have a fever.

Symptoms: Symptoms are same as stomach infection viz. vomiting with diarrhea, abdominal cramps, and fever.

3. Appendicitis:

Appendicitis is rare in infants and occurs in kids and teens of 10 to 20 years of age (2). An infected appendix can result in nausea and vomiting in toddlers, accompanied by excruciating pain in the abdomen, loss of appetite and a low fever. The infected appendix sends pain impulses throughout the nerves of the abdominal cavity, which cause the stomach muscles to move abnormally causing nausea and vomiting.

Symptoms: Piercing pain in the lower right side of the abdomen. There could be a constant sense of nausea along with vomiting. The toddler may also develop a fever.

[ Read: Appendicitis In Toddlers ]

4. Pediatric hernia:

A hernia happens when the bowel (small or large intestine) slips out of the abdominal cavity causing discomfort and increasing the risk of infection. Toddlers can be affected with two types of hernia: inguinal hernia and umbilical hernia (3). An inguinal hernia occurs when the bowel moves into the inguinal canal leading to a swollen bump near the groin. An umbilical hernia is when the abdominal wall right behind the navel is damaged, causing a portion of the small intestine to slip out of the damaged area. In either case, the hernia creates nerve pressure in the abdominal cavity, making the toddler throwing up frequently.

Symptoms: Hernias are generally visible in the form of a bump in the lower abdomen or groin area. Symptoms apart from vomiting include constant nausea, abdominal cramps, and constipation.

5. Ingestion of toxic substance:

Toddlers have a tendency to put things in their mouth. Vomiting can be the result of putting toxic substances, right from wild plants to soaps and detergents, in their mouth. These substances irritate the stomach lining causing the muscles to contract and expel the contents. In the case of ingestion of toxic substances, the toddler may vomit but have no other symptoms such as fever or diarrhea.

Symptoms: In this case, symptoms are subjective and depend on the potency and quantity of the toxic substance consumed by the toddler. Vomiting could generally be accompanied by nausea and abdominal pain.

6. Food allergy:

If your toddler is puking, usually after eating a particular food, then he may be allergic to that food. Vomiting is one symptom of food allergy (4). Throwing up white chunks of milk is a sign of milk allergy or lactose intolerance. Lactose intolerance is the inability of the small intestine to digest milk due to insufficient presence of the enzyme lactase that is necessary for milk digestion.

Symptoms: Vomiting is one of the many symptoms of a food allergy. Other symptoms could be abdominal pain, skin hives and swollen lips and eyelids.

7. Acid reflux and bile reflux:

Acid reflux occurs when the esophageal sphincter, between esophagus and stomach, opens abnormally and lets some of the stomach’s contents, including acid, move upwards through the food pipe. The irritation caused by the acid to the esophageal lining causes nausea and vomiting (5).

Sometimes, the toddler might throw up bile, which is a greenish-yellow fluid. This is caused by bile reflux. Bile reflux happens when the pyloric valve between the stomach and small intestine malfunctions, allowing bile to move from the small intestine to the stomach. It then irritates the stomach lining causing the muscles to contract and expel the bile outwards through the esophagus in the form of vomit (6).

Acid reflux and bile reflux can be distinguished by the color of the expelled liquid. If the toddler has acid reflux and bile reflux together then it becomes easier for the bile to come out of the stomach with the refluxed stomach acid.

Symptoms: Vomiting along with burning sensation in the upper abdominal region and esophagus, and constant dull pain in the abdomen.

8. Overeating and over-swallowing of air:

Overeating or swallowing of excess air during feeding can lead to vomiting (7). This may happen when the nipple of the feeding bottle has a big feeding hole. The toddler may thus consume more milk than needed causing his tiny stomach to fill till the brim and then throw up. Swallowing excess air due to poor positioning of the nipple in the mouth can also make the baby have nausea and vomiting.

Symptoms: Along with vomiting, there could be a stomach ache, and bloating in the abdomen area with heavy burping.

[ Read: Food Poisoning In Toddlers ]

9. Indigestion:

Indigestion can lead to vomiting due to the accumulation of undigested food in the stomach (8). The toddler will throw up undigested food hours after eating, indicating that the food has not been digested. This could happen when the little one has consumed food too quickly, overeaten or eaten food that is too spicy or rich in grease and oil.

Symptoms: Symptoms are subjective here. Generally, vomiting could be accompanied by pain in the stomach.

10. Certain medication:

Certain medicines also make toddlers feel sick and vomit, especially if he consumes them on an empty stomach. Vomiting can also be a known side-effect of some medicines.

Symptoms: Individual medicines have specific symptoms. Vomiting could be one of them.

11. Motion sickness and headaches:

If your toddler suddenly throws up with no symptoms or history of illness, then it could be that he suffers from motion sickness. Motion sickness can be an indicator of vertigo, a condition where an individual feels the sense of a shifting balance. This happens when the toddler is in a situation (like a roller-coaster) where there is a constant shift of equilibrium and orientation. This quick shift of balance overloads the inner ear, which is responsible for maintaining the body’s balance and makes it send erratic signals to the brain. This disorients the brain leading it to send distress nerve signals to the stomach muscles and making the toddler vomit. Other brain-related conditions such as headaches can also cause vomiting.

Symptoms: Dizziness, loss of balance, and a headache.

12. Ear infections:

Ear infections can induce vomiting along with dizziness (9). The symptoms here are similar to motion sickness but in this case, the condition is caused by a bacterial or viral infection of the middle or inner ear. Labyrinthitis is one such inner ear infection that can lead to vomiting along with vertigo. Similar to motion sickness, the inner ear sends disoriented signals to the brain (due to infection), which in turn stimulates the abdominal muscles to contract and throw up.

Symptoms: Dizziness, imbalance along with severe nausea and vomiting.

13. Pneumonia:

Pneumonia is the inflammation of the alveoli of the lungs due to bacterial or viral infection. A cough and trouble in breathing are the major symptoms of this condition but it can also manifest through vomiting (10). Vomiting and constant nausea are often triggered by a cough. It may also be triggered as a general effect of the infection since pneumonia leads to loss of appetite that makes the toddler feel sick every time he eats something.

Symptoms: Vomiting is a less common symptom of pneumonia and is accompanied by more common symptoms such as a cough, cold, fever and shortness of breath.

14. Certain infections and diseases:

Vomiting is one of the several symptoms of infections such as septicemia and meningitis (11).

Symptoms: Vomiting with a severe headache, body pain, fever and cold shivers.

15. Rumination syndrome:

This is the rarest of all the reasons for vomiting. Rumination syndrome is a rare and underdiagnosed condition in which an individual can regurgitate the contents of the stomach unconsciously without any pain or trouble (12). Unlike the classic case of vomiting, rumination does not make the toddler feel uneasy or cause any discomfort or heartburn. It is a natural contraction of abdominal muscles to push the food upwards, which is beyond the control of the toddler. This generally happens about 30 minutes after the last meal and does not create any secondary symptoms and problems. The expelled food tastes fresh and the toddler will usually chew and swallow it back. It is a key trait that differentiates rumination from vomiting, in which case the expelled food is stale, semi-digested and not fit to swallow.

There is no known cause for rumination, and it is speculated to occur due to problems in the nervous system. Since the cause is unknown and the condition rare, rumination syndrome is often misdiagnosed as some other reason for vomiting. Treatment of rumination syndrome is physiotherapy involving muscle training to promote the normal movement of abdominal muscles. The doctor may also prescribe some oral medication to subdue the involuntary urge of the nerves to stimulate regurgitation.

[ Read: Stomach Pain In Toddlers ]

What Is Dry Heaving In Toddlers?

Retching, also referred to as dry heaving, is the act of dry vomiting when the abdominal and mouth muscles contract like they do in vomiting but the toddler does not expel any substance from the mouth.

Toddlers dry-heave after they have a bout of vomiting or when they are just feeling nauseated. The reasons for dry-heaving are similar to vomiting, with the added cause that your toddler may retch when he is feeling stressed or uncomfortable.

When To Rush Your Toddler To A Doctor?

Sometimes, your toddler’s vomiting could indicate a serious health ailment. You need to take your tot to a doctor under the below circumstances:

  1. There is blood in vomit: If your toddler is throwing up blood, then it could indicate a serious problem. He could be vomiting blood due to a severe stomach infection, bruised esophageal lining due to acid reflux, inflammation in the small intestine, and many other reasons. You must take your little one to a pediatrician as soon as possible.
  1. Vomiting is accompanied by high fever and acute diarrhea: As mentioned earlier, vomiting, accompanied by diarrhea, can be dehydrating. If your toddler has a high fever, then it can make the condition even more distressful. A quick medical response is the best way to alleviate the condition.
  1. The vomit is always green or black in color: If the vomit is greenish in color, then it can be due to bile reflux, which could be an indicator of a serious intestinal infection or even ulcer. Black and dark brown vomit could be an indicator of blood clots due to an erstwhile internal bleeding. It can happen due to reasons ranging from milk allergies to deficiency of vitamin K.
  1. The abdomen is swollen: A visibly swollen tummy could be due to severe infection or fluid retention caused by a fundamental problem. Either way, it is an alarming sign and should be brought to swift medical attention.
  1. The toddler is fatigued and has weakened pulse: These symptoms will be accompanied by decreased alertness and a general disorientation. The toddler will urinate fewer times in the day, maybe once in eight hours. These all can be signs of severe dehydration due to loss of water and electrolytes through vomiting. The condition is aggravated if the toddler is also suffering from diarrhea.

Vomiting could be spontaneous or acute depending on the severity of the problem.

Treatment For Vomiting In Toddlers

The treatment for your toddler’s vomiting is subjective as the medicine for his vomiting will depend on the underlying problem. Generally, vomiting is a symptom of various problems. Therefore, a doctor will look for the other signs to diagnose the condition.

Similarly, precautions also depend on the underlying condition.

[ Read: Dehydration In Toddlers ]

Precautions To Prevent Vomiting

However, you can follow some generic safety measures to try and avoid the conditions that lead to vomiting.

  1. Always provide clean and hygienic food: Maintain cleanliness at home and your kitchen. Clean the utensils you use for your toddler and sterilize them. Prepare your baby’s food under hygienic conditions because eating clean food is one way of preventing exposure to disease-causing bacteria and viruses.
  1. Limit the quantity of acid reflux and indigestion-causing foods: Foods such as chocolates, processed foods, and citrus fruits may cause acid reflux. If your toddler is prone to acid reflux, then limit the quantity of these foods. Also, ensure he eats slowly and never overeats, to prevent indigestion.
  1. Learn the side-effects of medicines before giving it to your baby: Medicines may have side-effects when consumed on an empty stomach. When giving your baby such medicines, inquire from the doctor about all the probable effects on the baby’s digestion.
  1. Manage your toddler’s food allergy: If you know your toddler is allergic to a certain food, then take every step to prevent him from eating that food. Avoid the products that have the food as an ingredient.
  1. Avoid situations that may cause motion sickness: Do not take your motion-sick toddler for a ride on a mini-roller coaster in a theme park. Also, avoid other triggers like traveling through a long twisty road, a super fast elevator or anything that might make him throw up.
  1. Keep your baby hydrated: Vomiting can be dehydrating and if it is accompanied with diarrhea, then it can quickly deplete the body’s water reserves. Keep a steady inflow of water and electrolytes to prevent the risk of severe dehydration.

How To Make Your Toddler Feel Better?

If the precautions do not work, and your toddler is feeling sick, then you would want to make every effort to ease his condition. Here are some ways you can follow to make him feel better:

  1. Do not force your little one to eat: Do not force your toddler to eat anything when he seems visibly distressed due to constant vomiting. It is okay if he skips a meal since he is doing so because of the discomfort caused by vomiting and the underlying problem. Solid food may not be the right choice as his digestive system is not in a condition to digest it.
  1. Provide plenty of fluids: Feed him fluids since vomiting and diarrhea drain the body of water and electrolytes like sodium and potassium. Give your toddler fluids such as dissolved oral rehydration salts (ORS) in small sips or with a tablespoon. This should rehydrate him while also providing him with supplementary calories until he can eat solid food. Avoid giving milk and juices since they can be difficult to digest.
  1. Make your toddler rest: Ample rest helps the body in dealing with the infection that may have induced the vomiting.
  1. Follow the prescribed course of medicines: The doctor will generally prescribe a course of medicines, which will involve multiple drugs. Follow the course without deviation to prevent a relapse of the infection.

[ Read: Diarrhea In Toddlers ]

What To Feed A Vomiting Toddler?

When the baby vomits, the nutrients you have just tried to put into his body are all gone. Moreover, he will simply refuse to eat after this unpleasant experience. In such a scenario, how will you make sure he is getting enough energy? Follow these steps on feeding your toddler when he is vomiting:

  1. Stick to water and electrolytes initially: For hours after your little one last puked, give him small amounts of water and electrolyte solution. Do not attempt to feed him solid food any time soon since it can worsen his condition.
  1. Start with liquid diet: Once your baby seems better, you can start feeding him liquid food such as vegetable or chicken stock with added salt and no added condiments. You can also give him rice stock but avoid lentil stock since certain lentils can be hard to digest. Tender coconut water works well as it contains minerals and amino acids.
  1. Give bland solid food: Once he is fit enough to eat solid food, begin by giving him simple and bland foods. You can give him mashed boiled rice with some vegetable or chicken stock. Boiled lentils and vegetables can be good but stick to vegetables easy to chew. Do not give high fiber vegetables such as spinach and beans yet, since he is still recovering. You may blend and strain vegetables to make thin easy-to-digest soups. You can begin giving solid diet eight hours since your little one vomited.
  1. Once recovered, feed normally: Once your baby is responding well to the elementary diet and it has been 24 hours since he vomited, you can introduce him to solid foods. If your toddler consumes milk, you can reintroduce it but along with other food such as plain bread. Start with small quantities of milk of not more than 100ml. Once everything seems fine, let your toddler have regular food that he always used to eat.

Remember, your toddler can speak a lot of basic phrases, therefore, he will let you know when he is hungry and wants regular solid food. Do not force him to eat something or overwhelm him with food right after he has recovered. Giving some extra time for his body to get back on track will help prevent another round of vomiting.

Vomiting in toddlers can be a nasty thing but is generally a symptom of a health problem. Treating the condition can help your bundle of joy recover faster.

We hope you found this information useful. You can share your experiences with toddlers and vomiting by leaving us a comment below.

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Rohit Garoo

Rohit Garoo took writing as a profession right after finishing his MBA in Marketing. Earlier he graduated with a Bachelor’s degree in Botany & Zoology from the autonomous St. Xavier’s College in Mumbai. Rohit has also done a Stanford University certification course on breastfeeding. This botanist-zoologist turned writer excels at life sciences, and at MomJunction he writes everything about pediatrics and maternal care. In between writing and being overly curious, he spends time cooking, reading, and playing video games. LinkedIn profile – linkedin.com/in/rohit-garoo-263115aa
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