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Vomiting - Causes and management
July 13, 2012 by Dr. Mandar V. Bichu
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Vomiting - Causes and management

A baby or a child throwing up is not a pretty sight. Repeated vomiting in a baby or a child is a symptom which should never be taken lightly. It demands prompt medical attention and evaluation. Let’s find out some more facts about this seriously frightening symptom.


Vomiting in newborn baby and young infants:

One major thing to know in this age-group is to understand the difference between the simple regurgitation (Gastroesophageal Reflux) and vomiting. Vomiting is much more forceful and projectile ejection of entire stomach contents whereas in reflux, small quantity of stomach contents slowly dribbles out.


Gastroesophageal reflux (GER):

There is a sphincter (valve) situated at the lower end of food-pipe which guards against the upward reverse movement of stomach contents. In the early months of life, this valve is slightly lax and plus, any increase in intra-abdominal pressure as during coughing, crying, laughing, moving or defecating can cause this valve to further relax and allows reflux.

Usually the reflux is mild, needs no treatment and it improves with the increasing age and as the baby starts taking semisolids. In severe cases, medicines and even surgery might be needed.


Other important causes:

Feeding errors (wrong feeding position, not burping well after feeds and overfeeding) are common simple causes of vomiting in this age-group. Congenital abnormalities (like congenital hypertrophic pyloric stenosis and metabolic errors), surgical conditions (like intessusception) and significant infection (anywhere in the body!) are more serious causes which need immediate attention and treatment.


Vomiting in toddlers and children:

Common infections (Viral/bacterial gastroenteritis and upper respiratory infections), motion sickness, food intolerance/allergy and medicinal side-effects are a few relatively common causes of repeated vomiting in older children. Serious infections (Meningitis, typhoid, viral hepatitis) and surgical conditions (like appendicitis) are some other unusual causes to consider.


Danger signals in the infant/ child is vomiting:

  1. Sick look
  2. High fever
  3. Lethargy/ Drowsiness
  4. Greenish bile-stained vomiting
  5. Severe abdominal pain/ Headache/Neck-pain or rigidity
  6. Abdominal distention or lump
  7. Severe diarrhea or constipation
  8. Less urination
  9. Bloody stools
  10. Refusal to accept feeds/ fluids
  11. Signs of dehydration


Things to do when the infant/ child is repeatedly vomiting:

  • Don’t stop feeding. In breast-fed babies, breast feeding should be continued as usual. In formula-fed babies, it is better to dilute the formula. In children, semisolid foods (rice kanjee, khichri, soups, mashed fruits, fruit juices and yoghurt) are good options.
  • Don’t stop giving fluids but give them (ORS and similar fluids) as small sips.
  • Just administering anti-vomiting medicines is not the right way of treating it. One must identify and treat the underlying condition causing vomiting.
  • Seek a medical opinion.
  • Sometimes urgent investigations like blood and urine tests and X-rays and Ultrasonography might be necessary to find out the cause of vomiting. 

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