Baby or Toddler Throwing Up: Stomach Bug Care and Rehydration

Spit-up or vomiting?

Spit-up is an easy flow of milk, often with a burp, in a content baby (see the hiccups, spit-up and reflux guide). Vomiting is forceful, usually upsets the child, and often comes with illness. Most vomiting in babies and toddlers is a viral stomach bug: vomiting for 1-2 days, often followed by diarrhea for several more.

Rehydrating, step by step

1. After vomiting, give the stomach a short rest of about 15-30 minutes.
2. Start with tiny amounts: a teaspoon (5 mL) of oral rehydration solution (ORS) every few minutes, by spoon or syringe.
3. Breastfed babies: nurse for a few minutes at a time, more often.
4. Formula-fed babies: ORS first for a few hours if vomiting is frequent, then small amounts of regular-strength formula.
5. If it stays down for an hour, slowly increase the amount.
6. If your child vomits again, rest and restart with small sips.
7. Once vomiting slows, offer usual foods in small portions. No special diet is needed.

Skip juice, soda and sports drinks. Popsicles made from ORS can help a reluctant toddler.

Comfort and safety

• Hold your child upright or on their side while they vomit so they don't breathe it in.
• Babies still sleep on their backs on a flat surface. Healthy babies can clear their airway.
• Keep a bucket, towels and a change of clothes near the bed. Layer a crib sheet over a waterproof pad for quicker night changes.
• Don't give anti-nausea medicine unless prescribed. Doctors sometimes give one for older babies and toddlers who can't keep fluids down.

Watch for dehydration

Fewer wet diapers, dry mouth, no tears, sunken eyes or soft spot, or unusual sleepiness. See the diarrhea and dehydration guide for details.

When it may not be a stomach bug

• Projectile vomiting after every feed at about 2-8 weeks can be pyloric stenosis.
• Episodes of sudden severe crying with legs pulled up, between 3 months and 3 years, can be intussusception, a bowel problem that needs fast care.
• Vomiting after a head bump, or with a stiff neck or severe headache.
• A possible swallowed medicine, button battery, magnet or household product (call Poison Control at 1-800-222-1222).
• Vomiting without diarrhea that lasts more than a day can be a sign of another infection, such as a urinary tract or ear infection.

Stopping the spread

Norovirus spreads easily and survives on surfaces. Wash hands with soap and water, clean with a bleach-based cleaner, wash soiled laundry on hot, and keep sick children and adults out of the kitchen for a couple of days after symptoms stop.

When to check in

• Ask the pediatrician if vomiting lasts more than 24 hours, or 12 hours in a young baby.
• Call right away, day or night, for a rectal temperature of 100.4°F (38°C) or higher in a baby under 3 months. See them the same day for blood or coffee-ground material in vomit, or a child who can't keep any fluids down.
• If vomit is green, the belly is swollen and hard, or your child is very sleepy or hard to wake, call 911 or go to the ER.