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Vomiting in Children

Dr. Rajendra Kumar

Most children vomit occasionally for trivial reasons and need not cause undue alarm. Some children are more prone to vomiting. Vomiting due to benign causes may not lead to dehydration or cause loss of weight. But, recurrent vomting in children should be taken proper care of and medical advice should be sought for the same.


Vomiting is a sign of some underlying disorder. It is a term that indicates expulsion of the contents of the stomach forcibly. Vomiting is usually preceded by nausea or retching. Vomiting can occur when the lining of the intestines or stomach is irritated by an infection. Usually a virus causes the infection. Diarrhea and vomiting can drain water and salts from your child. These need to be replaced to prevent your child from becoming dehydrated (dry).

Vomiting in children may result from allergic sensitivity to various foods, undue distention of abdomen from overeating or indigestion. Worm infestation may also lead to vomiting.

Vomiting is also a sign of raised intracranial pressure, which could result from trauma, hydrocephalous or brain tumour.

In the newborn child, vomiting could be caused due to irritation of the stomach due to swallowed blood, amniotic fluid or drugs. Faulty feeding techniques may also result in vomiting.

In an infant overfeeding, excessive crying and starting solids before the child has learnt to chew can result in vomiting. Infections such as meningitis and congenital abnormalities are also a cause of vomiting. Congenital abnormalities and infections can also cause vomiting.

Another important cause of vomiting is the cow’s milk allergy. Symptoms of cow’s milk allergy manifest within the initial few months of life usually a few weeks after the initial exposure to cow’s milk. It occurs due to cow’s milk protein intolerance.Clinical intolerance to milk usually subsides by the second year of life.

In older children, the causes of vomiting could include sudden excitement, fear, anxiety, unpleasant sight or odour, motion sickness, disturbed parent child relationship and post nasal dripping. Amongst organic causes, viral or bacterial infections could lead to vomiting. Irritant food or drugs and food poisoning are also the possible causes.

Management
Most children vomit occasionally for trivial reasons and need not cause undue alarm. Some children are more prone to vomiting. Vomiting due to benign causes may not lead to dehydration or cause loss of weight. Recurrent and severe vomiting results in disturbances of fluids and electrolytes.

Children with recurrent and persistent vomiting associated with the following features should be taken to a physician and proper medical care should be given.

  • Persistent vomiting with or without fever
  • Excessive drowsiness
  • Failure to suck, swallow or demand feeds
  • Marked abdominal distention
  • Severe dehydration
  • Persistent headache or convulsions
  • Dehydration should be treated promptly with oral electrolytes and the child should be kept on a nutritious diet.

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