Vomiting is the forceful expulsion of stomach and intestinal contents through the mouth. The mechanism is strong contractions of the abdominal muscles against a closed stomach outlet.

It is commonly associated with nausea. Vomiting itself is not an illness but a sign of an underlying illness.

By contrast, regurgitation or reflux is the effortless spitting up of several mouthfuls of stomach contents in children under 15 months.

Most vomiting in children is caused by gastroenteritis, which may be due to bacteria, parasites or viruses. Bacterial causes include Campylobacter, Shigella, E. coli, and Salmonella.

Salmonella can be acquired through contact with reptiles such as lizards and turtles.

Parasitic causes include Giardia and Cryptosporidium parvum. Both of these are commonly acquired via contaminated water.

Viral causes include Norwalk virus and Rotavirus. In children, viruses are the most common cause for gastroenteritis.

Epidemics of viral diarrhea are usually spread through contaminated water or food or through the fecal-oral route.

If the vomiting is caused by gastroenteritis, the onset is often sudden with a decrease in appetite, nausea, abdominal cramps and commonly associated with diarrhea.
The child may also have muscle aches and general body weakness.

Vomiting with fever may indicate a bacterial infection rather than a viral or parasitic infection.

Other causes of vomiting can be acute infections outside of the gastrointestinal system such as upper respiratory tract infections and urinary tract infections.

Among the non-infectious causes of vomiting there is acute appendicitis, cholecystitis (an inflamed gallbladder) or intestinal obstruction.

If your child is a diabetic, uncontrolled diabetes may lead to a condition called diabetic ketoacidosis which results in vomiting, among many other signs and symptoms. Some drugs may cause nausea and vomiting.

These includes histamine, phenytoin (an anti-epileptic drug), drugs used in chemotherapy, aspirin, some antibiotics and ipecac.

Food poisoning can also cause vomiting. In infants, repeated projectile vomiting may indicate a bowel obstruction such as pyloric stenosis, which is narrowing of a part of the stomach.

Treatment plan
Bed rest is recommended with access to the toilet or bedpan if necessary. When the nausea is mild or has finished, feed the child some water, fruit juice or both.

Even if the child is vomiting, he or she should take small but frequent sips of these fluids. When the child can tolerate fluids without vomiting, bland foods such as cereal, bananas and toast can be added to the diet gradually. The greatest risk of vomiting due to gastroenteritis is dehydration.

It is important to alert health experts in case child has diarrhea, refuses fluids, is not urinating, cries without tears, has a dry mouth, or seems confused because these are signs of a worsening condition.

Other alarming conditions occur in case vomiting persists more than two days, which increases the risk of dehydration. Depending upon the degree of dehydration, your child may have to be admitted to hospital for intravenous administration of fluids, and, if a bacterial cause is present, possibly an appropriate antibiotic.

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