What is vomiting?

Vomiting is a very common symptom in children. It’s one of the most common reasons parents take their child to the doctor.

If your child is vomiting, the contents of their stomach is forced up through their mouth. Vomiting is also known as throwing up or being sick.

Babies often bring up small amounts of food after feeding — it’s known as posseting or reflux. It happens without any effort. This is in contrast to vomiting — which involves strong contractions of the muscles in their stomach.

Babies and children are especially at risk of dehydration when they are vomiting. This is when your child may not be able to take in enough fluids to make up for those lost from vomiting.

Your child may vomit for many different reasons. Viral gastroenteritis (‘gastro’) is the most common cause of sudden vomiting in children. Vomiting from viral gastroenteritis usually clears up in a couple of days.

What symptoms are related to vomiting in children?

Vomiting in children often happens with other symptoms, such as diarrhoea.

Other symptoms that can occur together with vomiting in children are:

• nausea (feeling sick and feeling that you are about to vomit)
• abdominal (tummy) pain
• fever
• headache
• coughing or breathing problems

Children can also projectile vomit. Projectile vomiting is when they vomit out of their mouth so forcefully that it can travel over a metre.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes vomiting in children?

Your child may be vomiting for a short time due to an infection. But vomiting in children can also be very serious or have a longer term cause.

Causes of vomiting in children include the following conditions:

• gastroenteritis
• food poisoning
• poisoning
• COVID-19
• urinary tract infections

Gastroenteritis

Gastroenteritis (also known as ‘gastro’ or a stomach bug) is caused by an infection in the digestive system. This is usually due to a virus, but sometimes it’s bacterial.

Gastroenteritis causes vomiting, diarrhoea, fever and abdominal pain. Gastro is easily spread between people, especially children.

Children and small babies are more likely to get dehydrated from gastroenteritis. If your baby is under 6 months old, and has gastroenteritis see a doctor.

Rotavirus is a common cause of severe gastroenteritis in babies. Your baby can have a free vaccine against this virus as part of the National Immunisation Program.

Older children are more likely to have gastroenteritis caused by norovirus.

Food poisoning

Food poisoning is caused by germs growing in food that has been poorly prepared or stored. The symptoms are the same as those caused by gastroenteritis, but usually more severe.

Your baby or small child could be at risk of dehydration. Take care that they stay hydrated (see below).

Poisoning

Poisoning is most common in young children, who often put things in their mouths.

Many household items are poisonous if swallowed. Symptoms of poisoning include:

• nausea and vomiting
• drowsiness
• seizures
• breathing difficulties

Do NOT attempt to make the child vomit, unless instructed by a medical professional.

Urinary tract infections

Vomiting can be a sign of a urinary tract infection (UTI) in children. They are common in young children. The symptoms of UTIs in children are often vague but can also include:

• fever
• tiredness
• being irritable
• pain when urinating (weeing)
• fewer wees than normal
• smelly urine

COVID-19

Symptoms of COVID-19 in children include:

• cough
• fever
• runny nose
• shortness of breath
• diarrhoea
• nausea and vomiting

Motion sickness

Motion sickness is more common in older children than babies. Car, train and air travel can cause it.

Motion sickness can also be triggered by virtual reality games and amusement park rides.

Appendicitis

Appendicitis causes pain around the navel (belly button) which then moves to the lower right side of the abdomen and becomes sharper.

A child with appendicitis may:

• have worsening tummy pain
• lose their appetite
• vomit
• feel uncomfortable when sitting upright or standing up
• experience pain when moving — they may try to keep very still

Meningitis

Meningitis is an infection and swelling of the membrane that covers the brain and spinal cord. It’s usually caused by a bacterial or viral infection. It’s rare but serious, and can quickly cause death.

Meningitis can cause symptoms such as:

• vomiting
• fever
• headache
• a stiff neck
• avoidance of bright lights (photophobia)
• distinctive skin rash

If your baby has meningitis they may be irritable and have a high-pitched cry. They may arch their back or hold their head back. The baby’s fontanelle (the soft spot on the top of the head) may be swollen and bulge.

Diabetic ketoacidosis

Diabetic ketoacidosis is sometimes the first sign that a child has diabetes. It happens when the body does not have enough insulin to use glucose (sugar) in the blood for fuel. The body breaks down fat instead and produces ketones as a by-product. The ketones make the blood too acidic (ketoacidosis).

Symptoms of diabetic ketoacidosis include:

• dehydration
• vomiting
• breathing fast
• tiredness
• confusion

You may notice that your child is more thirsty than normal and urinates (wees) more often.

Food allergy

A food allergy is more likely to happen in the first year of life, when you try a new food with your child.

If the allergic reaction is severe, the child may have anaphylaxis — a potentially life-threatening emergency. Symptoms of anaphylaxis are:

• breathing difficulties
• swelling of the throat
• wheeze
• collapse

Cow's milk allergy is an example of a food allergy that may cause vomiting in young children.

Other acute medical conditions

These include:

• intussusception (a part of the bowel slides into another part of the bowel)
• bowel obstruction (gut blockage)
• pyloric stenosis (narrowing of the valve between the stomach and the small intestine)
• raised intracranial pressure (pressure inside the skull)

How is the cause of vomiting diagnosed in children?

Your doctor will want to check how long your child has been vomiting. Tell your doctor about any other symptoms that your child has along with vomiting to help with diagnosis.

They will examine your child, and see if there are any signs of dehydration.

Tests that may help your doctor to understand the cause of chronic vomiting include:

• blood tests
• urine tests
• x-ray
• ultrasound
• lumbar puncture

If your child has been vomiting for a while, your doctor may suggest referring your child to a specialist. This could be a gastroenterologist, an allergy expert, a neurologist or a paediatrician.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

When should I take my child to the doctor?

Babies younger than 6 months should always be taken to the doctor if they are vomiting or you think they have gastroenteritis.

If your child has another health condition such as diabetes or epilepsy and they are vomiting they should see a doctor.

When should I get urgent medical care for my child?

Vomiting can be more dangerous in young babies. Here is a guide on when to get medical care for vomiting:

• All babies under 6 months old or weighing less than 8kg.
• Children aged under 3 years who have been vomiting for 12 hours.
• Children aged under 6 years who have been vomiting for 24 hours.
• Children 6 years or more who have been vomiting for 48 hours.

If your child is vomiting and has any of these symptoms, you should take them to the emergency department at your nearest hospital as soon as possible:

• blood in their vomit
• green or brown vomit
• vomiting that is projectile or isn’t stopping
• they can't keep fluids or water down
• severe pain in their abdomen (tummy) or rectum (bottom)
• stiff neck — with or without photophobia (pain when looking at bright lights)
• high fever (over 38.5°C)
• signs of dehydration, such as fewer wet nappies, darker coloured urine, or dry lips and mouth

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How is vomiting treated in children?

Most vomiting episodes in children are due to viral gastroenteritis. This can usually be treated at home.

If your child is dehydrated or is a baby under 6 months take them to the doctor.

Self-care at home

Vomiting will often clear up without any specific treatment. Focus on keeping your child hydrated.

Help them replace any lost minerals and salts by giving oral rehydration solution. You can buy it from a pharmacy or supermarket.

You may be able to care for your child with viral gastroenteritis at home. Vomiting caused by viral gastroenteritis usually gets better in 1-2 days, but the diarrhoea can go on for longer.

Here is some advice for caring for a baby or child aged over 6 months with vomiting due to gastroenteritis:

• Breastfed babies should continue to be breastfed, but more often. Offer milk each time after they vomit. You can also offer them oral rehydration solution or water for the first 12 hours.
• Bottle-fed babies should have their formula replaced with oral rehydration solution or water for the first 12 hours. Then they can have normal formula in small amounts. Give them this more often than normal. They should be offered a drink each time after they vomit.
• Make sure your baby rests.

Here is some advice for caring for an older child with vomiting due to gastroenteritis:

• Give older children small amounts of clear fluids to drink often — about every 15 minutes.
• Oral rehydration solutions are strongly recommended for any child with frequent diarrhoea or vomiting.
• Oral rehydration solution can be chilled or made into ice blocks for a child to suck.
• Don't give your child sports drinks, lemonade or cordial. These can make diarrhoea or dehydration worse.
• Children with gastroenteritis may refuse solid food. This is ok for a day or two, as long as they are still having fluids. You can get them back to eating when they are ready. Start by offering plain foods at first.
• Make sure your child rests.

Don't send them to nursery, day care or school until they have not had a loose bowel motion for at least 24 hours.

If your child is vomiting and you are worried that they are not getting better, seek help from your doctor or pharmacist.

Medicines for vomiting in children

Anti-vomiting medicines (antiemetics) are not generally recommended in children. Do not give your child an antiemetic without health professional advice.

You can give your child oral rehydration solution from the pharmacy.

LOOKING FOR A MEDICINE? — To search by brand name or active ingredient, use the Medicines information search feature.

Other ways that vomiting in children can be treated

Any other specific treatment will depend on the underlying cause of vomiting. Here are some examples:

• Motion sickness in children can often be prevented. If your child is over 2 years they may be able to try medicines. Talk to your doctor or pharmacist about what medicines may be suitable.
• Infections caused by bacteria, such as urinary tract infections, are usually treated with antibiotics.
• Meningitis is treated in hospital. Bacterial meningitis is treated with antibiotics. Viral meningitis is not helped by antibiotics. Your child may also need steroids to reduce swelling on the brain.
• Diabetic ketoacidosis will need to be treated in hospital. This involves safely reversing any dehydration, stabilising blood sugar levels with insulin and closely monitoring your child.
• Surgery is usually needed for conditions where there are blockages or problems in the digestive system — such as appendicitis, bowel obstruction and pyloric stenosis.

Can vomiting in children be prevented?

Gastroenteritis is the most common cause of vomiting in children. It’s highly infectious and can easily spread between children.

You can help stop the spread of gastroenteritis by:

• washing your hands regularly, before food preparation and after going to the toilet or changing a nappy
• practising good food safety
• wearing gloves when cleaning up diarrhoea or vomit — seal these in a plastic bag before putting it in the bin
• keeping your child away from nursery, day care or school until they have not vomited for 24 hours

If your child is vomiting after eating particular foods, speak to your doctor or a dietitian for advice.

There are vaccines available to prevent some causes of vomiting in children, such as rotavirus or meningitis.

Complications of vomiting in children

Whatever the cause of vomiting, you need to ensure that your child doesn’t become dehydrated. This can happen because of the fluids lost when vomiting.

Dehydration in babies or small children can be fatal. Some signs of severe dehydration are:

• less than 4 wet nappies a day for a baby
• dry mouth, tongue and lips
• sunken eyes
• being listless or irritable
• shedding fewer tears when crying

If your child becomes dehydrated, they may need to go to hospital for rehydration. At the hospital they can get fluids via a nasogastric tube, which goes down their nose into their stomach, or intravenously on a drip.

Resources and support

For more information and support, try these resources:

• The Royal Children’s Hospital Melbourne — Kids’ health information.
• The Sydney Children’s Hospitals Network — Fact sheets.

Learn about food allergy symptoms at Nip allergies in the Bub.

Find information on how to introduce solid foods to babies for allergy prevention.

For resources in languages other than English, visit The Royal Children’s Hospital Melbourne — Gastroenteritis.

If you need advice on what to do for your child, call healthdirect on 1800 022 222 to speak with a registered nurse, 24 hours, 7 days a week.

Pregnancy, Birth and Baby has a helpful list of resources. Visit Who can I call for information and advice?