Most vomiting is caused by a viral infection of the gastrointestinal tract (stomach flu) or after having eaten something that upsets the digestive tract. The most sever vomiting usually stops within six to 24 hours, but children can vomit intermittently for three to five days. Dietary changes usually speed up recovery, but the main goal is to prevent dehydration.
Do not offer anything by mouth until the first episode of vomiting ceases. This may last one to two hours, or until the stomach is empty. After the initial episode of vomiting stops, wait about 30 – 60 minutes and then slowly start with clear liquids for the next eight hours. For infants, use electrolyte solutions like Pedialyte™, Kao-electrolyte™ or Resol™. In older children, you may use flat soft drinks (colas, ginger ale or lemon-lime), Kool-Aid™, Gatorade™, popsicles or weak tea. Avoid diet sodas.
Start with one teaspoon at a time (for infants) or one tablespoon (for older children) of clear liquids every 10 to 15 minutes. If tolerated, then increase to two spoonfuls every 10 minutes for the next hour, then three the following hour, etc. If your child vomits during the process, wait 30 to 60 minutes and start over with one spoonful. If vomiting occurs during the night, allow the child to sleep and start liquids slowly the next morning.
For the next eight hours, in addition to clear fluids, you may introduce bland foods like saltines, toast, clear soups, rice and mashed potatoes. Most children can return to a normal diet after 24 hours or when their appetite returns.
For breast-fed babies, after the initial vomiting stops, try breast feeding smaller amounts than usual, more frequently and limit the baby to only one breast at a feeding. If vomiting continues then put the baby on Pedialyte or Kao-electrolyte for eight hours as outlined above. Afterwards, resume breast feeding with smaller, more frequent feedings for the next eight hours.