Kids and throwing up: Should you worry

Kids Health: “Stomach Flu,” “Food Poisoning,” “Concussion.”

Why Is My Child Throwing Up With No Fever?

Throwing up is no fun for kids. But it can worry you, too. A kid who’s vomiting but doesn’t have a fever could be dealing with any number of things. Knowing what else to look for can help you narrow down the reasons for your child’s upset stomach –and get their the treatment they need.

Stomach Flu

This isn’t the same as influenza (the flu). It’s the term people use when they’re talking about an illness called gastroenteritis. Most of the time, gastroenteritis is caused by a virus like rotavirus or norovirus. But you can also get it from bacteria like E. coli or salmonella. Although norovirus can sometimes cause a low-grade fever, you can also have it with no fever at all.

Norovirus is contagious like all viruses. If your child has it, they got it in one of three ways:

• They came into contact with someone who has it.
• They ate food that had the virus in it.
• They touched a surface with the virus on it, then touched their mouth or nose before washing their hands.

Symptoms start 12–48 hours after your child gets the virus. Along with throwing up, they’ll probably also have diarrhea, nausea, and stomach cramps.

Most kids get better within 1 to 3 days, but symptoms may last 7-10 days longer.

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Food Allergy

Sometimes throwing up is a sign your child is allergic to food they’ve eaten. Throwing up may be their only symptom, but there could also be others, like trouble breathing, hives, repetitive cough, wheezing, or trouble swallowing. Nine out of 10 allergic reactions are linked to the following foods:

• Peanuts
• Tree nuts (almonds or walnuts, for example)
• Fish
• Shellfish (shrimp, for example)
• Eggs
• Cow’s milk
• Wheat
• Soy

Very young babies who try cow’s milk, soy, certain grains, and some other solid foods for the first time are at risk for something called “food protein-induced enterocolitis syndrome” (FPIES). It shows up 2 to 6 hours after they eat and makes them throw up many times. They may also have bloody diarrhea or stools flecked with blood. Take your child to the doctor right away if you suspect they have FPIES.

Food Poisoning

Anytime germs hitch a ride on food your kids eat, there’s a chance they could get a food-borne illness (food poisoning). Some of the bacteria that usually hide in food are:

You can get food poisoning from almost any food, especially if it hasn’t been cooked or stored correctly. The most common culprits are:

• Meat
• Poultry
• Eggs
• Shellfish
• Unwashed vegetables, like lettuce

Your child might start throwing up within a couple of hours of eating contaminated food. Sometimes it can take a day or two for symptoms to show up. Usually, your child will also have nausea, watery diarrhea, and stomach pain.

It’s possible for food poisoning to cause fever, but it’s common for it to cause throwing up with no fever, too. Symptoms can last anywhere from a couple of hours to several days.

Intestinal Obstruction

In newborns, it can be hard to tell whether they’re throwing up or spitting up. Vomit usually comes out with more force than spit-up. Spit-up also tends to be linked to feeding, usually occurs shortly afterward, and is effortless. Your doctor can help you figure out which one you’re dealing with.

Forceful throwing up in babies is rare, but when it happens, it can be a sign of a blockage in your baby’s intestines. It’s also possible that your little one could have what doctors call “pyloric stenosis.” That means their stomach is too narrow for food to pass through. Both of these are serious problems you should see a doctor about right away.

Concussion

Kids hit their heads a lot — especially when they’re learning to walk or if they play sports. Anytime your child gets a head injury, it’s important to watch for signs of a concussion. Throwing up is one of these signs. Others include:

• Losing consciousness
• Headache
• Blurred vision
• Trouble walking
• Confusion
• Slurred speech
• Trouble waking up

Throwing up and other symptoms may not show up until 24 to 72 hours after your child hits their head.

Seek medical attention immediately if vomiting occurs after your child sustains a head injury.

Medications

If your child takes certain medications on an empty stomach, it can make them throw up. Sometimes, vomiting is a sign you’ve given your child too much of certain medications. The most common meds that cause this are:

• Codeine
• Erythromycin
• Some birth control pills
• Some asthma medications, like theophylline
• Iron
• Acetaminophen
• Ibuprofen

Motion Sickness

When your child’s brain gets mixed signals about how they’re moving, it can make them feel sick enough to vomit. For example, some kids might feel sick just watching a movie — their eyes see motion, but their body doesn’t feel motion. Carsickness is common in kids who are too small to see out the car window.

Motion sickness usually starts with a tummy ache or a queasy feeling. Some kids may also sweat, lose their appetite, and not want to eat. Eventually, throwing up starts. It’s a genetic condition. Your child is more likely to have motion sickness if one of their parents did.

Migraines

About 10% of school-age children deal with migraines. These headaches can happen in kids as young as 18 months old. They cause head pain, but it’s also common for a migraine to make your child throw up. In addition, your child may have:

• Dizziness
• Nausea
• Sensitivity to touch, sound, and odors

Experts aren’t clear what causes migraines. It could be caused by something your child is around a lot. It’s also genetic: If one parent has migraines, your child has a 50% chance of getting them. If both their parents have migraines, their chance of getting them goes up to 75%.

if your child has a headache, fever, and vomiting, consult their doctor.

Stress

It’s true — some kids throw up when they’re stressed. It may be because some other health problem, such as an ear infection, is bothering them. Or your child might throw up after crying for a long time. A good way to tell if the throwing up is stress-related is if it happens only once or twice and they don’t have any other symptoms like stomach pain or diarrhea.

Show Sources

Kids Health: “Stomach Flu,” “Food Poisoning,” “Concussion.”

Merck Manual: “Gastroenteritis in Children.”

Mayo Clinic: “Viral gastroenteritis (stomach flu),” “Food poisoning.”

Minnesota Department of Health: “Norovirus Fact Sheet.”

American College of Allergy, Asthma, & Immunology: “Food Allergy.”

UpToDate: “Patient Education: Food Poisoning (Foodborne Illness),” “Patient Education: Nausea and Vomiting in Infants and Children.”

Medscape: “Vomiting in the Pediatric Age Group.”

American Academy of Pediatrics: “Vomiting Without Diarrhea,” “Car Sickness.”

Migraine Research Foundation: “Migraines in Kids and Teens.”

Kids and throwing up: Should you worry?

Throwing up is no fun, for kids and parents alike. It can also be alarming. A pediatrician in CHOC’s primary care network explains what causes children to vomit and when to be concerned enough to call the doctor.

Vomiting, stomach flu and stomach viruses in kids

The most common cause of throwing up is a stomach virus, otherwise known as the stomach flu or acute gastroenteritis, according to Dr. Reshmi Basu. It is often accompanied by diarrhea. Vomiting could also be caused by reflux in babies, a toddler’s aversion to certain smells or foods, motion sickness, food allergies, food poisoning, urinary tract infection, appendicitis or other less common conditions.

“It’s also really common for a child to cough so hard that they throw up,” Dr. Basu says. “This can be scary, but should go away once the underlying cause of the cough is resolved.”

Treatments for vomiting and stomach bugs for kids

Treatment for vomiting varies depending on the cause. In some cases, anti-nausea medication may be prescribed to give your child some relief. A stomach virus should clear up on its own after a few days. When vomiting is caused by reflux, food allergies or motion sickness, the underlying issue can be treated.

A child who vomits one time and has no other symptoms should be fine, Dr. Basu says. They may just have an upset stomach or strong gag reflex.

When to call the doctor for a vomiting child

Call the doctor if your child:

• Is throwing up for more than two days but has no other symptoms
• Has severe abdominal pain with vomiting
• Has severe headaches with vomiting
• Has a high-grade fever with vomiting
• Has unexplained weight loss with vomiting, or
• Has any signs of dehydration (see below).

“Also, if your child or teen is throwing up periodically over a prolonged period of time, without any obvious reason, I would want to investigate that,” Dr. Basu says.

Watch out for dehydration in kids

Kids who have thrown up multiple times are at risk for dehydration, and that risk goes up the younger they are or if they also have diarrhea. Signs of dehydration include extreme fatigue, tired-looking sunken eyes, going several hours without urinating, dark urine, dry lips, dry mouth, dizziness, and, in babies, crying without tears or a sunken soft spot. Your child should see a doctor immediately if they have any of these symptoms.

To prevent dehydration, encourage your child to drink lots of fluids. Pedialyte is best, but if they refuse that then offer what they will take such as water or diluted juice, although it is better to avoid milk. Your child’s stomach may only be able to handle small amounts at first. Dr. Basu recommends starting with one tablespoon of fluid; wait 10 minutes, then try two tablespoons, and gradually increase as tolerated.

Your child should see a doctor if they cannot tolerate any liquids.

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