The Vomiting Toddler
Q) Dear Dr. Gwenn,
I have an active, happy and playful 15 month old son. His solid and liquid intake is good. He is not experiencing cold, fever or any allergy symptoms but he has eczema and is on hydrocortisone weekly for the past month. For the past weeks, he throws up at the most 5 times a week. It is all that he ate a moment ago covered with clear mucus.
Please advice.
Thanks,
YP
A) Dear YP:
Vomiting in toddlers is always alarming. Although your child is well appearing, it is still possible he has a mild stomach virus. Food poisoning is a consideration with acute vomiting although this has gone on for a while. Other considerations in this setting are reflux or even allergies. I've seen a number of children who have such significant post-nasal drip they throw up due to the amount of mucous they swallow.
The first step is to help your son feel better and make sure he doesn't get dehydrated. Push clear fluids and reintroduce solids slowly following theso-called BRAT diet – breads, rices, applesause and toast...essentially, very bland foods! Also, touch base with your pediatrician to get not only more guidance but to start discussing what may be the actual underlying cause of this situation. An office visit will likely be needed to accomplish that. And, since your pediatrician knows your child well by know and your child's history, he or she can better advise you on what may be occurring. Once an office evaluation is done, your pediatrician can advise you if any further testing is needed. Often wtih children the diagnosis of vomiting is apparant from the history and physical but because the GI tract is a plumbing system, sometimes we need xrays to peer inside.
For all vomiting situations, seek medical care immediately if your child can not keep anything down, especially fluids. Children can become dehydrated quickly. Sometimes we have to give the children bowel rest and use intravenous fluids to keep them hydrated and safe while we let the work up progress. Other symptoms to call for with vomiting include vomiting green material or blood, fever, or abdomial pain.
Dr. Gwenn
