What to Do When Kids Vomit…

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GI Bugs suck.

I’ve been lucky that (most) of my kids have learned how to puke in a bowl or run to the toilet pretty early on. But it’s still never fun to have a stomach bug work it’s way around your house.

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It’s also never fun when your 6 year old wakes you up in the middle of the night to let you know he just puked 3 times…once on his bed, once on the carpet, and once on the cabinet next to the toilet.

#CantWinThemAll

So what’s a Mama to do when vomit strikes the house? How do you deal with your child’s nausea? How do you prevent dehydration? What if they don’t want to eat anything for the entire day?

In my house, we’ve got those questions covered using what I call our “Family Protocol for Vomiting.”

DISCLAIMER: I am a Registered Nurse, but I am not your Registered Nurse. The information in this article is basic info that applies to most situations where an otherwise healthy child (or adult) comes down with a relatively common, run-of-the-mill sort of illness. You should always follow your Mama instincts and seek additional help when you need it!

What is a Stomach Bug?

Stomach bug, stomach flu, GI illness…whatever you call it, it’s basically the same: an illness caused by either a bacteria or a virus (must most often a virus!) that causes nausea, vomiting, and/or diarrhea.

Often, there’s also stomach cramps involved. Those can seem a bit scary sometimes, especially when you’re child is literally writhing on the floor in pain and clutching their stomach.

But during a stomach bug, the cramping usually has an “on and off” pattern that is relieved by either puking or pooping.

I haven’t decided yet whether that’s a good thing or a bad thing. But I think we can all agree that it’s a gross thing!

What are normal symptoms of a Stomach Bug in Kids?

It can be rather jarring to see your normally rambunctious child suddenly stopped in their tracks and not feeling well. And any Mama’s heart always hurts to see them laying there uncomfortable…and every Mama’s mind can’t help but worrying.

But while a stomach bug may not be “normal”, there ARE some symptoms that go along with it that are considered “normal” for a stomach bug in kids.

  • doesn’t feel good
  • laying around and acting “lethargic” (although it’s not true medical lethargy, I’ll talk more about that in a second)
  • more tired than usual, may nap even though they usually don’t
  • nausea
  • mild to severe vomiting, may be unable to keep food or water down
  • mild to severe diarrhea
  • stomach pain, sometimes severe, but comes and goes and is relieved after an episode of vomiting or diarrhea
  • may not have an appetite…or may be begging for food, only to vomit it right back up again

A Note about TRUE Lethargy

Back when I used to work as an After-Hours Pediatric Phone Triage nurse, I discovered how many Mamas describe their sick child as “lethargic.”

However…

…the way we commonly use the term “lethargic” in our everyday speech is significantly different than the true medical meaning of “lethargic”.

Usually, when we say “our child is lethargic,” we mean that they are much less active than usual. They’re lying around, when they would normally be up and running. They’re much quieter than usual, when normally they would be asking a million questions, begging you for snacks, and talking non-stop.

But with this kind of “lethargy,” our kids are still responsive. They answer our questions, ask for things they need, are able to sit up on their own, and walk to the bathroom or bedroom independently. They are definitely less energetic than usual, and don’t feel good, and might prefer not to move around…but they can.

True, medical lethargy is more like being a rag doll. The child may be slow to respond, or even non-responsive. They would have less muscle tone than usual, and feel a bit “floppy.”

True, medical lethargy is a medical emergency! So seek medical care immediately if your child experiences it.

“Lethargic” as most Mamas use the word, is more of a normal and expected symptoms when a child has a GI Bug.

Biggest Fear of Mamas: Dehydration

The biggest worry I hear from Mamas during their child’s stomach bug is dehydration. It can drive you to practically beg your child to drink! You can try all kinds of different drinks and tricks to get them to sip, anything from sports drinks to pediatric electrolyte drinks to popsicles.

However, in most cases, you don’t need to worry so much. Keep an eye on it, yes, of course. But mild to moderate dehydration is sort of normal and expected during a GI Illness, where you’re vomiting or pooping much more than usual, and not eating or drinking as much as usual.

Luckily, the mild to moderate dehydration that usually occurs can be treated at home in most cases. (You can go here to read more about common causes of dehydration)

Home Care for Pediatric Stomach Bugs

For those of us that hate going to the doctor unless we absolutely have to, the good news is that, in most cases, stomach bugs can be treated successfully at home.

Definitely go for your basic “all illness” protocols: cancel your plans, clear your schedule, force your kids to wash their hands (twice), and plan for plenty of rest…and probably more than a little bit of Disney+.

(And for those in your household that aren’t nauseous yet, eat all the Elderberry Gummies)

Don’t automatically try to force your child to drink in order to prevent dehydration…and then start panicking because they “won’t stop vomiting”.

This is, by far, the biggest mistake that I see Mamas making.

When you allow your child to eat/drink too soon after vomiting, you’re much more likely to trigger the vomit reflux again and again…thereby causing the very thing that you’re desperately trying to prevent!

Instead, anytime your child starts puking due to a suspected stomach bug, immediately remind yourself that they are NOT in any immediate danger! After all, do you always feel like eating or even drinking when you’ve got a stomach bug? Chances are that you don’t.

So the best solution I’ve found when I’m worried about my child like this is to have a “Family Stomach Bug Protocol” in place.

That way, I have some good, written guidance to instruct me what to do when my Mama brain overrides my RN brain!

One more tip…make your kid carry around a dedicated “puke bowl” with them throughout the day, and teach them how to use it. That way, even if they can’t make it to the bathroom in time, you might be able to contain the mess.

Here’s the protocol my family uses…

Protocol for Stomach Bug

HOW I USE THIS PROTOCOL: The first time my child vomits, I immediately start with step 1. Then I follow each step as instructed based on how my kid responds.

So after the first episode of vomiting, I…

1) Let them have a tiny sip of water to clear their mouth and throat (or swish and spit if they are old enough, and don’t feel like drinking).

2) Give them about 30-60 minutes before letting them drink more water. The first “test cup” should only be a small amount, approximately 2 ounces (about 1/4 cup) is a good. Then move on to the appropriate part of step 3…

3a) *If they DON’T puke within 15-20 minutes after drinking water (OR have worsening stomach pains, which means puke is likely heading your way soon…): I let them continue to sip water on-demand. I encourage them to take it slow and not* chug it.

3b) If they PUKE UP the “test” water: I will offer them ice cubes or ice chips to suck on. Sometimes this smaller amount of water is easier tolerated without triggering the puke reflex. If they can keep the ice down, I let them have unlimited ice cubes. If they puke after every ice cube…then they have to wait at least 30-60 minutes before trying another ice cube. Once they can keep the ice cubes down for an hour or two, I will repeat the 2-ounce water test in Step #2.

3c) If they CONTINUE to puke up even the ice cubes for several hours: This is when I move on to Activated Charcoal. Adults can just swallow a pill…but good luck getting most kids to do that! Instead, open 1 capsule of Activated Charcoal and and sprinkle it into 1/4-cup of apple juice. Let your child drink it with a straw so it’ doesn’t look as weird. My 6-year old describes the taste as “Apple juice with flour in it.” Often, the Activated Charcoal will help “grab” whatever is causing the tummy upset, and allow your child to start drinking water again without vomiting. With 10-years of parenting and (so far) 5 kids, I have only needed to do this once so far. Usually my kids stop vomiting long before this step. I treat this like a version of the Step 3 “water test”…if they don’t puke up the apple juice within 15-20 minutes then they can progress to drinking more fluids.

4) Once they can keep water down for at least 2-3 hours, then I will let them try eating something IF they say they are hungry. never make them eat, so if they’re not asking for food, I won’t offer it. At this point, unsweetened applesauce is always my “go to” food. It’s also shelf-stable, so I always keep an extra jar in my pantry for unexpected GI illnesses. #FoodAsMedicine Start with a small amount of applesauce…I feel like 1/4 cup is a safe amount. If they keep that down for 15-20 minutes, then they can have a little more. If they puke it back up…then go back to Step 3a for another 1-2 hours or so.

5) If they don’t puke up the applesauce for 1-2 hours, AND if they want to eat something more substantive…then I will let them try to eat something else. But remember…never make them eat! If they say they don’t want to eat something, then I trust that their body is not ready yet.

6) Theres something about a good night’s sleep that seems to reset the body. In most cases, I find that by the next morning, my child’s appetite is completely back to normal. It’s almost as if nothing had ever happened (other than maybe a few more days of mild diarrhea, of course…parenting is fun!). But if they’re still declining to eat “real food”, and requesting unlimited applesauce instead, then I use the classic Mama test: I offer them a snack that I know they love to eat. If they decline to eat their favorite snack, then I continue offering applesauce until lunchtime. Buuut….if they eat their snack willingly and without any sign of stomach upset…they are most likely back to normal. Feel free to force them to eat their veggies again.

Troubleshooting Vomiting Illnesses

Here’s how I generally handle some “special situations” that sometimes come up, as well as my answers to some questions that my Mama friends frequently ask me.

Should I give my child an electrolyte drink, or just water?

Honestly, I have never, ever bought a Pediatric Electrolyte drink in my life. I feel like it’s an over-priced product that plays on the fears of parents. In the same vein, I also don’t like to give my kids sugared up sports drinks (YOU know what I’m talking about) that are filled with artificial colors and flavors.

In the vast majority of cases, kids will be fine drinking only water while recovering from a Stomach Bug. But if it feels like the hours are dragging on and you’re starting to get concerned, then as soon as the puking stops I might switch to apple juice or a Homemade Electrolyte Drink (recipe coming soon!) to help get there energy back up.

Why I Won’t even LET my kids eat or drink…even when they beg me.

Hopefully I’ve made it clear by now that I never force my kids to drink (or eat) when their stomach doesn’t feel well during a puking illness. In fact, I often take it even a step further.

I usually won’t even let them eat or drink if they’ve recently puked…even if they claim they’re starving

(And they DO sometimes! They will look me straight in the eye, only fifteen minutes after I’ve cleaned up the carpet, and ask for something to eat because they are sooo hungry that their stomach hurts!)

But don’t be fooled.

Their stomach does not hurt because they are hungry. Their stomach hurts because it wants to puke again. And if you let them eat solid foods before their little bodies are truly ready, then you might as well leave out the carpet cleaning supplies because you’re gonna need ’em again soon.

But when your Mama heart is breaking because you just told told them “no” to food and now they are literally accusing you of trying to kill them…keep reminding yourself that otherwise healthy people don’t die from not eating for a day. Or even two.

But on the other hand…you could potentially lengthen a Stomach Bug by letting them eat or drink too soon. At the very least, you risk making the symptoms even worse and uncomfortable for your child by triggering extra vomiting episodes.

This is a classic case of being a parent who is willing to do the hard (but good!) thing even if it doesn’t “feel good” in the moment…because it is better in the long run.

Kind of like when you let them cry and throw a tantrum… because they’re SOOOO HUUUNGRY….and you won’t give them a snacky snack fifteen minutes before dinner is ready.

So yeah. That’s why I have no problem telling my kid “No, you can’t eat pancakes right now even though you think you feel like you’re starving, because you literally just puked up water 10 minutes ago.”

And I don’t feel like cleaning puked-up pancake simply because my child hasn’t yet learned how to differentiate their body’s “hunger” feeling from their body’s “If you put any real food in me I’m going to upchuck” feeling.

When to call the doctor…

Here’s the deal…call the freakin’ doctor anytime you want some reassurance, a second opinion, or your Mama instinct says something is up. Almost all pediatricians have after-hours hotlines nowadays, so you might as well use them if it’ll make you feel better.

I’m an RN, but even that part of my brain goes haywire sometimes when it comes to my own kids, and I find myself calling the after-hours nurse hotline for the same sort of symptoms that I would feel confident advising my friends about. It’s a weird parent thing, I guess.

On the other hand, I also often disagree with the advice they give me when I call the hotline, and end up doing my own thing anyway. To each her own.

#Rebel

You definitely want to consider the ER if you start seeing signs of severe dehydration, or in some cases even moderate dehydration that seems to be getting increasingly worse with no end in sight.

And also for true lethargy, because that is never normal.

Also if there is blood in the vomit (or their poop), especially if it happens repeatedly, then you’ll definitely want to get that checked out ASAP.

Hang in there, it shouldn’t last too long…

Most GI Bugs move pretty quickly and are gone in 24-36 hours…for an otherwise healthy kid, this makes them more of an annoyance than a major health concern.

But while they’re here, they are a pretty major annoyance. So steel yourself, Mama! The best thing you can do when a Stomach Bug strikes is to clear your calendar, rev up your patience, refer to this protocol for advice…

…and maybe order some applesauce, activated charcoal, and a little Green Machine from Wal-mart Online Grocery delivery (you can get $10 off your first order using this link…in fact, why don’t you go ahead and get that stuff ordered right now so you’ll be prepared for the next puke-fest?).

Just in case.

Leave a comment! What’s your least favorite part of a Stomach Bug?

(Please spread the word on social media! Thank you!)

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