Vomiting and Diarrhea

What is it?

Like fever, vomiting and diarrhea are not illness themselves, but are common symptoms of many other common illnesses of childhood. The most common cause of vomiting and diarrhea in children is a stomach or intestinal infection, typically caused by a virus, but occasionally can be caused by a bacteria or parasite. These viruses are contagious, so typically other children or family members will have it as well. Other illnesses that can cause vomiting and diarrhea include:

  • Strep throat infection
  • Urinary tract infection
  • Respiratory or sinus infection
  • Meningitis
  • Ear infection
  • Appendicitis
  • Reyes syndrome
  • Milk or food allergy
  • Side effects from oral medications (usually antibiotics)

What are the symptoms?

The following signs indicate a need to contact the child's physician:

  • Stomach contents or diarrhea with blood or bile in them. Bile is a bright yellow green color.
  • Severe abdominal pain
  • Strenuous, repeated vomiting
  • Swollen abdomen
  • Lethargy or severe irritability
  • Convulsions or seizures
  • Inability to drink adequate amounts of fluid
  • Vomiting following a head injury
  • Moderate to severe dehydration (see below) or continued vomiting or watery diarrhea with a mild diarrhea
Condition Symptom
Mild dehydration
  • Restless / fussy
  • Acts hungry or thirsty all the time
  • Urinates less frequently than unusual, requires fewer diaper changes. Urine will have a strong odor and will be darker yellow than normal.
Moderate dehydration
  • Has decreased interest in play
  • Eyes are sunken with few tears
  • Child's mouth is dry with little or no saliva
  • Has not urinated in 8 hours or has urinated fewer than
  • 3 times in 24 hours
Severe dehydration 
Severe dehydration is a medical emergency. Call 911 or emergency services immediately
  • Lack in interest in playing and extreme sleepiness (the child may be so sleepy that he or she is difficult to wake up)
  • Eyes are very sunken and without tears
  • Mouth and tongue are very dry
  • Drinks poorly/unable to drink
  • No urination in 12 hours

How can I treat vomiting and diarrhea?

It is important to prevent dehydration. Make sure your child drinks plenty of fluids when they are sick (even though they may not be thirsty) such as an oral rehydration solution. Nursing mothers should continue to breastfeed. If your child is suffering from diarrhea, avoid sugar-based beverages such as sports drinks, soda, or juices. The sugar can draw water into the intestines and away from the rest of the body, making the diarrhea worse and increasing the risk of dehydration. Additionally, these beverages may not contain electrolytes that need to be replenished.

Oral-rehydration suggested scheduled:

Age Amount Timing
Less than 2 ½ cup Every hour
Older than 2 Up to 1 cup Every hour
If vomiting - even if your child vomits after drinking the fluid part if it will stay down 1-2 teaspoons Every 1-2 minutes. Once the child is doing better increase to bigger sips spread 5 minutes apart

Once nausea and vomiting have subsided you can resume a normal diet such as breastfeeding, formula (½ strength for 2 days), or solid foods (avoid high fat foods)

Important additional information

  • When a toddler vomits, it is important to make sure he or she has not swallowed medications, household liquids, or other poisons. Look around the house for empty containers and spills. There may be pills in your child's vomit or the vomit may have an unusual appearance, color, or odor.
  • Do not give your child anti-diarrheal medications unless your physician tells you too.

The following are examples of over-the-counter (OTC) products that can be used to treat the symptoms of vomiting and diarrhea:

Symptom relief Helpful medications Active ingredients* to look for in generic and name brand OTC products
Dehydration Oral rehydration products** Oral electrolyte solution 
Example: Pedialyte®

* Active ingredients: ingredients in a medication that produce a therapeutic response

** Oral rehydration solutions are helpful medications for keeping your child hydrated however, they will not stop diarrhea

Note: This information is intended to provide readers with health information. The information provided is not a substitute for consultation with a healthcare provider. Brand names included on this Web page are provided for examples only. Their inclusion does not mean that they are endorsed by Blue Cross and Blue Shield of North Carolina.