How long would you wait before hospitalizing a child for vomiting?

[jld]

My 22 mos. old has been throwing up 5-6 times a day since Saturday (it's Monday morning here). He has had some wet diapers, and has shown some energy (not completely lethargic), but just now threw up all his breastmilk again. Dh says to just wait it out. The doctor we saw Sat. said it's probably a virus, and we could wait it out or hospitalize him. We decided to wait it out, but now I'm not sure. Yesterday I gave him the medicine for vomiting, and he threw it up.

 

To complicate matters, ds5 started throwing up last night, too. Dh is back to work (in another city), so dd15 and I will be dealing with this on our own (until we get it, too, I suppose). We're in India, and I know tropical bugs are no laughing matter. The boys may have a slight fever, but nothing raging. I'm just not sure if I should keep waiting, or at least take them to the doctor again. Any thoughts?

[dansamy]

I'd think the little one needs some IV rehydration by this point. When was his last wet diaper? Really wet? Or a strong, concentrated urine?

 

I'd also not get too ticked with the staff when it takes several IV attempts to get a line. You're going to be bringing in a baby who is even more dehydrated than when IV therapy was first suggested. It's not going to be easy or fun getting an IV on that kid.

[Jan in SC]

Can you get the meds in a suppository form? If not, I would want an IV soon.

[abbeyej]

Try pinching some skin on his abdomen and holding for a few seconds (not to be painful), then let go. It should return to normal position between instantly and 2 seconds. If it takes more than two seconds, I would take him in now. If less than two seconds, I would assume the dehydration itself isn't urgent. But I'd keep a close eye on him...

[justasque]

The simple answer is to check with the doc again, and see if they feel the situation has changed.

 

I've had to watch while a dehydrated child got an IV. They stuck her for 30 minutes before they found a good vein. It was horrible.

 

In the mean time, 1 tsp oral rehydration fluid (Gatorade, Pedialyte, or a homemade alternative) every five minutes would be wise. Set a timer.

[nd293]

Getting an IV into a dehydrated child is horrible. I would base my decision on the behaviour and look of my child, rather than on how much he was throwing up. I'd also be more worried about an unwillingness to feed than the fact that the feeds are getting vomited up - some is probably staying down.

 

I'd also be less worried if your other child is throwing up - I have a tendency to let the sytem deal with bugs in its own way. On the other hand - when ds was 8 months he threw up repeatedly with screaming, and it took 3 Drs visits over 3 days before they diagnosed an intestinal problem (intussusseption) which required surgical intervention.

 

I second the suggestion of suppository for meds.

[IsabelC]

I would take the child to hospital if he shows signs of dehydration (eg scant or smelly urine), if he is too lethargic to suck at the breast, if he is having other worrying symptoms (eg fits) or if your gut instinct is telling you that he needs medical care. I wouldn't be so worried about how long it's been or how much milk he appears to be throwing up, because human milk is so easily digested that he could be absorbing more than you think before it comes back up.

Edited June 28, 2010 by Hotdrink

[usetoschool]

This happened to my son when he was about 18 months old. I would say take him in to at least have an IV. It can go downhill quickly when they start to get dehydrated. My son was still nursing and couldn't keep anything down and it kind of spirals. They put the IV line in his foot and within 20 minutes there was a dramatic improvement. As soon as he started getting some energy back he was able to nurse and the doctor gave us some suppository anti-emetics and it all turned around quickly. I felt dumb for waiting for so long to do something about it.

[jld]

Thank you so much for every reply. I decided to wait it out, and he hasn't vomited since. Ds5 hasn't, either, though he stayed inside all day yesterday, just lying around, drinking juice, generally resting.

 

I'm really glad I posted, because I had never heard of suppositories for vomiting before. I had heard of suppositories, but have no actual experience with them, so I was a little nervous about having to use one on anyone. Fortunately ds22 mos. let me escape that lesson, lol.

 

Ds5 was in the hospital for 2 days in Dec. with a tropical illness, and it took some time for them to find a vein (ouch!), so I hear what everyone was saying about really being sure that's the route we wanted to go before taking the toddler in. It sure can be scary, though, to see a thin child get even thinner in just a few days' time.

 

One reason I was hesitating to go back to the doctor is that he doesn't seem to have a lot of confidence in breastfeeding. He told me the sugar in my breastmilk was likely causing the baby to throw up, and advised me to use Pedialyte. Maybe he's right, but I get a little nervous when a doctor throws any sort of doubt about nursing out there. In developing countries it is really helpful for a baby to be nursed long term, as it's really hard to be absolutely sure about the quality of liquid he may be getting. I may need to look for a new pediatrician . . .

 

Once again, sincere thanks to everyone who replied. I really hope we're on the mend now. :)

[Mom2J112903]

My son vomited only TWICE, one time it was not much at all, and had to be admitted for IV fluids. Now J *did* have a fever and tonsilitis, but WOW was this child dehydrated :( This happened literally over-night. So I would be VERY careful and honestly, if it were *my* child, we would have done the admission on Saturday.

 

We got J's IV in first try-the nurse was AWESOME. He cried more over the finger stick than the IV.

[cathmom]

I'm glad they seem better! How scary!

[jld]

Thanks, cathmom. Yes, it was. In Dec., 3 of us ended up in the hospital with a tropical bug, and I was afraid we were going to repeat that. But I am just crossing my fingers that we're through the worst of this one . . .

[nd293]

Glad your kiddies on are on the mend! How strange for a doctor to tell you breastfeeding is bad for a vomiting baby! I've always heard the opposite.

[jld]

I know. But he's kind of old, and I'm wondering if that has something to do with it?

 

And I can't really say that he said nursing was bad, just that he thought the baby was rejecting the sugar in the milk. It just sounded suspicious to me.

[Rosie_0801]

And I can't really say that he said nursing was bad, just that he thought the baby was rejecting the sugar in the milk. It just sounded suspicious to me.

 

But he would accept sugar in anything else? Uh huh...

 

Rosie

[Night Elf]

I took my dd12 to the hospital last year when she had been throwing up all day and was looking pretty pitiful at night. Kaiser was closed and the hospital was our only option. They said she was dehydrated and gave her IV fluids and she perked right up. They also gave her medicine that kept her from vomiting anymore. I don't like waiting things out. I've seen some scary stuff and when someone thinks I'm overreacting, I think about those bad things I know can happen and do what I think is necessary for my child, or for myself for that matter.

 

But I have no experience outside of the U.S.

[juelle]

So glad your littles are better. It is scary, just waiting. Well done for thinking it through and asking for advice - often I just have to admit I need advice, and then the answer becomes clear. I hope everyone stays well at your house.:grouphug:

[texasmama]

If he has been throwing up for that long and cannot even keep down breastmilk (which is the very best thing for him at this point), then I would think he must be dehydrated and in need of IV fluids.

 

We had the exact situation with my now 7 year old (he couldn't keep down breastmilk) and he spent a few hours in the ER being rehydrated. He wasn't admitted and was able to nurse and keep fluids down in the hospital before he was released.

[phathui5]

He told me the sugar in my breastmilk was likely causing the baby to throw up, and advised me to use Pedialyte.

 

He doesn't sound very well-educated about nutrition there.

[newlifemom]

FYI, when dd was throwing up and we were debating whether or not to take ehr to er, the dr told me to get a can of peaches in heavy syrup and give her a teaspoon. [she couldn't hold down the pedialyte] Well it worked like a charm and then I was able to give her the tablespoons of pedialyte and she was fine.