When there is continued vomiting, you need to make certain that dehydration doesn't occur. (Dehydration is a term used when the body loses so much water that it can no longer function efficiently.) If allowed to reach a severe degree, it can be serious and life-threatening. To prevent this from happening, make sure your child consumes enough extra fluids to restore what has been lost through throwing up. If she vomits these, notify your pediatrician.

Occasional vomiting may occur during the first month. If it appears repeatedly, or is unusually forceful, call your pediatrician. It may be just a mild feeding difficulty but also could be a sign of something more serious.

Between 2 weeks and 4 months of age, persistent forceful vomiting may be caused by a thickening of the muscle at the stomach exit. This prevents food from passing into the intestines and is known as hypertrophic pyloric stenosis and requires immediate medical attention. Surgery usually is required to open the narrowed area. The important sign of this condition is forceful vomiting occurring approximately 15 to 30 minutes or less after every feeding. Any time you notice this, call your pediatrician as soon as possible.

Occasionally, the spitting up in the first few weeks to months of life gets worse instead of better; even though it's not forceful, it occurs all the time. This happens when the muscles at the lower end of the esophagus become overly relaxed and allow the stomach contents to back up. This condition usually can be controlled by the following:

1. Thicken the milk with small amounts of baby cereal.

    

2. Avoid overfeeding.

    

3. Burp the baby frequently.

    

4. Leave the infant in a quiet, upright position for at least 30 minutes following feeding. If this is not effective, you may want to put the child in a prone or prone-elevated position (prone with head elevated).

Guidelines for Fluids after Vomiting

For the first 24 hours or so of any illness that causes vomiting, keep your child off solid foods and, encourage her to suck or drink clear fluids, such as water, sugar water (1/2 teaspoon [2.5 cc] sugar in 4 ounces [120 cc] of water), popsicles, gelatin water (1 teaspoon [5 cc] of flavored gelatin in 4 ounces of water) or preferably an electrolyte solution (ask your pediatrician which one), instead of eating. Liquids not only help to prevent dehydration but are less likely than solid foods to stimulate further vomiting.

Here are some guidelines to follow for giving your child fluids after she has vomited:

1. Wait for two to three hours after the last vomiting episode, and then give 1 to 2 ounces of cool water every half hour to one hour for four feedings.

    

2. If she retains this, give 2 ounces of electrolyte solution alternated with 2 ounces of clear liquids every half hour.

    

3. If this is retained for two feedings, add half-strength formula or milk (depending upon age), and continue increasing the quantity slowly to 3 to 4 ounces every three or four hours.

    

4. After 12 hours to 24 hours with no additional vomiting, gradually return your child to her normal diet, but continue to give her plenty of clear fluids.

In most cases, your child will just need to stay at home and receive a liquid diet for 12 hours to 24 hours. Your pediatrician usually won't prescribe a drug to treat the vomiting.

If your child also has diarrhea, ask your pediatrician for instructions on giving liquids and restoring solids to her diet.

If she can't retain any clear liquids or the symptoms become more severe, notify your pediatrician. She will examine your child and may order blood and urine tests or X-rays to make a diagnosis. Occasionally, hospital care may be necessary.