Best food for baby after vomiting

3 Tips for Managing Vomiting in Infants and Children

December 18, 2017

Jennifer Gershman, PharmD, CPh, PACS

It can be daunting for parents to see their child vomiting, especially when this occurs in the evening after the pediatrician's office may be closed.

It can be daunting for parents to see their child vomiting, especially when this occurs in the evening after the pediatrician’s office may be closed. Pharmacists are very accessible and can be a great resource to provide support and counseling tips for families. Parents may be overwhelmed with trying to determine the cause of the vomiting as well as management options. Vomiting in children is generally caused by gastroenteritis, which is an infection of the digestive tract.

Here are 3 tips for managing vomiting in infants and children:

Educate parents to stay calm.

Vomiting can be frightening for children and parents. Children will become exhausted, so rest along with replacing the fluids lost is extremely important. Reassure parents that their child will most likely feel better within 24 hours.¹ Educate parents to wash their hands frequently with soap and water to avoid contracting the infection from their children. It can be challenging for parents to care for their children when they are sick themselves.

Prevent dehydration through oral rehydration therapy (ORT).

Sports drinks, sodas, and juices should be avoided in children since they contain inadequate sodium and too large a quantity of carbohydrates. After the child vomits, parents should wait about 30 minutes for the stomach to settle before initiating ORT. Recommend an ORT solution such as Pedialyte, which is available over-the-counter. The estimated electrolyte requirements are based on weight (Table 1).

Table 1: Estimated Electrolyte Requirements by Weight for Vomiting¹

Body Weight (pounds)

Electrolyte Solution Requirements (ounces in 24 hours)

6-7

If an infant vomits an entire feeding more than once and is exclusively breastfeeding, then the baby should be breastfed for shorter periods of time (5 to 10 minutes at a time) every 2 hours. ² The feeding time can be increased as the infant is able to tolerate, and after about 8 hours the normal breastfeeding schedule can be resumed.²

Formula-fed infants should receive about 2 teaspoons (10 ml) of an unflavored electrolyte solution every 15-20 minutes with a spoon or an oral syringe.² Juice (about 3 ml) can be added to the electrolyte solution for infants 6 months and older as a flavor enhancer.² The solution amount can be increased once the infant can tolerate the solution without vomiting for more than 2 hours. Formula can be restarted after the infant goes more than 8 hours without vomiting.

Children 1 year of age and older should receive ORT in small amounts every 15 minutes.² Other clear liquids include ice chips or sips of water, broth, and gelatin desserts.

Educate parents to watch for the following signs and symptoms of dehydration:²

Dry or sticky mouth
Few or no tears when crying
Sunken eyes
Sunken soft spot in babies
Urinating less frequently or fewer wet diapers
Dry, cool skin
Irritability
Drowsiness or dizziness

If children do not improve after receiving ORT, then they may need intravenous fluids in the hospital.

Keep children off of solid foods for 24 hours after vomiting.

Solid foods should be avoided for about 24 hours. The BRAT diet (bananas, rice, applesauce, and toast) is an effective way to reintroduce food after vomiting. These bland foods can help children ease into normal eating. Once these bland foods are tolerated, then a normal diet can gradually be reintroduced.

References

American Academy of Pediatrics. Treating vomiting. https://www.healthychildren.org/English/health-issues/conditions/abdominal/pages/Treating-Vomiting.aspx. Accessed December 10, 2017.
KidsHealth. Vomiting. http://kidshealth.org/en/parents/vomit.html. Accessed December 10, 2017.

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Diet for Vomiting and Diarrhea (Infant/Toddler)

Vomiting and diarrhea are common in babies and young children. They can quickly lose too much fluid and become dehydrated. This is the loss of too much water and minerals from the body. This can be serious and even life threatening. When this occurs, body fluids must be replaced. This is done by giving small amounts of liquids often.

For babies, breastmilk or formula is the best fluid. Breastmilk can help reduce how serious the diarrhea is. But if your child shows signs of dehydration, their healthcare provider may tell you to use an oral rehydration solution. This can replace lost minerals called electrolytes. It can be used in addition to breast or bottle feedings. Oral rehydration solution may also reduce vomiting and diarrhea. You can buy it at grocery stores and pharmacies without a prescription.

In cases of severe dehydration or vomiting, a child may need to go to a hospital to have IV (intravenous) fluids.

Giving liquids and feeding

For breast or formula feedings:

Continue the breast or formula feedings. Do this unless your healthcare provider says otherwise.
If you use formula, the healthcare provider may tell you to try a different kind of formula. A common cause of vomiting in newborns is a problem with formula.
Give your baby short, frequent feedings. Feed every 30 minutes for 5 to 10 minutes at a time over a period of 2 to 3 hours. This will help give your baby more fluids.
If vomiting or diarrhea doesn't stop, the provider may tell you to give a formula with no lactose, or low lactose. Lactose is a milk sugar that can be hard to digest. Follow the provider's advice about what type of formula to give your baby.

If using oral rehydration solution:

Follow the healthcare provider's instructions when giving the solution to your baby. Oral rehydration solution may be alternated with breast or formula feedings.
Use only prepared, purchased oral rehydration solution. Don't make your own solution.
Give your baby short, frequent feedings. Feed every 30 minutes for 2 to 3 hours. This will help replace lost electrolytes.
If vomiting or diarrhea gets better after 2 to 3 hours, you can stop the oral rehydration solution. Resume breastmilk or full-strength formula for all feedings.

For children on solid foods:

Follow the diet your child's healthcare provider advises.
If desired and tolerated, your child may eat regular food.
If unable to eat regular food, your child can drink clear liquids such as water, or suck on ice chips. Don't give high-sugar fluids such as juice or soda. Give small amounts of food and drink often.
If clear liquids are tolerated, slowly increase the amount. Alternate these fluids with oral rehydration solution as your healthcare provider advises.
Your child can start a regular diet 12 to 24 hours after diarrhea or vomiting has stopped. Continue to give plenty of clear liquids.

Follow-up care

Follow up with your child’s healthcare provider, or as advised. If a stool sample was taken or cultures were done, call the healthcare provider for the results as instructed.

Call 911

Call 911 if your child has any of these symptoms:

When to get medical advice

Call your child’s healthcare provider right away if any of these occur:

Fever (see "Fever and children" below)
Belly (abdominal) pain that gets worse
Constant lower right abdominal pain
Repeated vomiting after the first 2 hours on liquids
Occasional vomiting for more than 24 hours
Continued severe diarrhea for more than 24 hours
Blood in vomit or stool (black or red color)
Refusal to drink or feed
Dark urine or no urine for 8 hours, no tears when crying, sunken eyes, or dry mouth
Fussiness or crying that can't be soothed
Abnormal drowsiness
New rash
More than 8 diarrhea stools in 8 hours
Diarrhea lasts more than 1 week on antibiotics

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.
Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.
Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

Fever readings for a child age 3 months to 36 months (3 years):

Rectal, forehead, or ear: 102°F (38. 9°C) or higher
Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

Repeated temperature of 104°F (40°C) or higher in a child of any age
Fever of 100.4° F (38° C) or higher in baby younger than 3 months
Fever that lasts more than 24 hours in a child under age 2
Fever that lasts for 3 days in a child age 2 or older

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How to eat and rest, so as not to end up in an infectious diseases hospital later.

Another common summer problem is poisoning. In the heat, food spoils very quickly, and the risk of intestinal poisoning increases significantly. In addition, in the summer we walk a lot, which means that we often eat on the street and in summer cafes, and street food sellers, unfortunately, do not always carefully monitor their food. A separate item is poisoning on vacation - there, to all of the above, a general frivolous mood is added, and even bacteria in another city, and even more so in a country that is "foreign", unusual.

What rules must be observed in order not to spend the summer in an infectious diseases hospital?

Product selection

When purchasing products, pay special attention to the date of manufacture , the expiration date and the conditions in which they are stored in the store. Give preference to large stores, where they carefully monitor the storage conditions and shelf life of products than in small stalls.

If you buy berries or fruits on the street - do not eat immediately, only after a thorough washing.

If possible, do not buy fast food on the street. This is especially dangerous in hot weather.

Food storage

Vegetables, fruits, greens, eggs and even meat - everything must be thoroughly washed before being put in the refrigerator. And before cooking - wash again. Even if you just washed the food with plain water, the risk of catching an infection is significantly reduced.

In summer, food must be stored in the refrigerator - in food left even “literally for half an hour” in the heat, bacteria actively begin to multiply.

If you are going to nature, carry food in a cooler bag. Believe me, buying such a bag will cost you less than treatment for acute intestinal or food poisoning!

Try to cook at once so that you do not have to store salads and soups - in the summer they deteriorate very quickly. Long-term storage of food - even in the refrigerator - can lead to infection.

Do not put raw meat and poultry next to fish.

Store raw and cooked foods separately.

Cover foods to protect them from insects and rodents that carry infections.

Cooking

Be sure to observe the basic hygiene rules. Yes, yes, those same “wash your hands before eating”, and, accordingly, before cooking. Before you start cooking, be sure to wash your hands thoroughly with soap and water, as well as the products themselves.

Cut meat, vegetables and greens on different boards and different knives to avoid the so-called cross-contamination. After cooking, rinse the boards, knives, etc. well. If you cut meat, do not be lazy and pour boiling water over the plank and knife. By the way, kitchen planks are generally recommended to be regularly rinsed with boiling water - this way you do not give bacteria a single chance to multiply.

Be sure to wash your eggs before cracking them.

The most dangerous are dishes that do not undergo sufficient heat treatment (raw or half-cooked).

Symptoms of food poisoning and acute intestinal infection

The disease is characterized by an acute onset: nausea, repeated vomiting, diarrhea. Pain and cramps in the abdomen, fever, headache can be severe or minor. Chills, weakness, general malaise also appear. Gradually, dehydration develops, and the corresponding symptoms appear: dry mouth, dizziness, dark yellow urine, or a decrease in the volume and frequency of urination.

Usually the disease goes away in 1-3 days. It is recommended to consult a doctor immediately when the first signs of poisoning appear. If food poisoning happened to a child, a pregnant woman, an elderly person, call an ambulance immediately!

What to do in case of poisoning

If you or your child has the above symptoms, do not delay, contact an infectious disease specialist immediately. The doctor diagnoses the presence of dangerous pathogens in the body, selects medications that will alleviate your condition and contribute to a speedy recovery, as well as prevent possible complications.

In case of poisoning, it is important to observe bed rest and a special diet.

Until nausea, vomiting and diarrhea stop, do not eat anything! If you load the already irritated digestive organs, this can worsen your condition. But you need to drink as much as possible! The liquid removes toxins and allows you to replenish the mineral balance of the body. Drink should be in small portions - about half a glass at a time, so as not to provoke vomiting. The first day after poisoning, it is worth drinking boiled water, weak warm black tea without sugar. To make up for the lack of salt in the body, you can drink water with salt (1 teaspoon per glass of water). Also, after poisoning, the body needs to replenish the supply of potassium. To do this, you can drink vegetable or fruit decoctions, decoctions of medicinal herbs (St. John's wort, chamomile, mint).

To relieve nausea, you can use green tea with mint. With painful sensations in the stomach and intestines, a decoction of potato starch drunk on an empty stomach (1 tablespoon of starch per glass of warm boiled water) will help.

After the acute stage has passed, the unpleasant symptoms are gone, it is important to follow a sparing diet - otherwise the disease may return. Approximately one or two weeks it is recommended to eat as follows: in small portions (50-100 g every 2-3 hours), refuse fats and complex carbohydrates, heavy food; drink plenty of fluids, dried fruit compote is especially recommended, as it contains all the many useful vitamins and minerals.

Can

Weak black or green tea, liquid cereals on the water (especially: rice and oatmeal), initially brewed without salt and sugar, later - you can add sugar or honey, dried fruits, dried fruit compote, white bread crackers, unsalted crackers. If you feel good, you can steam chicken or turkey meatballs.

Not allowed

Black bread, eggs, fresh vegetables and fruits, whole milk and dairy products, spicy, smoked and salty foods, as well as any foods containing fiber; coffee, fruit jelly and juices.

A week after poisoning, vegetable soups (without cabbage and beans) and cereal broths can be gradually introduced into the diet.

Then you can gradually include fresh vegetables in your diet, starting with tiny portions - literally 1 tablespoon each.

Only three weeks after the poisoning, you can start eating buns and fresh bread, but you should not try fatty, fried, salty and pickled products earlier than after 5-6 weeks.

Take care of yourself, follow the hygiene requirements, wash your hands more often, keep the food clean and fresh. Food poisoning prevention isn't that hard, so make it a daily habit!

Diet for diarrhea in a child of 1 year

When a child is sick, it is always a serious test for the family. Moreover, if the baby has vomiting, frequent loose stools, fever, he refuses to eat. In such cases, parents naturally face the question: what to do?

The first thing to do is to see a doctor. In most cases, this condition is associated with an acute intestinal infection and can lead to serious consequences for the baby. And timely treatment allows you to quickly deal with the problem.

The second significant issue facing the parents of a sick child is the issue of proper nutrition. Unfortunately, you can still find recommendations to stop feeding a child during diarrhea, but this should not be done categorically.

Important!

It has been proven that "water-tea" breaks and starvation diets significantly weaken the protective functions of the child's body and lead to a delay in recovery processes in the intestines. Therefore, at present, most pediatricians insist on the mandatory continuation of the child's nutrition in case of acute intestinal infections, but with the obligatory consideration of the latest achievements in nutrition.

The main principles for managing the nutrition of a child with diarrhea should be:


Phased	The development of the disease has a staging, each stage must correspond to certain approaches to diet therapy
Accounting for the age of the child	Each age should have its own products and their schemes for their purpose
Accounting for the severity of the disease

There are three main stages of diet therapy. The first stage corresponds to the acute period of the disease, when the maximum manifestations of the disease are noted (vomiting, loose stools, fever), and the child may refuse his usual diet. During this period, proper nutrition is an integral part of treatment. And the success of treatment largely depends on the correct organization of diet therapy in a child.

The second stage is the recovery period. There are no longer those manifestations of the disease that were noted in the baby in the acute period, the child has an appetite, he becomes more active, but it must be remembered that any acute intestinal infection leads to significant changes in the child's body. This is a violation of the microflora of the gastrointestinal tract, and dysfunction of enzyme systems, bile secretion and other digestive processes. It takes time to restore the correct functioning of the gastrointestinal tract, which requires a sparing diet at this stage. Violation of the diet during this period can lead to the formation of a chronic pathology of the gastrointestinal tract.

The third stage of diet therapy is aimed at a gradual transition to the usual diet for this baby. Breastfed babies should continue to breastfeed. If the baby is bottle-fed, the doctor will prescribe a formula that matches the baby's condition. In children older than one year, it is necessary to exclude whole milk from the diet, they are also shown the appointment of fermented milk products as a diet therapy, the favorable properties of which are due to a number of positive qualities: the presence of lactic acid gives the product pronounced bactericidal properties and inhibits the growth of pathogenic microflora, the positive effect of these products on intestinal microbiocenosis, the secretory function of the digestive glands and intestinal motility, and they also have immunomodulatory properties.

One of the important components of diet therapy is the use of dairy-free cereals with pro- and synbiotics. Clinical studies have shown that the appointment of this diet therapy contributes to a more rapid relief of the main symptoms of intestinal dysfunction, as well as the restoration of intestinal microflora.

Choose foods for the diet

It is most correct to start with rice porridge, as it has pronounced sorption properties and helps to stop diarrhea. As the child recovers, oatmeal and buckwheat porridge can be included in the diet.

Vegetables and fruits are an important component in the first stage of diet therapy. Preference should be given to products that contain pectin (baked apple, boiled carrots), as they contribute to the sorption of pathogens and their toxins. At the first stage of diet therapy, the use of fresh vegetables and fruits, as well as juices, is not shown.

The second stage - the patient's condition improves, the child becomes active, appetite improves, and in some children it even becomes elevated, which is often perceived by parents as a signal for increased nutrition. It is absolutely impossible to do this, since the child's body has not yet recovered from the disease. During this period, it is necessary to continue eating sour-milk, lactose-free and low-lactose products.