Doctors Lounge - Pediatrics Answers
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Forum Name: Pediatric Topics
|Fireflower - Wed Aug 04, 2010 1:59 pm||
My 23 month old daughter has not been herself since last Thursday. Every evening - with the exception of Saturday and Monday - she has vomited. It usually happens only once (Thursday it was twice) but the VOLUME of vomit is unreal. It seems that she is losing everything she's eaten all day, up until then. Other than this she is fine. No fever. No diarrhea. Not dehydrated. A little lethargic and not as hungry as usual but happy within herself. They haven't noticed anything unusual at daycare. She hasn't tried any new foods. We took her to the clinic last night and were told not to worry; that it was just a 'tummy bug'. I've never heard of a tummy bug that acted like this. Wouldn't she be sick all day? Wouldn't there be some other symptom? Please advise. I am worried..
|Faye Lang, RN, MSW - Sat Aug 07, 2010 4:30 pm||
Vomiting happens often in toddlers and can be "normal." Vomiting such as you describe your daughter is doing could be due to delayed gastric emptying, where the food and drink stay in the stomach longer, the stomach becomes overfull, and thus the child vomits. A medication called Reglan or certain antibiotics can be given to help the stomach empty faster. (Note: antibiotics should be used judiciously and only when necessary to avoid needing increasingly stronger dosages) If there is weight loss or signs of dehydration, or if you know she isn't improving, she needs to be re-evaluated. Since children can't report symptoms well and it's a matter of observation, the American Pediatric Association recommends that you keep a symptom diary of her vomiting, noting the time, what she was doing at the time she vomited (as, crying or playing), and what she last had to eat and/or drink. If she doesn't return to normal soon, have her regular doctor check her, and don't hesitate to get a second opinion if you are still concerned.
Some general guidelines of actions to take when children are unusually ill:
When to call 911: if the child is having trouble breathing, or if there is severe dehydration, which includes excessive sleepiness, fussiness, sunken eyes, cold, dizziness, splotchy hands and feet, or delerium. In these situations, minutes count.
When to go to the Emergency Room: if there is severe abdominal pain, vomit has bile (dark green substance) or more than a tinge of blood or blood that looks like coffee grounds (and take a sample of vomit with you to the ER), has a swollen, tender abdomen, or is irritable or lethargic, which may also occur with a stiff neck (signs of meningitis), or there is high fever (102 F or above).
When to call your doctor: if there has been vomiting steadily for 24 hours, signs of dehydration (decreased urine - as, 6 to 8 hours without a wet diaper, blood in vomit (a tiny amount is likely due to esophogeal irritation and isn't cause for alarm), or jaundice (yellowing of skin and whites of eyes).
If you suspect your child has swallowed a toxic substance, call the American Association of Poison Control Center hotline (800-222-1222) or your local poison control center immediately.
I hope this helps. Good luck to you.
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