KidStuff

The Doctor Tosses Out Some Ideas For Dealing With Vomiting, Nausea

By Paul M. Marz, M.D.
All of us have experienced this uncontrollable reflex at one time or another. Whether it’s called barfing, hurling, or any other colorful term it still refers to a similar function—the forceful expulsion of food from the stomach.

One time or another, we’ve all experienced this often embarrassing circumstance, so difficult to suppress or control because it is actually a reflex.

Many believe they have a sensitive stomach, but, really, your stomach has little to do with it. The actual controller is up there in the brain itself. Quite often, even the sight or sound of a person performing this reflex may trigger the same reflex in others to do the same.

Is this reaction a protective reflex? Maybe the episode was caused by bad food. Perhaps nearby observers subconsciously feel they’d better get rid of the offending matter themselves—in a hurry—as a matter of self-protection.

In any case, quite a mess.

The causes can range from a viral illness to poison, motion effects, chemical imbalances, post-surgery aftereffects, anxiety, shock or fear, to name just a few.

Most emesis—the technical term for nausea—is due to the reality that the body does not want that food in there. This discomfort needs to be addressed as well.

Since everything else is running just fine, your need for food and fluids is just the same or may be slightly increased due to illness. How to deal with this contradiction when you don’t feel like eating?

If you’re really sick—hospital sick—no problem. You’ll have an IV needle stuck in your hand somewhere. That way your fluids and food go in anyway even if you are not eating at all.

This is not possible at home, so we do the next best thing. Since you’re not able to digest any solids, avoid foods requiring that service. The fluid of choice is water and the food of choice is sugar.

Other options include Kool-Aid, Popsicles, Jello and Pedialyte--to name a few. Any or all will maintain your fluids. And, as it is water, it will not go through the bowels, but through the kidneys!

The more complicated the food, the more likely you will see it again. Try to choose nice bland clear liquids to keep the child hydrated. As a rule, an ounce or so at a time with 10 to 20-minutes between servings. Any larger volume likely will come back up in a hurry.

As for nausea, we have a few tricks grandma will remember. A spoonful of any thick sugar syrup seems to be calming and examples can be the historic Coke syrup, or the heavy syrup from canned fruit, or maple syrup. Each family has its own standard treatment.

For a home medicine, there is Benadryl (diphenhydramine) syrup. This can do wonders, but follow the package instructions for the correct dosage. Once your patient is 30 minutes past his last emesis, you can start up the sips of fluids as we described.

Follow this handy feeding chart:
First 24 hours: Clear liquids, start small and advance slowly
Next day: BRAT diet only—bananas, rice, apple sauce and toast (dry)
Next day: Foods are okay at this point, but NO DAIRY
And lastly: All foods are fine, like milk and cheese and yogurt too.

You now should be ready to handle almost any crisis that requires a mop.

(Dr. Marz, a board-certified pediatrician, is supervising physician for the Town of Barnstable school system. He practices with Bass River Pediatrics in South Yarmouth.)