Vomiting child
First of all, we need to define what age group of children we are treating. The following procedure is reasonably applicable (with some exceptions) to children aged 1 year and older. For infants under 1 year, we prefer careful breastfeeding in small amounts and discontinuing solid foods.
So how do we manage older children? → Preparation of a rehydration solution:
• Complex method: Ideally, we give a rehydration solution (ORS), such as Kulíšek, Enhydrol, Fluidex (the advantage is that it comes in soluble effervescent tablets), or BioGaia ProTectis Plus. The ORS should be served chilled to 8°C – put the first batch in the freezer for an hour to cool it quickly, and store the second batch in the fridge, prepared at the same time. Children often dislike the taste of these preparations, which is why serving them cold helps.
• Simple method: If the child refuses these preparations or if the process seems too complicated, you can use regular fluids – a mild black tea (steeped for 30 seconds) – the benefit of black tea is its astringent effect on the mucosa. Hibiscus tea is also worth trying. These teas should be sweetened with grape sugar (glucose, e.g., Glukopur), not regular beet sugar, which can worsen fermentation processes in the gut. As a third step, add a shot-glass worth of Fatra or Sulinka mineral water into the tea (this adds minerals). Avoid concentrated fruit juices, regular juices, and carbonated drinks.
How to administer fluids:
Fluids should be given by spoon as follows:
• First hour: 1 teaspoon every 10 minutes
• Second hour: 1 teaspoon every 5 minutes
• Each following hour: shorten the interval by half
Common mistake: Letting a thirsty child (who just started feeling better) drink a large amount at once – this almost always leads to vomiting again.
When to reintroduce food:
If the child is vomiting, DO NOT give any food – follow only the rehydration protocol described above.
You can only start offering food once the child has gone 24 hours without vomiting.
Until then – only fluids!
After 24 hours, start with plain crackers and ladyfingers, continuing to give the rehydration solution for the next 24 hours. Nothing else should be given during this time.
Only 48 hours after the last vomiting episode can you begin reintroducing light, cooked/steamed meals (e.g., potato, rice, carrot, banana). If the child tolerates this, you can gradually increase the portions and add white meat.
For about a week, avoid anything fatty, irritating, or heavy (e.g., fries, hamburgers, sausages), as well as chocolate, cookies, sweets, ketchup, mustard, tartar sauce, etc.
If the situation is complicated by diarrhea, be especially vigilant, as dehydration and metabolic imbalance can occur very quickly. In that case, contact a doctor sooner rather than later, and combine this approach with immediate use of probiotics, as detailed in the recommendations for treating diarrhea:
When to go to the hospital?
If the child:
• Has not urinated for more than 6 hours
• Is vomiting many, many times (e.g., 15–20 times in the last few hours)
• Cannot tolerate rehydration despite your best efforts
• Is lethargic, has dry mucous membranes, dry skin
• Has a fever over 38.5°C along with vomiting