From the Guidelines
For an 8-month-old with vomiting, focus first on preventing dehydration by offering small, frequent sips of oral rehydration solution like Pedialyte, as recommended by the 2017 Infectious Diseases Society of America clinical practice guidelines 1.
Key Recommendations
- Start with 5-10 ml every 5-10 minutes and gradually increase as tolerated, based on the guidelines for mild to moderate dehydration in infants and children 1.
- Avoid dairy products, fruit juices, and solid foods initially, as they can exacerbate dehydration and vomiting.
- Once vomiting decreases, slowly reintroduce the baby's normal diet, starting with bland foods like rice cereal or bananas.
- Do not give over-the-counter anti-nausea medications to infants as they can be dangerous, according to the 2017 Infectious Diseases Society of America clinical practice guidelines 1.
Monitoring and Follow-up
- Contact a doctor immediately if you notice signs of dehydration (fewer wet diapers, dry mouth, sunken eyes, lethargy), if vomiting persists beyond 24 hours, if there's blood in the vomit, if the baby has a high fever, or appears very ill.
- Keeping the baby upright for 30 minutes after feeding may help reduce vomiting caused by reflux, which is common in infants, as suggested by the American Academy of Pediatrics 1.
Additional Considerations
- Most infant vomiting is caused by viral gastroenteritis, which typically resolves within 24-48 hours.
- Gastroesophageal reflux disease (GERD) can also cause vomiting in infants, and may require further evaluation and treatment, as discussed in the guidelines for pediatric GERD management 1.
From the Research
Treatment of Vomiting in 8-Month-Old Children
- Vomiting in children can be caused by various organic and non-organic disorders, including gastrointestinal and non-gastrointestinal issues 2.
- Acute gastritis and gastroenteritis are leading causes of acute vomiting in children, and other life-threatening conditions such as congenital intestinal obstruction, pyloric stenosis, and sepsis should be considered in infancy 2.
- Initial evaluation of vomiting in children should focus on assessing airway, breathing, and circulation, as well as hydration status and red flag signs such as bilious or bloody vomiting, altered sensorium, and severe dehydration 2.
Use of Ondansetron in Treating Vomiting
- Ondansetron, a 5-HT3 serotonin antagonist, has been shown to be effective in treating vomiting in children with acute gastroenteritis, increasing the chance of vomiting cessation and reducing the risk of failure of oral rehydration therapy 3, 4, 5, 6.
- Studies have demonstrated that ondansetron can improve the efficacy of oral rehydration therapy, reduce the need for intravenous rehydration, and decrease the risk of hospitalization 3, 4, 6.
- A single dose of oral ondansetron (0.2 mg/kg) or intravenous ondansetron (0.15 mg/kg) can be effective in preventing vomiting episodes in children with acute gastroenteritis 2, 5.
Management of Vomiting in 8-Month-Old Children
- Treatment priorities for vomiting in children include addressing dehydration, stopping oral fluids/feeds, and decompressing the stomach with a nasogastric tube in patients with bilious vomiting 2.
- Antiemetic medication such as ondansetron may be indicated in children unable to take orally due to persistent vomiting, and its use can be considered to promote oral rehydration therapy success among dehydrated children 2, 4.