From the Guidelines
To manage a child with vomiting, it is essential to prioritize hydration with small, frequent volumes of oral rehydration solutions (ORS) like Pedialyte, as recommended by the most recent guidelines 1. The goal is to prevent dehydration and ensure the child's body can recover from the underlying cause of vomiting.
- Start with small amounts: 1-2 teaspoons every 5-10 minutes, gradually increasing as tolerated.
- Use ORS: solutions like Pedialyte are designed to replace lost electrolytes and fluids.
- Monitor and adjust: watch for signs of dehydration, such as dry mouth, decreased urination, and lethargy, and adjust the hydration plan accordingly.
- Consider antiemetic medication: for children over 4 years old, ondansetron (Zofran) may be prescribed by a doctor to facilitate tolerance of oral rehydration 1. Some key points to consider when managing a child with vomiting include:
- Avoid solid foods initially: wait until vomiting subsides before reintroducing bland foods like crackers, toast, rice, or bananas.
- Keep the child comfortable and rested: monitor for warning signs, including persistent vomiting, severe abdominal pain, or high fever, which may require immediate medical attention.
- Be aware of the limitations and potential side effects of medications and treatments, and always follow the guidance of a healthcare professional. The most recent and highest quality study 1 provides the basis for these recommendations, emphasizing the importance of oral rehydration and careful monitoring in managing a child with vomiting.
From the Research
Management of Vomiting in Children
To manage a child with vomiting, the following strategies can be employed:
- Oral rehydration therapy (ORT) to prevent dehydration, as recommended by the World Health Organization guidelines 2
- Administration of oral ondansetron to facilitate successful rehydration and reduce the risk of hospitalization and intravenous rehydration 2, 3, 4, 5
- Encouraging the child to continue their usual diet plus drink adequate fluids to reduce the duration of diarrhea 6
- Use of probiotics to shorten the course of diarrhea 6
- Good handwashing practices to reduce the incidence of acute gastroenteritis 6
Role of Ondansetron
Ondansetron has been shown to be effective in:
- Reducing the risk of failure of oral rehydration therapy 2, 4, 5
- Decreasing the number of vomiting episodes 2, 4
- Reducing the need for intravenous rehydration 3, 4, 5
- Reducing the risk of hospitalization 3, 4, 5 However, it is noted that ondansetron may increase episodes of diarrhea 6
Economic Impact
The use of oral ondansetron has been shown to result in significant economic savings, particularly in terms of hospitalization costs 3