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In children, vomiting is the most common symptom of a functional disease, i.e. functional disorders. However, they can also be caused by an organic disease, e.g. a defect in the gastrointestinal tract.
This should be considered when assessing the health risks of vomiting their duration (short-term, episodic, chronic), violence (increasing or decreasing), and above all – whether they are accompanied by general symptoms.
In the neonatal period, vomiting is quite a common symptom. As long as they are sporadic, they do not endanger the health of the baby. But repeated vomitingwhich impair weight gain and worsen the child’s general condition (dehydration) require urgent diagnosis and treatment.
A common cause of vomiting in a newborn and young infant is immaturity of the sphincter connecting the esophagus to the stomach. It causes ‘incontinence’ in the stomach. In the treatment of such cases, it is recommended to place the child in a semi-sitting position after feeding and to use special thickening mixtures, the so-called AR.
Persistent vomiting with an admixture of mucus and saliva, accompanied by choking, may be a symptom of obstruction of the gastrointestinal tract above the stomach, while tinted with yellow – duodenal obstruction below the mouth of the bile duct.
An admixture of fresh blood in vomiting, it may come from the mother (her blood may have been swallowed by the newborn during delivery by caesarean section or may flow out of the bleeding nipple). However, blood in vomiting can also be a symptom of an illness in a newborn baby. The tinge differentiating both sources of bleeding is the color of the admixture – “maternal” blood is brown in color, neonatal blood remains vivid red.
Characteristic sloshing vomit (immediately after each feeding, under high pressure, abundant) appear in an infant at the age of 2-3 weeks and are a symptom of a stomach defect called hypertrophic stenosis of the pylorus. This disease is treated surgically – with a very good effect.
If the vomiting of the newborn and infant is accompanied by fever should be suspected sepsis (inflammation of the ears, kidneys, meninges). Then an urgent visit to the pediatrician is necessary.
In older children vomiting occasionally accompanies respiratory tract infections with strong cough agitation. However, the most common cause of vomiting preceded by nausea is digestive indigestion caused by dietary mistakes, less often gastrointestinal infections and parasites.
Vomiting occurring on empty stomachwithout any preceding nausea and independent of food intake may be a symptom brain tumors.
Chronic vomiting may be a symptom of metabolic and hormonal disorders. The so-called acetonemic vomiting – paroxysmal, recurrent, leading to dehydration and electrolyte disturbances.
Vomiting can also be caused overdosing of certain medications, e.g. vitamin D3.
Finally – along with pain – vomiting is the first symptom “surgical” diseases – appendicitis, peritonitis or gastrointestinal obstruction.
Text: lek. med. Grażyna Słodek – pediatrician
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