American Academy of Pediatrics

Vomiting—Child Care and Schools


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What is vomiting?

  • The exit of stomach contents through the mouth.

  • Vomiting may have many causes and is not always from an infection. For example, children with gastroesophageal reflux have frequent spit-ups and vomiting episodes that are neither contagious nor necessarily abnormal. A child who has fallen may vomit because of a head injury.

What are the signs or symptoms?

  • Children with vomiting from an infection often have diarrhea and, sometimes, fever.

  • Prolonged or severe vomiting can result in children becoming dehydrated (dry mouth, no tears, no urine).

What are the incubation and contagious periods?

If vomiting is associated with an infection, the incubation and contagious periods depend on the type of germ causing the infection.

How is it spread?

Direct contact with vomit can result in the spread of certain infections.

How do you control it?

  • Use good hand-hygiene technique at all the times listed in Chapter 2.

  • Clean and disinfect surfaces that have been contaminated with body fluids.

  • Exclude children with vomiting who do not have a known reason and care plan for it. Reflux is an example of a condition that does not require exclusion because it is a known reason for the vomiting.

What are the roles of the teacher/caregiver and the family?

  • Use good hand-hygiene technique at all the times listed in Chapter 2.

  • Review Standard Precautions, particularly hand hygiene.

  • Report the condition to the staff member designated by the child care program or school for decision-making and action related to care of ill children. That person, in turn, alerts possibly exposed family and staff members to watch for symptoms.

  • Suggest the family consult the child's health professional if vomiting continues or the child develops other symptoms.

Exclude from group setting?

Yes, if

  • Vomited more than 2 times in 24 hours and vomiting is not from a known condition for which the child has a care plan.

  • Vomiting and fever.

  • Vomit that appears green or bloody.

  • No urine output in 8 hours.

  • Recent history of head injury.

  • Child looks or acts very ill.

  • The child is unable to participate and staff members determine they cannot care for the child without compromising their ability to care for the health and safety of the other children in the group.

Readmit to group setting?

Yes, when all the following criteria have been met:

  • When vomiting has resolved

  • When other exclusion criteria are resolved, the child is able to participate, and staff members determine they can care for the child without compromising their ability to care for the health and safety of the other children in the group

Adapted from Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide.

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The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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