Patient's question:
Main symptoms: My son has a good appetite and tends to overeat, often consuming a lot. However, at night when he sleeps, he has a bad habit of easily vomiting. Sometimes, even slight coughing or a dry throat can trigger vomiting. We often teach him to hold it in, but sometimes he can't resist and vomits a lot (a lot of what he vomits is undigested). For this reason, we are very anxious, and the child also feels stressed. I don't know how to prevent and check it now (the doctor said it's a developmental issue and will gradually improve as he grows). I urgently hope that relevant experts can provide a solution.Doctor's answer:
Vomiting is a common issue in children. Many children experience one or two episodes of vomiting each year. Fortunately, most cases of vomiting are mild and can be quickly resolved with proper treatment. If handled well, most vomiting can be cured without medication. However, if the vomiting is severe or prolonged, it can lead to serious problems such as dehydration, electrolyte imbalance, and in some cases, even threaten life.Causes of Vomiting in Children
There are many reasons why children may vomit, including gastrointestinal infections, intussusception, pyloric stenosis, appendicitis, and more. Among these, gastrointestinal infections are the most common, caused by viruses such as rotavirus, adenovirus, and enterovirus. Eating unsuitable food is also a common cause of vomiting.
In addition to gastrointestinal diseases, other conditions such as otitis media, urethritis, colds, meningitis, and hydrocephalus can also cause vomiting. Certain medications, such as aspirin, iron supplements, and erythromycin-based antibiotics, can cause allergic reactions and poisoning, leading to gastrointestinal symptoms like vomiting.
Moreover, many cases of vomiting in children are due to psychological issues or excessive stress. For example, when children are forced to do things they don’t want to, such as studying or eating, or when they feel pressured about their schoolwork or fear going to school, they may vomit. Although this type of vomiting is not related to illness, it should still be taken seriously.
There are also situations where vomiting occurs without any medical cause, such as when a child cries intensely or vomits due to motion sickness or overeating. These cases are usually easy to identify and generally do not require examination or treatment.
Issues That May Be Confused with Vomiting
When caring for breastfeeding infants, it is easy to mistake spitting up for vomiting. Spitting up occurs when a baby’s esophagus is too short or the lower esophageal sphincter is relaxed, and there is gas in the stomach. After feeding, the gas in the stomach pushes the milk out, causing spitting up. Spitting up is not a disease but rather a result of improper feeding.
When spitting up occurs, careful observation can reveal that it differs from vomiting. Spitting up only happens in newborns or infants within the first few months of life. It does not affect the child’s appetite, mental state, or weight gain. In contrast, vomiting causes symptoms such as lethargy, poor appetite, fever, and weight loss or failure to gain weight.
Handling Vomiting
When vomiting occurs, the first step is to calm the child and prevent them from crying loudly. Immediately stop the suspected cause of vomiting, especially if food poisoning is suspected.
After vomiting, the child should not eat or drink for one to two hours to allow the stomach and intestines to rest. If the child is given water or food immediately after vomiting, it can increase the burden on the gastrointestinal system, leading to persistent and severe vomiting, which may cause further harm. During the fasting period, encourage the child to take a short nap.
Two hours after vomiting, if there has been no further vomiting, the child can be given small amounts of water, such as plain water, glucose water, or diluted beverages. Milk-based drinks should be avoided. When drinking, the child should take small sips frequently. For example, after vomiting, the child can drink one teaspoon of water every five minutes for the third hour after vomiting, two teaspoons every ten minutes for the fourth hour, and three teaspoons every fifteen minutes from the third to the sixth hour.
If the situation stabilizes, the child can gradually be introduced to solid foods. These foods should be simple and easy to digest, such as white rice porridge, white bread, noodles, or crackers. Avoid difficult-to-digest foods like curry, fried foods, or greasy dishes.
After eating, the child should sleep on their side to prevent vomit from entering their lungs. Infants can be held while sleeping.
When to Seek Immediate Medical Attention
1. Severe or recurrent vomiting lasting more than six hours.
2. Signs of dehydration, such as sunken eyes, dry lips, reduced skin elasticity, or no urination.
3. Vomit that is yellow-green or contains blood.
4. Severe abdominal pain during vomiting, especially if it persists for more than two hours.
5. Severe diarrhea accompanied by vomiting.
6. Head or abdominal injury before vomiting.
7. Suspected poisoning from food, plants, or medication.
8. Neck pain, stiffness, confusion, or changes in behavior during vomiting.
9. Suspected aspiration of vomit into the airway, causing breathing difficulties.
Traditional Chinese Medicine Treatments for Childhood Vomiting
Childhood vomiting is primarily characterized by the reverse flow of milk or food from the stomach to the mouth. The condition is often caused by overeating, stomach heat, stomach cold, liver Qi invading the stomach, or fright and panic. Below are several successful dietary and medicinal recipes for treating "childhood vomiting":
1. Fresh Carrot and Honey Soup
- 500g fresh carrots, 150g honey.
- Wash the carrots, cut them into pieces, blanch them in boiling water, drain the water, and dry them in the sun for half a day.
- Put them back in a pot, add honey, and simmer over low heat. Stir well, let it cool, and store in a bottle.
- Consume after meals.
- Suitable for vomiting due to overeating.
2. Shenqu and Clove Tea
- 15g shenqu, 1.5g cloves.
- Boil the herbs with hot water and drink as tea.
- Suitable for vomiting due to overeating.
3. Ginger, Vinegar, and Brown Sugar
- Wash ginger, slice it, and marinate it in vinegar for 24 hours.
- Simmer 3 slices of ginger with brown sugar and hot water for a moment, then drink as tea.
- Suitable for childhood vomiting.
4. Orange Peel and Rice Porridge
- 3–5g dried orange peel, 50g glutinous rice.
- Dry and grind the orange peel into a fine powder.
- Cook glutinous rice in a pot with water to make a thin porridge, add the orange peel powder, and simmer for a moment.
- Let the porridge thicken, then turn off the heat.
- Warm and eat in the morning and evening.
- 5 days per course.
- Suitable for stomach cold and vomiting.
5. Millet, Cucumber, Ginger, and Salt
- Peel and slice fresh cucumbers, wash millet, and smash ginger.
- Boil 1,000ml of water in a pot, add millet, and bring to a boil.
- Simmer over low heat until the rice is tender, then add cucumber slices.
- Continue cooking until the soup thickens and a layer of oil forms on the surface.
- Season with salt and serve as a meal.
- Suitable for summer heat-induced vomiting and diarrhea.
6. Loquat Leaf, Glutinous Rice, Fresh Bamboo Root, and Rock Sugar
- 10–15g dried loquat leaves (30–60g fresh), 100g glutinous rice, 60g fresh bamboo root, a small amount of rock sugar.
- Boil the loquat leaves and fresh bamboo root in water, strain the liquid, and cook with glutinous rice into porridge.
- Add rock sugar and cook for a moment.
- Effective for stomach heat-induced vomiting.
7. Bamboo Vinegar and Fresh Bamboo Root Tea
- 30g bamboo vinegar, 30g fresh bamboo root, 3 slices of ginger.
- Boil the ingredients, strain the liquid, and drink as tea.
- Suitable for stomach heat and vomiting.
8. High-Quality Ginger and Glutinous Rice Porridge
- 15g high-quality ginger, 50g glutinous rice.
- Boil the ginger, strain the liquid, and cook with glutinous rice into porridge.
- Eat on an empty stomach.
- Suitable for stomach cold-induced vomiting.
9. Lean Lamb Stew
- 500g lean lamb, 30g garlic, 5g scallions, 5g ginger, 3g salt, 3g sugar, 5ml cooking wine, 3ml soy sauce, 5g soybean paste, 2g MSG, 10g sesame, 2 walnuts, 10ml sesame oil, 500ml cooking oil (25ml used), and milk soup as needed.
- Wash the lamb, cut it into even pieces, and blanch it with scallions and ginger.
- Dry the lamb, marinate with salt and cooking wine for 1 hour, then steam until tender.
- Cut the lamb into 4cm x 2cm strips.
- Heat cooking oil in a pan, fry the lamb strips until dry, then remove.
- Add scallions and ginger to the remaining oil, stir-fry, add soy sauce, cooking wine, sugar, milk soup, and garlic paste.
- Mix in soybean paste, add the lamb, reduce the heat, and thicken the sauce.
- Remove scallions and ginger, add MSG, sesame, and sesame oil, and mix well.
- Suitable for stomach cold and vomiting.
10. Fennel, Ginger, and Sugar Tea
- Boil fennel and ginger, add sugar, and drink warm.
- Suitable for stomach Qi stagnation-induced vomiting.
11. Potato, Ginger, Orange Juice, and Fennel Juice
- Extract juice from potatoes, ginger, and fennel, mix with fresh orange juice, and warm before drinking.
- 1 time per day.
- Suitable for liver Qi invading the stomach-induced vomiting.
12. Tianma, Gouteng, Shijue Ming, and Lotus Root Powder Soup
- Boil tianma, gouteng, and shijue ming, strain the liquid, and mix with lotus root powder and sugar.
- Take 1 dose per day for 4–5 days.
- Effective for stomach heat-induced vomiting.