Bilious vomiting factsheet

Vomiting is a very common symptom in children. It's one of the most common reasons parents take their child to the doctor.
If your child is vomiting, the contents of their stomach is forced up through their mouth. Vomiting is also known as throwing up or being sick.
Babies often bring up small amounts of food after feeding — it's known as posseting or reflux. It happens without any effort. This is in contrast to vomiting — which involves strong contractions of the muscles in their stomach.
Babies and children are especially at risk of dehydration when they are vomiting. This is when your child may not be able to take in enough fluids to make up for those lost from vomiting.
Your child may vomit for many different reasons. Viral gastroenteritis ('gastro') is the most common cause of sudden vomiting in children. Vomiting from viral gastroenteritis usually clears up in a couple of days.
Vomiting in children often happens with other symptoms, such as diarrhoea.
Other symptoms that can occur together with vomiting in children are:
Children can also projectile vomit. Projectile vomiting is when they vomit out of their mouth so forcefully that it can travel over a metre.
Your child may be vomiting for a short time due to an infection. But vomiting in children can also be very serious or have a longer term cause.
Causes of vomiting in children include the following conditions:
Gastroenteritis (also known as 'gastro' or a stomach bug) is caused by an infection in the digestive system. This is usually due to a virus, but sometimes it's bacterial.
Gastroenteritis causes vomiting, diarrhoea, fever and abdominal pain. Gastro is easily spread between people, especially children.
Children and small babies are more likely to get dehydrated from gastroenteritis. If your baby is under 6 months old, and has gastroenteritis see a doctor.
Rotavirus is a common cause of severe gastroenteritis in babies. Your baby can have a free vaccine against this virus as part of the National Immunisation Program (Opens in new tab).
Older children are more likely to have gastroenteritis caused by norovirus.
Food poisoning is caused by germs growing in food that has been poorly prepared or stored. The symptoms are the same as those caused by gastroenteritis, but usually more severe.
Your baby or small child could be at risk of dehydration. Take care that they stay hydrated (see below).
Poisoning is most common in young children, who often put things in their mouths.
Many household items are poisonous if swallowed. Symptoms of poisoning include:
Do NOT attempt to make the child vomit, unless instructed by a medical professional.
Vomiting can be a sign of a urinary tract infection (UTI) in children. They are common in young children. The symptoms of UTIs in children are often vague but can also include:
Symptoms of COVID-19 in children include:
Motion sickness is more common in older children than babies. Car, train and air travel can cause it.
Motion sickness can also be triggered by virtual reality games and amusement park rides.
Appendicitis causes pain around the navel (belly button) which then moves to the lower right side of the abdomen and becomes sharper.
A child with appendicitis may:
Meningitis is an infection and swelling of the membrane that covers the brain and spinal cord. It's usually caused by a bacterial or viral infection. It's rare but serious, and can quickly cause death.
Meningitis can cause symptoms such as:
If your baby has meningitis they may be irritable and have a high-pitched cry. They may arch their back or hold their head back. The baby's fontanelle (the soft spot on the top of the head) may be swollen and bulge.
Diabetic ketoacidosis is sometimes the first sign that a child has diabetes. It happens when the body does not have enough insulin to use glucose (sugar) in the blood for fuel. The body breaks down fat instead and produces ketones as a by-product. The ketones make the blood too acidic (ketoacidosis).
Symptoms of diabetic ketoacidosis include:
You may notice that your child is more thirsty than normal and urinates (wees) more often.
A food allergy is more likely to happen in the first year of life, when you try a new food with your child.
If the allergic reaction is severe, the child may have anaphylaxis — a potentially life-threatening emergency. Symptoms of anaphylaxis are:
Cow's milk allergy is an example of a food allergy that may cause vomiting in young children.
These include:
Your doctor will want to check how long your child has been vomiting. Tell your doctor about any other symptoms that your child has along with vomiting to help with diagnosis.
They will examine your child, and see if there are any signs of dehydration.
Tests that may help your doctor to understand the cause of chronic vomiting include:
If your child has been vomiting for a while, your doctor may suggest referring your child to a specialist. This could be a gastroenterologist, an allergy expert, a neurologist or a paediatrician.
Babies younger than 6 months should always be taken to the doctor if they are vomiting or you think they have gastroenteritis.
If your child has another health condition such as diabetes or epilepsy and they are vomiting they should see a doctor.
Vomiting can be more dangerous in young babies. Here is a guide on when to get medical care for vomiting:
If your child is vomiting and has any of these symptoms, you should take them to the emergency department at your nearest hospital as soon as possible:
Most vomiting episodes in children are due to viral gastroenteritis. This can usually be treated at home.
If your child is dehydrated or is a baby under 6 months take them to the doctor.
Vomiting will often clear up without any specific treatment. Focus on keeping your child hydrated.
Help them replace any lost minerals and salts by giving oral rehydration solution. You can buy it from a pharmacy or supermarket.
You may be able to care for your child with viral gastroenteritis at home. Vomiting caused by viral gastroenteritis usually gets better in 1-2 days, but the diarrhoea can go on for longer.
Here is some advice for caring for a baby or child aged over 6 months with vomiting due to gastroenteritis:
Here is some advice for caring for an older child with vomiting due to gastroenteritis:
Don't send them to nursery, day care or school until they have not had a loose bowel motion for at least 24 hours.
If your child is vomiting and you are worried that they are not getting better, seek help from your doctor or pharmacist.
Anti-vomiting medicines (antiemetics) are not generally recommended in children. Do not give your child an antiemetic without health professional advice.
You can give your child oral rehydration solution from the pharmacy.
Any other specific treatment will depend on the underlying cause of vomiting. Here are some examples:
Gastroenteritis is the most common cause of vomiting in children. It's highly infectious and can easily spread between children.
You can help stop the spread of gastroenteritis by:
If your child is vomiting after eating particular foods, speak to your doctor or a dietitian for advice.
There are vaccines available (Opens in new tab) to prevent some causes of vomiting in children, such as rotavirus or meningitis.
Whatever the cause of vomiting, you need to ensure that your child doesn't become dehydrated. This can happen because of the fluids lost when vomiting.
Dehydration in babies or small children can be fatal. Some signs of severe dehydration are:
If your child becomes dehydrated, they may need to go to hospital for rehydration. At the hospital they can get fluids via a nasogastric tube, which goes down their nose into their stomach, or intravenously on a drip.
For more information and support, try these resources:
Learn about food allergy symptoms at Nip allergies in the Bub (Opens in new tab).
Find information on how to introduce solid foods to babies for allergy prevention (Opens in new tab).
For resources in languages other than English, visit The Royal Children's Hospital Melbourne — Gastroenteritis (Opens in new tab).
If you need advice on what to do for your child, call healthdirect on 1800 022 222 to speak with a registered nurse, 24 hours, 7 days a week.
Pregnancy, Birth and Baby has a helpful list of resources. Visit Who can I call for information and advice?
Find out how we develop and review our content.
Last reviewed: February 2024









