Nausea.md

🤢 Nausea in Children: What Parents Can Do Today (and When to Worry)

✅ Nausea is common and usually temporary—but sometimes it’s the body’s early warning sign.
This guide helps you treat safely at home, spot red flags, and know what to expect next.

1) 🧾 Quick “At-a-glance” box (top of page)

✅ Condition name: Nausea
Common names: “Upset stomach,” queasy feeling, “feels like throwing up”

Plain-language summary (2–3 lines):
Nausea is the feeling that you might vomit. In kids, it’s most often caused by a short viral illness, constipation, motion sickness, anxiety, reflux, or something they ate. Most cases improve with fluids, small meals, rest, and time.

Who it affects (typical ages):
All ages. Causes vary by age (infants vs school-age vs teens).

✅ What parents should do today:

• Focus on hydration first (small sips often).
• Use simple foods when ready (small, bland portions).
• Check for constipation (very common hidden trigger).
• Use a safe nausea plan (see section 5).

⚠️ Red flags that need urgent/ER care:

• Signs of dehydration (no urine 8–12 hours, very sleepy, dizzy/faint)
• Vomiting green (bilious) or blood, or black “coffee-ground” vomit
• Severe belly pain, hard/swollen belly, or pain that is worsening
• Severe headache + stiff neck, confusion, or new weakness
• Testicular pain/swelling in boys (emergency)
• Persistent vomiting with inability to keep fluids down

🟡 When to see the family doctor/clinic:

• Nausea lasting > 1–2 weeks
• Recurrent episodes (especially morning nausea or school-related nausea)
• Weight loss, poor growth, persistent diarrhea, blood in stool
• Suspected reflux disease, migraine pattern, anxiety, or medication side effects

2) 🧠 What it is (plain language)

Nausea is a feeling of “I might throw up.”
It comes from signals between:

• the stomach and intestines,
• the brain (vomiting center),
• the balance system (inner ear),
• and the nervous system (stress response).

What part of the body is involved? (small diagram required)

Common myths vs facts

• Myth: “If my child is nauseated, they must have food poisoning.”
  Fact: Many causes exist—viral illness, constipation, anxiety, reflux, migraine, motion sickness.
• Myth: “They should stop eating completely.”
  Fact: Fluids first, then small bland foods can help once tolerated.
• Myth: “If there’s no vomiting, it’s not real.”
  Fact: Nausea can be very real even without vomiting.

3) 🧩 Why it happens (causes & triggers)

Common causes (most likely)

• Viral gastroenteritis (often with vomiting/diarrhea)
• Constipation (can cause nausea even without obvious belly pain)
• Motion sickness (car rides, screens in the car)
• Anxiety / stress (school mornings, tests)
• Reflux (heartburn, sour taste, throat symptoms)
• Overeating or skipping meals (empty stomach nausea is common)

Less common but important causes (brief)

• Appendicitis (worsening pain, fever, localized tenderness)
• Bowel obstruction (green vomit, swollen belly, severe pain)
• Migraine (nausea with headache/light sensitivity)
• Kidney infection/UTI (fever, pain with urination)
• Medication side effects (antibiotics, iron, some ADHD meds)
• Pregnancy (in teens of reproductive age—must be considered clinically)

Triggers that worsen nausea

• Strong smells, heat, car rides
• Greasy/spicy foods
• Dehydration
• Anxiety and hyperventilation
• Constipation untreated

Risk factors

• Family history of migraine/IBS/anxiety
• Prior episodes of motion sickness
• Chronic constipation
• Irregular sleep and meals

4) 👀 What parents might notice (symptoms)

Typical symptoms (most common first)

• “My tummy feels yucky,” queasy feeling
• Less appetite
• Gagging, retching
• Increased saliva
• Pale, tired, “not themselves”
• Sometimes vomiting or diarrhea

Symptoms by age group

• Infant: poor feeding, fussiness, gagging/spit-up, fewer wet diapers
• Toddler: refuses food, holds tummy, may vomit
• School-age: nausea before school, motion triggers, constipation-related nausea
• Teen: stress-related nausea, reflux, migraine, medication-related patterns

What’s normal vs what’s not normal

✅ Often okay to watch at home: mild nausea, child alert, drinking, urinating, improving
⚠️ Needs medical review: dehydration, severe pain, green/bloody vomit, severe headache/neck stiffness, weight loss, persistent symptoms

Symptom trackers (what to write down)

• Timing: morning vs after meals vs car rides
• Vomiting: how many times, color (green/blood?)
• Stool pattern (constipation? diarrhea?)
• Fever, headache, dizziness
• Hydration: wet diapers/urine count
• Trigger notes: school, stress, foods, travel
• Medications/supplements started recently

5) 🏠 Home care and what helps (step-by-step)

✅ What to do in the first 24–48 hours

1. Hydration first (tiny sips often).
2. Rest in a cool, quiet room.
3. Avoid heavy foods until nausea settles.
4. Check constipation (last stool? hard/painful? stool withholding?).
5. Use simple nausea tools below.

Hydration plan (the most important step)

✅ Do this now:

• Offer 5–10 mL (1–2 teaspoons) every 2–3 minutes for young kids.
• For older kids: small frequent sips every few minutes.
• Oral rehydration solution is best if vomiting/diarrhea is present.

Signs hydration is working: more urine, more energy, moist mouth, tears when crying.

Food plan (when your child is ready)

• Start with small bland foods:
  • toast, crackers, rice, banana, applesauce, soup, yogurt if tolerated
• Avoid:
  • greasy, spicy, very sugary foods
• Don’t force eating—fluids matter most early on.

Practical routines (common helpful habits)

• Keep child upright after eating (helps reflux)
• Fresh air and slow walking can reduce nausea
• Warm bath may soothe (if no dehydration risk)

Tools that can help nausea

• Acupressure P6 point (wrist nausea point)
• Ginger (age-appropriate; avoid choking hazards)
• Peppermint tea (older kids; not for infants)
• Breathing to stop “panic nausea” (slow belly breathing)

What usually makes it worse

• Big meals
• Lying flat right after eating
• Screens in the car (motion sickness)
• Skipping breakfast
• Constipation not addressed

6) ⛔ What NOT to do (common mistakes)

Unsafe treatments parents commonly try

• Using anti-diarrhea medications without guidance
• Giving unregulated herbal remedies
• Forcing large volumes of fluids quickly (can trigger vomiting)

“Avoid unless your clinician told you”

• Repeated use of “strong” anti-nausea medicines without evaluation
• Restrictive elimination diets for vague nausea (risk of poor nutrition)

When not to give over-the-counter medications

• Avoid cold/flu products for nausea
• Avoid bismuth subsalicylate in kids unless clinician approves (age-related cautions)

7) 🚦 When to worry: triage guidance

🔴 Call 911 / Emergency now

• Trouble breathing, turning blue, fainting
• Severe confusion, seizure
• Severe weakness with signs of shock

Example: “My child is very sleepy and won’t wake normally.”

🟠 Same-day urgent visit

• Cannot keep fluids down, vomiting repeatedly
• Dehydration: no urine 8–12 hours, very dry mouth, dizzy, sunken eyes
• Green vomit (bilious) or blood/black vomit
• Severe belly pain or swollen/hard belly
• Severe headache with neck stiffness

Example: “Vomiting every hour and no pee since morning.”

🟡 Book a routine appointment

• Nausea lasting > 1–2 weeks
• Recurrent nausea (morning/school pattern)
• Weight loss, poor growth, persistent fatigue
• Suspected reflux, migraine, anxiety, or medication side effect

Example: “Nausea every school morning but fine on weekends.”

🟢 Watch at home

• Mild nausea, child drinking and urinating, improving day by day
• No red flags

Example: “Queasy after a viral cold, better with small sips and rest.”

8) 🩺 How doctors diagnose it (what to expect)

What the clinician will ask

• Pattern: when it happens, triggers, morning vs after meals
• Vomiting details (color, frequency)
• Stool pattern and constipation history
• Fever, headache, dizziness
• Growth and weight changes
• Medication/supplement review
• In teens: confidential screening when appropriate

Physical exam basics

• Hydration check, abdominal exam, vital signs
• Neurologic check if severe headache/concerns

Possible tests (and why)

• Urine test if fever or UTI concern
• Blood work if dehydration, weight loss, persistent symptoms
• Stool tests if diarrhea/blood
• Imaging if appendicitis or obstruction is suspected

What tests are usually not needed

• Scans for short-lived mild nausea that is improving and exam is reassuring

What results might mean (simple interpretation)

• Normal tests + functional pattern suggests gut–brain triggers (constipation, anxiety, reflux)
• Abnormal findings guide targeted treatment

9) 🧰 Treatment options

First-line treatment

• Hydration plan + rest
• Constipation management if present
• Trigger management (motion sickness strategies, regular meals)
• Reflux strategies if symptoms fit

If not improving (next steps)

• Evaluate for constipation, reflux disease, migraine, anxiety
• Consider anti-nausea medication only under clinician guidance if vomiting prevents hydration
• Consider referral if persistent/recurrent (pediatric GI, neurology for migraine pattern, psychology for anxiety pattern)

Severe cases (hospital care)

• IV fluids if dehydration
• Urgent evaluation for obstruction/appendicitis or other serious causes

Medication/treatment details (parent-friendly)

Oral rehydration solution

• What it does: replaces fluids and salts
• How to give: tiny sips frequently
• Side effects: none; too much too fast can cause vomiting
• When to stop/seek help: worsening dehydration

Antiemetic (example: ondansetron) — clinician-directed

• What it does: reduces vomiting so hydration is possible
• How to give: as prescribed; often single dose or short course
• Common side effects: constipation, headache
• Serious side effects (rare): heart rhythm issues in certain high-risk situations
• When to stop and seek help: severe dizziness, fainting, allergic reaction
• Interactions: tell clinician about heart conditions, electrolyte problems, QT-prolonging medications

Constipation treatment

• If constipation is present, treating it often improves nausea (see your constipation resources)

10) ⏳ Expected course & prognosis

Typical timeline

• Viral nausea: often improves in 24–72 hours (sometimes longer)
• Constipation-related nausea: improves over days to 1–2 weeks once stools soften and regularize
• Motion sickness: improves with prevention strategies
• Anxiety-related nausea: improves with skills practice over weeks

What “getting better” looks like

• More urine, better energy
• Less queasiness, able to eat small meals
• Less vomiting and better sleep

What “getting worse” looks like

• Less urine, more sleepiness
• Increasing pain, green/bloody vomit
• Cannot keep any fluids down

Return to school/daycare/sports

• Return when:
  • drinking well,
  • fever-free,
  • energy is returning,
  • vomiting controlled.
• Start with light activity and small snacks.

11) ⚠️ Complications (brief but clear)

Common complications

• Dehydration
• Constipation worsening after illness
• Temporary food avoidance

Rare serious complications

• Obstruction/appendicitis/migraine emergencies (watch red flags)

12) 🛡️ Prevention and reducing future episodes

• Hand hygiene (for viral illnesses)
• Regular meals and hydration
• Constipation prevention plan
• Motion sickness prevention:
  • look out window, fresh air, avoid screens, light snack before travel
• Stress plan for school mornings: breathing + predictable routine

13) 🌟 Special situations

Infants

• Feeding refusal, dehydration, fever in young infants requires prompt medical assessment.

Teens

• Consider migraine, reflux, stress, medication effects
• Clinicians may consider pregnancy as part of routine medical evaluation when appropriate.

Kids with chronic conditions (asthma, diabetes, immunosuppression)

• Lower threshold for evaluation and dehydration management.

Neurodevelopmental differences/autism

• Use predictable hydration routine, preferred cups, visual schedules
• Monitor dehydration closely (some kids don’t communicate nausea well)

Travel considerations

• Motion sickness plan + acupressure bands + snacks + hydration

School/daycare notes

• Encourage water access and bathroom breaks
• Avoid sending child back too early if dehydration risk remains

14) 📅 Follow-up plan

• Follow up with your family doctor/pediatrician if:
  • symptoms persist > 1–2 weeks
  • recurrent nausea episodes
  • weight loss/poor growth
  • red flags occur
• Bring:
  • symptom diary (timing/triggers)
  • medication list
  • stool pattern notes

15) ❓ Parent FAQs

“Is it contagious?”

Sometimes. Viral stomach bugs can spread easily. Nausea from constipation, reflux, migraine, or anxiety is not contagious.

“Can my child eat ___?”

Usually yes, but start with small bland foods. Avoid greasy/spicy foods until improved. Don’t skip breakfast if morning nausea is a pattern.

“Can they bathe/swim/exercise?”

Baths are fine if not dehydrated. Swimming/exercise is okay once hydration and energy are back.

“Will they outgrow it?”

Depends on the cause. Viral nausea passes. Constipation/motion sickness/anxiety-related patterns improve with targeted strategies.

“When can we stop treatment?”

Stop extra supports once your child is drinking/eating normally and symptoms are gone. Keep prevention routines (hydration, constipation prevention) if recurrent.

16) 🧾 Printable tools (high-value add-ons)

🧾 Printable: One-Page Action Plan (Nausea)

Step 1 — Hydrate (most important):

• 5–10 mL every 2–3 minutes (young kids)
• Small frequent sips (older kids)
• Oral rehydration solution if vomiting/diarrhea

Step 2 — Calm the stomach:

• Cool quiet room
• Fresh air
• P6 wrist acupressure / wristband
• Slow belly breathing

Step 3 — Food when ready:

• Small bland foods (toast/crackers/rice/banana/soup)
• Avoid greasy/spicy foods

Urgent care if: no urine 8–12 hours, cannot keep fluids down, green/bloody vomit, severe pain, severe headache/neck stiffness.

🧾 Printable: Medication Schedule Box

(Use only if prescribed by clinician.)

• Morning: __________________ Time: ______
• Afternoon: ________________ Time: ______
• Evening: __________________ Time: ______
• Side effects to watch: __________________________

🧾 Printable: Symptom Diary / Tracker

Date/Time: _________

• Nausea severity (0–10): ____
• Vomiting? (how many / color): ______________
• Stool today (constipation/diarrhea?): _________
• Fever/headache/dizziness: ___________________
• Fluids taken: _______________________________
• Wet diapers/urine count: _____________________
• What helped: ________________________________

🧾 Printable: “Red Flags” Fridge Sheet

⚠️ Urgent/ER: dehydration (no urine 8–12 hours), repeated vomiting, green/bloody/black vomit, severe belly pain or hard belly, severe headache with stiff neck, fainting, trouble breathing, testicular pain/swelling.

🧾 Printable: School/Daycare Instructions Page

• Allow water bottle access
• Allow bathroom access
• Encourage small snacks if tolerated
• Call parent if vomiting repeats, severe pain, or child becomes very sleepy

17) 📚 Credible sources + last updated date

Trusted references (examples):

• Children’s hospital pages on vomiting/nausea and dehydration
• National pediatric society parent education on gastroenteritis and rehydration
• Pediatric guidance on motion sickness strategies

Last reviewed/updated on: 2025-12-30
Local guidance may differ based on your region and your child’s health history.

18) 🧡 Safety disclaimer (short, not scary)

This guide supports—not replaces—medical advice. If you are worried, trust your instincts and seek urgent care—especially for dehydration signs or abnormal vomit color (green/bloody/black).

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This guide was fully developed & reviewed by Dr. Mohammad Hussein, MD, FRCPC ROYAL COLLEGE–CERTIFIED PEDIATRICIAN & PEDIATRIC GASTROENTEROLOGIST Board-certified pediatrician and pediatric gastroenterologist (Royal College of Physicians and Surgeons of Canada) with expertise in inflammatory bowel disease, eosinophilic gastrointestinal disorders, motility and functional testing, and complex nutrition across diverse international practice settings. To book an online assessment Email Dr. Hussein’s Assistant Elizabeth Gray at: Elizabeth.Gray@pedsgimind.ca In the email subject, please write: New Assessment Appointment with Dr. Hussein Important: This appointment is completely online as Dr. Hussein is currently working overseas. This service is not covered by OHIP