The main short-term risk from repeated vomiting and watery diarrhea is dehydration. Warning signs include much less urine, a very dry mouth, few or no tears, unusual sleepiness or irritability, weakness, dizziness, sunken eyes, or a sunken soft spot in an infant.
What are common signs of dehydration?
- Urinating much less often, dark urine, or no urine for about 8 hours
- A dry tongue and inside of the mouth, and fewer or no tears when crying
- Playing less than usual, unusual fussiness, excessive sleepiness, weakness, or dizziness
- Sunken eyes or a sunken soft spot in an infant or toddler
- Cool or discolored hands and feet, or being too weak to stand in more severe cases
What fluids are usually most useful?
Small, frequent amounts of an oral rehydration solution are often easier to keep down than a large drink. Breastfeeding can usually continue. The best fluid and amount depend on the child's age, weight, symptoms, and medical history.
Very sugary drinks can worsen diarrhea. Do not give an over-the-counter anti-vomiting or anti-diarrhea medicine to a child unless a clinician specifically recommends it for that child and illness.
Can telemedicine help?
A video visit can help assess alertness, breathing, hydration clues, urine output, abdominal symptoms, fever, exposures, and whether the child can keep fluids down. It can also help determine whether home oral rehydration is reasonable or whether the child needs an abdominal examination, laboratory testing, urine testing, or IV fluids.
A child with suspected moderate or severe dehydration should not wait for a routine virtual appointment.
Information to have ready for the visit
- The child's age and current weight
- How many times the child has vomited or had watery stool and when it started
- The time of the last urine or wet diaper
- Whether there is blood or green material in vomit, blood in stool, fever, or persistent abdominal pain
- Recent travel, sick contacts, unusual food exposure, medications, and relevant medical conditions
Get urgent or emergency care for high-risk symptoms
Young children can become dehydrated quickly, and some vomiting or abdominal symptoms point to problems other than a routine stomach virus.
- The child cannot wake normally, is confused, is too weak to stand, or has severe breathing difficulty
- No urine for about 8 hours with a very dry mouth, no tears, marked sleepiness, or other dehydration signs
- Green vomit, blood or coffee-ground material in vomit, blood in stool, or a swollen abdomen
- Severe or persistent abdominal pain, suspected poisoning, or inability to keep fluids down
- A baby younger than 12 weeks who has repeated true vomiting rather than normal spit-up
Sources reviewed
This general educational page was prepared using the sources below. It does not replace an individualized medical assessment.