Vomiting—Child Care and Schools

What is vomiting?

• Vomiting is the exit of stomach contents through the mouth.

• Vomiting can be caused by a viral infection of the stomach or intestine (gastroenteritis), including COVID-19.

• 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. Food allergy can cause vomiting sometimes with hives. Vomiting can also be caused by ingestion of a toxic substance, or it can be dietary or medication related. A child who has fallen may vomit because of a head injury. Some children may vomit as a behavior or after crying from intense emotions.

What are the signs or symptoms?

Children with vomiting from an infection may have the following related signs or symptoms:

• Diarrhea

• Abdominal pain or cramping

• Strong coughing before vomiting

• Headache

• Fever

• Signs of dehydration resulting from prolonged or severe vomiting, including dry mouth, no tears, or no urine for 8 hours

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 of Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 7th Edition .

• 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 educator and the family?

• Review Standard Precautions (see Chapter 2 of Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide, 7th Edition ), particularly hand hygiene.

• Report the condition to the staff member designated by the early childhood education program or school for decision-making and action related to care of ill children and staff members. 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 educational 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 educational setting?

Yes, when all the following criteria are 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