Nausea and Vomiting

Your child may have an upset stomach because of an illness or as a side effect of a medicine or disease treatment. Nausea or vomiting can happen at any time. Your health care team may prescribe medicine to help prevent nausea and vomiting. Non-medicine treatments such as complementary approaches or diet changes may also help.

What is nausea?

Nausea is the feeling of sickness or discomfort that a person feels along with the urge to vomit. Nausea usually involves:

• Unpleasant sensations in the throat or stomach
• Dizziness
• Trouble swallowing
• Sweating
• Feeling chilled or flushed

What is vomiting?

Vomiting, or throwing up, happens when abdominal muscles contract and push what is in the stomach up and out the mouth. You may see or hear the term emesis. Emesis is the clinical name for vomiting. Anti-nausea or antiemetic drugs are medicines that treat nausea and vomiting.

Nausea and vomiting are related, but you may have one without the other.

Causes of nausea and vomiting

There are many reasons your child may have nausea or vomiting. Nausea and vomiting are common symptoms of illness or infection. Your child might have an upset stomach if medicines or other treatments affect their stomach or digestive system. Health conditions such as problems of the stomach and intestines or increased pressure in the brain can also lead to vomiting.

Medical treatments also can trigger areas in the brain. One area of the brain (area postrema) controls nausea. Another area in the brainstem controls vomiting. These areas are separate from each other. So, it is possible for your child to have nausea but not vomit.

Sometimes, just the thought of treatment can cause nausea or vomiting. This is called anticipatory nausea and vomiting.

Other causes of nausea and vomiting include:

• Chemotherapy
• Radiation therapy
• Fever and infection
• Medicines, including antibiotics, opioid medicines, and anti-seizure drugs
• Cancer, especially if the tumor affects the brain or digestive system
• Stomach or digestive tract problems
• Acid reflux
• Inner ear problems
• Hormones
• Stress and anxiety
• Motion sickness
• Overeating
• Unpleasant sights or smells
• Pain

Learn more about Nausea and Vomiting During Cancer Treatment

How to manage nausea and vomiting

Anti-nausea medicines

Your care team may suggest certain medicines called antiemetics to prevent and treat nausea and vomiting. Talk with your health care provider or pharmacist to find out if your child could benefit from these medicines. Follow dosing instructions for nausea medicines. Make sure you refill the prescription before you run out. Talk to your care team if the medicine does not control your child’s nausea or vomiting.

Diet changes to manage nausea and vomiting

Changes to your child’s diet may help prevent or reduce nausea and vomiting. Plan small meals and snacks more often throughout the day.

Do not offer your child’s favorite foods until nausea and vomiting stop. This will keep your child from connecting these foods with feelings of illness.

At meals:

• Offer your child dry, bland foods such as crackers, toast, pretzels, and vanilla wafers.
• Avoid foods that are fried, spicy, greasy, or rich.
• Encourage your child to eat and drink slowly.
• Avoid foods that have strong odors.
• Do not eat in places that have strong smells. Avoid eating around cigarette smoke.
• Limit liquids with meals.

Between meals:

• Give your child cool, clear liquids between meals.
• Have your child try chewing gum or sucking on hard candy, popsicles, or ice. 
• Make sure your child does not lie flat after meals. Have them rest with their head raised.

Tips for patients and families

• Keep a record of symptoms. Write down when nausea occurs, what makes it worse, and what makes it better.
• Watch for any other symptoms. Let your care team know if your child as other symptoms such as pain, loss of appetite, diarrhea, or constipation.
• Rinse your child’s mouth after vomiting. Stomach acid can cause mouth irritation and tooth decay.
• Involve your child in planning when and what to eat. Help your child manage symptoms by having meals and snacks when they are feeling better.

Let your care team know if your child’s nausea or vomiting gets worse or does not improve. Also tell your care team if your child has problems getting fluids or nutrition. Your child may need IV fluids to prevent dehydration or other nutrition support to make sure they get the nutrients they need.

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