Vomiting
Most of the vomiting is due to irritation of the stomach (called gastritis), and so at the most, some antacids and antiemetics may be of benefit. Vomiting quite commonly presents itself along with diarrhoea; a condition called “gastro-enteritis”. By and large, vomiting is self-limiting. Vomiting doesn’t always mean a stomach upset.
In fact any disease in the child ranging from ear infections, kidney infections etc. to brain fever can be the cause of vomiting. The chances of retaining fluids increase in vomiting if it is cold and palatable (icecream is a good choice). Also the chances of retaining are appreciably more if the child is offered the food that he wants. This is the same with adults.
If they have the urge/appetite for a particular food, chances are less that they will vomit it out during periods of illness. It is better to give food in small quantities frequently, so that the incidence of vomiting will be reduced. So you should not force feed the child and not offer food/liquids that you consider appropriate but rather ask the child what he wants to take. If he says that he doesn’t want anything, do not give, as it will almost certainly cause vomiting. It is better to start with plain water initially and if the child tolerates it, to proceed to glucose water, fruit juices, soups, liquid diet, semi-solid diet and so on.
Constipation
Constipation may be there when the child is suffering from an acute febrile illness. This is due to the dehydrating effect that the fever has on the body plus in illnesses, the gut motility may also be transiently reduced. This is self-limiting. Don’t be bothered about it. Just give some extra fluids to your baby. Some parents have the misconception that unless the child has normal stools his fever or disease won’t get better, which is erroneous.
Chronic (long term) use of enemas or laxatives is strongly discouraged for transient constipation, as the child may become habituated to it and may find passing stools difficult without it in the long run. Often I have seen parents being prescribed suppositories (which are to be inserted anally into the child’s rectum. It is a disagreeable way of treatment.
Stomach-aches
Another common problem in children is pain of the abdomen. While the commonest and an obvious cause is infection of the intestines (gastro-enteritis), sometimes no obvious cause can be detected and the diagnosis remains elusive. So if your doctor, after a thorough physical examination and some simple tests like stool and urine analysis, doesn’t find anything wrong, don’t be much bothered. Costly and sophisticated tests visually add little to the already available information. So desist from them unless a doctor strongly recommends them.
Many of the stomach-aches in childhood are “functional” rather than due to an underlying disease, which requires nothing else but psychological reassurance both to the parents and to the child. Also called as “irritable bowel syndrome (IBS)” this pain is usually peri-umbilical, dull aching type with vague localisation. There is no association with feeding or bowel habits. Contrary to popular belief, it can also be present when the child is sleeping though the incidence is much higher in an awake child.
It is usually never present when the child is playing and enjoying himself and is mentally relaxed. Remember, the pain for the child is real and not a made up, fictitious one. So it should never be suggested that he doesn’t have any pain or the pain exists only in his “head”; and not in his stomach. A calculated neglect of the pain (and not the child) along with reassurance helps in the child outgrowing the pain. The parents should understand that the child requires love, attention and security at all times and not while he is complaining of pain abdomen.
Compare this pain with malingering where the child makes up the abdominal pain whenever he is confronted with some unpleasant task, particularly going to school. This type of pain never occurs on holidays and subsides rapidly once the wish of the child is granted; e.g. he enjoys a day off from school. This doesn’t mean that a day off from school is the treatment for this type of pain. This will only positively reinforce the behaviour and make it a vicious cycle. Since this type of pain is in the “head” and not in the stomach, parents should be strict and in no case should there be school avoidance. Rather the child should be told firmly that he has to go to school and that once he is in the class, the pain will become OK.