Another common symptom of illness in two-year-olds is vomiting. Vomiting is usually the first symptom of a stomach virus that the body must expel. It is often followed by diarrhea, which (especially in combination with vomiting) can put your child at risk for dehydration.
Vomiting is most often caused by viruses, but it can also be caused by bacteria and parasites. Occasionally vomiting can be caused by serious intestinal problems (that is, appendicitis or abdominal obstructions) requiring surgery, but these are rare in two-year-olds. In such cases the vomiting is usually severe and unrelenting.
Cases of vomiting that follow a meal may be caused by esophageal reflux, but this is also unusual in two-year-olds. In addition to the danger of dehydration, vomiting can be very scary and exhausting for a child, and it can hurt. If your child has been vomiting, watch him to see if he is dehydrated. Your child is dehydrated if he looks pale, isn't urinating, has a dry mouth, cracked lips, and is very thirsty. His eyes may also look sunken.
If your two-year-old has long bouts of vomiting or diarrhea, he needs to drink fluids to replace those lost from vomiting. If you suspect dehydration, you should talk to your doctor. In the meantime, encourage your child to drink an oral rehydration solution (ORS), such as Pedialyte, which contains the right mix of salt, sugar, potassium, and other elements to help replace lost body fluids. If your child won't drink Pedialyte (it is very salty), try to flavor it with Gatorade or another electrolyte sports drink. Encourage him to drink water, watered-down juice (too much sugar might upset his stomach), and chicken broth.
If your two-year-old is vomiting, try giving him small amounts of ORS, such as one teaspoonful every five minutes. When he is able to keep the drink down, slowly increase the amount you give. If he keeps vomiting, wait thirty to sixty minutes after the last time he vomited, and then give him a few sips of ORS. Small amounts every few minutes may stay down better than a large amount all at once. When he stops vomiting, you can increase how much ORS you give each time and lengthen the time between drinks to three to four hours. Keep giving ORS until your child stops vomiting.
Once he's ready to eat again, try giving your child dry toast, small amounts of pasta without sauce, a hard-boiled egg, rice, or a banana. It will take a few days for his appetite to return to normal. Don't force him to eat, but make sure he has plenty to drink. Remember, it is often difficult to judge dehydration. When in doubt, contact your pediatrician.