Vomiting—Child Care and Schools

What is vomiting?

  • The exit of stomach contents through the mouth.

  • 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. A child who has fallen may vomit because of a head injury.

What are the signs or symptoms?

  • Children with vomiting from an infection often have diarrhea and, sometimes, fever.

  • Prolonged or severe vomiting can result in children becoming dehydrated (dry mouth, no tears, no urine).

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.

  • 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 teacher/caregiver and the family?

  • Use good hand-hygiene technique at all the times listed in Chapter 2.

  • Review Standard Precautions, particularly hand hygiene.

  • Report the condition to the staff member designated by the child care program or school for decision-making and action related to care of ill children. 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 group 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 group setting?

Yes, when all the following criteria have been 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

Adapted from Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide .

Any websites, brand names, products, or manufacturers are mentioned for informational and identification purposes only and do not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Copyright © American Academy of Pediatrics Date Updated: Nov 17 2024 20:38 Version 0.1

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Is Your Child Sick?®

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starfish
February 12, 2026
There have been cases of measles in NC, with exposures in Chapel Hill, Durham, and Wake County. We can give the MMR dose early to families who want it. This applies to infants 6-12 months who have not gotten a dose yet or kids under 4-5 years who have not gotten their second MMR dose. At this time, the NC DHHS and health departments are not recommending this unless traveling or living in an area with sustained transmission. Two doses of the MMR vaccine are highly effective (97%) at preventing measles infections. At CHCAC, children receive their first dose at 12 months of age and a second dose at 4 years of age, ensuring they are fully protected as soon as possible, in accordance with the most up-to-date AAP recommendations. Some infants aged 6 months to 11 months who travel internationally or in high-prevalence areas may need a dose to protect them; however, they still require the 1-year and 4-year-old doses as well. If you are ever concerned about a possible exposure to measles, please CALL before entering our office. DO NOT ENTER the office. NC DHHS keeps a list of areas with measles exposures here . This is a highly contagious illness, and special precautions must be taken to prevent spread. The virus can be present in the air for 2 hours after an infected person is in the room, and 90% of susceptible patients can be infected. As always, if you have questions, we are here to help make sense of it all!