Parental instincts are usually felt strongly when issues occur pertaining to the health of their children. However, this may often lead to anxiety among parents. Pediatricians report that fever and vomiting in children are among the most common symptoms causing parental anxiety. In general, fever is a defense mechanism of the body towards the process of infection. If a child is experiencing fever along with vomiting, parents should consider the possibility of several potential causes, which include: Infection of the digestive tract, such as gastroenteritis. This may occur due to bacteria or virus. An example of a common virus affecting the digestive tract is rotavirus. On the other hand, common bacteria may include Salmonella and E. coli. Aside from fever and vomiting, other accompanying symptoms may include abdominal pain and diarrhea.

• Infection of the respiratory tract. Infection of the respiratory tract is characterized by cough, but vomiting may also occur sometimes. Other accompanying symptoms may include coryza and shortness of breath.
• Infection of the urinary tract. This type of infection generally manifests as pain during urination or abnormal smell in urine.
• Infection of the ear. Ear infections can also manifest as fever, along with decreased appetite, nausea, and eventually vomiting. The main symptoms are generally pain or presence of discharge from the ear.

Vomiting that is not accompanied by fever can generally be due to food poisoning or allergy. Parents may attempt to recall whether their child had recently consumed food outside the home or tried a new type of food. If the vomiting is severe, it may also be due to a disorder of the digestive tract or hernia (an anatomical abnormality causing a part or the entirety of an organ to protrude to surrounding tissues due to weakness in the supporting walls – which may lead to compression of the surrounding tissues and organs). When your child experiences vomiting, observe and attempt the following steps:

• Prevent dehydration. The main approach in managing a vomiting child is to prevent dehydration. Therefore, check for the following dehydration signs:
  • Dry mouth
  • No production of tears on crying
  • Decreased urine frequency and amount
  • Appears weak and drowsy
  For a child who is still breastfeeding, this should be continued. If the child is more than six months old, slowly provide drinking water at a warm or normal temperature and avoid fruit juices. If the child vomits after drinking, wait approximately 20-30 minutes before resuming drinking. Slowly provide oral rehydration solution if it has previously been prescribed by the doctor.
• After 8 hours without vomiting, or if the child feels hungry, provide food that is not spicy or highly seasoned slowly and in a small portion.
• Provide fever medication as per the doctor’s instructions, particularly if this is the first time your child has a fever. Be cautious if the child has a history of drug allergy. The purpose of fever medication is to reduce the body temperature and help the child feel more comfortable, but it does not treat the underlying cause of the disease. Parents can provide fever medication when the body temperature exceeds 38°C (axillary temperature). Other than providing fever medication, parents can also apply warm compress on the body fold areas, such as the neck, axilla, and groins, to help relieve fever.

When the child vomits, pay attention to the presence of certain characteristics. If the following things occur, consult the doctor for further management:

• The child vomits more than once.
• The vomit is green in colour or contains blood.
• The child shows signs of severe dehydration, such as drowsiness, crankiness, increased thirst, or lack of urination.
• Abdominal pain.
• The child experiences headaches, neck stiffness, seizures, or skin spots.
• The child experiences shortness of breath or bluish discolouration of the lips.