Stephen J. Schueler, M.D.

Sickle Cell Crisis Vomiting in Children

Home treatment of vomiting in children with sickle cell anemia includes hydration and dietary therapy. Those who are able to drink liquids can restore lost water and salt with oral rehydration therapy (ORT).

ORT fluids used in infants include:

  • Infalyte
  • Lytren
  • Naturalyte
  • Pedialyte
  • Rehydralyte

ORT fluids used in older children include:
  • Sports drinks (Gatorade)
  • Broth
  • Dilute fruit juices
  • Flat soda
  • Weak tea with sugar

Strategies for breast-fed infants younger than 6 months:
  • If the infant tolerates breast milk, continue breast-feeding in small amounts very frequently.
  • Provide additional ORT fluids to supplement breast milk.
  • Feed very small amounts every 30-60 minutes, or try giving small amounts more frequently, such as:
    • Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
    • Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Strategies for formula-fed infants younger than 6 months:
  • If the infant tolerates formula, continue to provide small amounts very frequently.
  • Provide additional ORT fluids to formula.
  • Try giving small amounts more frequently, such as:
    • Children up to 5 kg (11 lb): give 5 ml (1 teaspoon) every 5 minutes
    • Children 5-10 kg (11-22 lb): give 10 ml (2 teaspoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Strategies for children over 6 months:
  • Provide as much ORT fluids as your child desires.
  • If vomiting occurs, provide small amounts of ORT fluids more frequently:
    • Children 10-20 kg (22-44 lb): 15 ml (1 tablespoon) every 5 minutes
    • Children 20-40 kg (44-88 lb): 22 ml (1 and 1/2 tablespoons) every 5 minutes
    • Children 40 kg (88 lb) and over: 30 ml (2 tablespoons) every 5 minutes
  • Watch for dehydration: dry mouth, decreased urination, dark yellow urine and lack of tears.

Dietary Therapy
Most children with vomiting improve in a few hours and symptoms usually resolve in one day. Once vomiting and nausea resolves, provide bland foods first. If bland foods are tolerated, then you resume a normal diet.

Foods that are easiest to tolerate include:
  • Crackers
  • Oatmeal
  • Jell-O
  • Soft foods
  • Yogurt

Foods to avoid include:
  • Concentrated fruit juices
  • Junk foods
  • Milk products
  • Recently introduced foods
  • Spicy foods

Nonprescription medicines for vomiting should only be used under the direction of your doctor.

Continue to Sickle Cell Crisis Warning Signs

Last Updated: Jan 4, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Sickle Cell Crisis References
  1. Ander DS, Vallee PA. Diagnostic evaluation for infectious etiology of sickle cell pain crisis. Am J Emerg Med. 1997 May;15(3):290-2. [9148990]
  2. Fletcher C. Appraisal and coping with vaso-occlusive crisis in adolescents with sickle cell disease. Pediatr Nurs. 2000 May-Jun;26(3):319-24. [12026399]
  3. Johnson L. Managing acute and chronic pain in sickle cell disease. Nurs Times. 2005 Feb 22-28;101(8):40-3. [15754942]
  4. Miller JA, Hinrichs CR. Sickle cell crisis in the adult: chest radiographic findings and comparison with pediatric sickle cell disease. J Natl Med Assoc. 2001 Feb;93(2):58-63. [12653383]
  5. Silbergleit R, Jancis MO, McNamara RM. Management of sickle cell pain crisis in the emergency department at teaching hospitals. J Emerg Med. 1999 Jul-Aug;17(4):625-30. [10431951]
  6. Yale SH, Nagib N, Guthrie T. Approach to the vaso-occlusive crisis in adults with sickle cell disease. Am Fam Physician. 2000 Mar 1;61(5):1349-56, 1363-4. [10735342]
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