Q: My 10-month-old baby has a high fever (39.2°C) and keeps vomiting water and medicine. What should I do?

Medically reviewed by Sang Hyun Ahn, MD

Content edited by Myeongchan Kim, MD

This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

Question:

Hello, I have a 10-month-old boy who weighs 10kg. He suddenly developed a high fever yesterday with no other symptoms. We went to the clinic this morning, and he tested negative for the flu, COVID-19, and RSV. His blood test result was 2.0. Since he has a history of urinary tract infections, they also did a urine test, but it came back negative. The doctor wasn't entirely sure but suspected it might be roseola or the beginning of a simple cold, so he prescribed antibiotics and basic cold medicine.

The problem started tonight. Despite the fever, he ate very well, finished his formula, took his medicine, and went to sleep. However, he woke up 4 hours later and vomited everything. I cleaned it up and, worried about dehydration, gave him some cooled boiled water, but he threw it up immediately. To make matters worse, his fever was rising (39.2°C), so I tried giving him a fever reducer, but he vomited that too. He just keeps throwing up.

He is asleep right now, but his fever hasn't dropped because he couldn't keep the medicine down. Should I wake him up in an hour or two to try giving him fluids/medicine again? What should I do? Also, even though we did various tests, could this be gastroenteritis (stomach flu)? Does that require a different test?

Answer:

It is completely understandable that you are very worried about your 10-month-old baby’s high fever and repeated vomiting, especially since he is unable to keep his medication down.

Based on your description, the current situation involves a high fever (39.2°C), repeated vomiting, and an inability to retain oral fluids, though major respiratory infections were ruled out this morning. Since his condition rapidly worsened after eating well earlier, here is what you should do:

Immediate Actions to Take:

1. Fever Reducer: Since he is vomiting oral medications, use an acetaminophen (Tylenol) suppository if you have one. For a 10kg baby, a 100-150mg suppository is appropriate. If you do not have suppositories, let him rest and try waking him in about 2 hours to give a very small dose of oral medicine.

2. Hydration (Crucial Step): Do not give him large amounts of fluid at once, as this will trigger the gag reflex and cause more vomiting. Give him just 1 teaspoon (about 5ml) of fluid every 5 to 10 minutes. Oral rehydration solutions (ORS) or pediatric electrolyte drinks are much more effective than plain water.

3. Sleeping Position: Make sure to lay him on his side while he sleeps to prevent him from inhaling any vomit (aspiration).

Signs You Need to Go to the Emergency Room:

Please monitor him closely for the following signs of severe dehydration. If you notice any of these, head to the ER immediately:

* He has not produced a wet diaper in 8 hours or more.

* His lips are dry, and he cries without tears.

* He continues to vomit and cannot keep any fluids down whatsoever.

* He becomes extremely lethargic or unresponsive.

Regarding your question about gastroenteritis (stomach flu), yes, it is a strong possibility. Diagnosing it usually requires evaluating his symptoms and sometimes running a stool test. However, right now, confirming the exact virus is less important than preventing dehydration.

Since he is currently sleeping, let him rest for 1 to 2 hours, then gently wake him to try offering very small sips of an electrolyte solution. If the vomiting continues or you spot any signs of dehydration, please do not hesitate to take him to the emergency room for an in-person evaluation and IV fluids, even if it is the middle of the night.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

https://fevercoach.us