Q: My 36-month-old child keeps vomiting and has a fever even after getting IV fluids for suspected gastroenteritis. Should we go back to the doctor?

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, my 36-month-old child has been unwell and I would like some advice.

Yesterday at 3 AM, my child vomited all of their dinner. At 9 AM, they vomited a little scorched rice while trying to swallow. At 3 PM, they asked for milk before a nap but vomited again after falling asleep. We rushed to the hospital, where the doctor suspected gastroenteritis. My child received IV fluids and we went home.

They seemed fine for a while, managed to eat a couple of spoonfuls of white porridge for dinner, and at 9 PM, I gave them their prescribed gastrointestinal medication and probiotics before bed. They had a mild fever of 37.7°C, so I also gave a fever reducer.

However, at 2 AM today, they woke up suddenly and vomited a palm-sized amount of mostly liquid. The fever rose to 38.3°C. I gave them the prescribed gastrointestinal medication and ibuprofen, and they are sleeping now. Do we need to visit the hospital again today?

Answer:

It must be very exhausting and concerning to deal with your child's repeated vomiting throughout the night.

Yes, a re-evaluation at the hospital today is necessary.

Signs that require calling emergency services (911) immediately:

• Blue lips or difficulty breathing

• Hard to wake up or completely unresponsive

• Seizures or a stiff neck

Signs that require an immediate visit to Urgent Care or the ER:

• No urine output for over 8 hours

• Dry lips, dry tongue, or crying without tears

• Extreme lethargy and refusing to drink any water

• Blood or green bile in the vomit

• Severe abdominal pain causing the child to constantly curl up

Summary of the current situation:

• Despite receiving IV fluids yesterday, the vomiting and fever returned at night, indicating a risk of recurrent dehydration.

• Vomiting continued even after taking the prescribed medication twice. This means the medication may not have been absorbed properly, or stronger medical intervention is needed.

• A fever of 38.3°C is common with gastroenteritis, but it requires re-evaluation when vomiting and the risk of dehydration persist.

What you can do at home until morning:

• Temporarily stop giving water and medication to let the stomach rest for 30 to 60 minutes.

• Once the child wakes up, try giving 1 teaspoon of cool water every 5 minutes (do not use a straw, as gulping can trigger vomiting).

• Strictly monitor urine output and frequency (by checking diaper weight or bathroom visits).

• Observe the child's lips, tears, and skin elasticity to check for dehydration.

What to tell the doctor during today's visit:

Clearly explain that despite yesterday's IV fluids, the child vomited and developed a fever again overnight. Mention that the prescribed medication was given but seemed ineffective. Be sure to report the child's most recent urine output and current energy levels.

If possible, call the clinic you visited yesterday to schedule a follow-up appointment for today. If it is the weekend or after hours, please visit a local urgent care clinic or emergency room for prompt evaluation.

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