Fever With Vomiting in a Child: What to Do and When to Get Help
A fever with vomiting is common, especially with viral infections, and usually settles on its own. The main things to manage are keeping your child hydrated and working out whether fever medicine is staying down. Here's what to do, how to handle medicine when vomiting gets in the way, and the signs that need urgent attention.
Why fever and vomiting often go together
Many common childhood infections cause both fever and vomiting at the same time. Viral gastroenteritis (a "stomach bug") is the most frequent cause, but vomiting can also come with throat infections, ear infections, and other illnesses where a high temperature upsets the stomach on its own.
A child who vomits once or twice but is still drinking, alert, and able to settle between episodes is usually managing the illness itself. The two things worth tracking are whether they can keep enough fluid down, and whether fever medicine is being absorbed.
Giving fever medicine when your child is vomiting
If your child vomits within 15 to 30 minutes of a dose and you can see the medicine in the vomit, they likely absorbed little of it. Even so, do not give a full replacement dose straight away. Some of the dose may have been absorbed before it came back up, and giving a second full dose on top of that risks giving too much.
Note the time and what you saw, then wait until the next scheduled dose unless the fever is high and your child seems unwell, in which case call your pharmacist or GP for advice on whether a partial replacement dose makes sense.
If vomiting keeps getting in the way of oral medicine, a suppository of the same medicine is an option. It is absorbed through the back passage rather than the stomach, so it is not affected by vomiting in the same way.
→ Suppositories for a child's fever: what they are and how to give them
Watching for dehydration
Fever already increases fluid loss, and vomiting adds to it. Wait 15 to 30 minutes after a vomiting episode, then offer a teaspoon or two of fluid every 5 to 10 minutes, increasing the amount gradually as your child tolerates it. Trying to get them to drink a full cup at once often triggers more vomiting.
If diarrhoea is also present, oral rehydration solution (ORS) is useful because it replaces the salts lost as well as the fluid. Mix it exactly as the packet instructs.
→ Fever and dehydration: early signs, what to offer, and ORS guidance
Signs that need urgent attention
Call your GP or polyclinic the same day if vomiting continues for several hours, your child cannot keep any fluids down, or they have fewer wet nappies than usual.
Go to your nearest 24-hour A&E if your child has a fever with vomiting and any of these:
- !Blood, or what looks like coffee grounds, in the vomit
- !Severe or persistent abdominal pain
- !No wet nappy or urine passed for 12 hours or more
- !A dry mouth and tongue, with no tears when crying, or sunken eyes
- !Very drowsy, floppy, or hard to wake
- !Under 3 months old with any fever of 38.0°C or above
→ Toddler fever 39°C: when to monitor vs seek help
→ What happens when you take a feverish child to A&E
Frequently asked questions
My child vomited soon after I gave paracetamol or ibuprofen. Should I give another dose?+
Not straight away. If it came back up within 15 to 30 minutes and you can see the medicine in the vomit, your child likely absorbed little of it, but giving a full second dose risks giving too much if some was absorbed. Wait until the next scheduled dose, or call your pharmacist or GP if the fever is high and you are unsure.
Is vomiting with a fever normal?+
Yes, it is common, especially with viral infections such as gastroenteritis or even some throat and ear infections. A single vomit or a few episodes, with a child who is otherwise drinking and alert between times, is usually not a cause for alarm on its own.
When does vomiting with a fever need a same-day doctor visit or A&E?+
Call your GP or polyclinic the same day if vomiting continues for several hours, your child cannot keep any fluids down, or there are fewer wet nappies than usual. Go to A&E if there is blood or what looks like coffee grounds in the vomit, your child is very drowsy or floppy, has severe abdominal pain, or shows signs of dehydration listed below.
Can I use a suppository if my child keeps vomiting oral medicine?+
Yes, a suppository is one of the main reasons it exists. If your child cannot keep oral paracetamol or ibuprofen down, a suppository of the same medicine bypasses the stomach. It still counts toward the same total dose and timing as the oral form of that medicine.
What if my child has both vomiting and diarrhoea with the fever?+
This points toward gastroenteritis, which is usually viral and settles within a few days. Fluid loss happens faster with both together, so focus on small frequent sips and watch for the dehydration signs below. Oral rehydration solution (ORS) is useful here, mixed exactly as the packet instructs.
How much fluid should I offer after a vomiting episode?+
Wait 15 to 30 minutes after vomiting, then offer a teaspoon or two of fluid every 5 to 10 minutes. Increase the amount gradually if it stays down. Trying to get your child to drink a full cup at once often triggers more vomiting.