"I frew up"

I've woken up too many nights to a little visitor standing beside my bed looking miserable. "What's the matter?" I ask groggily.

"I frew up."

Then comes the midnight trek to discover exactly where she "frew up" — hoping to see the mess before stepping in it.

Toddlers tend to vomit without much hesitation or control, and some do so frequently with little provocation. (One of mine once threw up because he saw another child sucking on a mitten.) As parents, we generally have two concerns: First, is this a symptom of something serious? And second, how best should we deal with the mess?

"Some toddlers do just tend to be barfy," explains Michelle Ponti, chair of the Canadian Paediatric Society's Community Paediatrics Committee. "These are often the ones who tended to spit up or regurgitate a lot as infants — what we call 'happy spitters.' They are content and healthy otherwise, but they tend to spit up easily."

Parents have a good sense of what's normal for their children, she adds. "I always start off by saying if parents are worried, they should seek medical attention. The amount of spitting up that would be not unusual for one child could be a concern with a toddler who almost never throws up."

Ponti lists these as the most common reasons for toddler vomiting:

• gastrointestinal infections (what most of us call "stomach flu")

• the generally barfy child, who may throw up out of excitement, when he coughs, when he sees something that turns his stomach, if he eats or drinks too much or runs around after eating, and so on.

• other kinds of infections, some of which can be serious (If your child is vomiting repeatedly and has other symptoms such as fever, lethargy or pain, or if you are concerned, consult with your doctor.)
Many toddlers don't seem to mind throwing up, but if yours is upset about it or feeling miserable, offer reassurances that vomiting is OK and he won't be in trouble for making a mess. Let him swish his mouth with water and spit it out to get rid of the "yucky taste" and wash his face with cool water.

Cleaning up is another issue. Christine Barnett,* mother of four, says: "My experience with toddler barfing has branded me, but I've learned to deal with it." Her tips:

• "I always sleep with a rolled-up towel nearby," she says. Toddlers are notorious for wanting to inform you about their upset stomachs during the night, and that often leads to something yucky on your bed or the floor beside it. A towel can cover up the mess on the floor until morning or protect the pillow if you see it coming.

• Empty ice cream buckets make great containers for toddlers who can't get to the bathroom in time (and that's pretty much all of them). Barnett washes them out, stores them and sets them in strategic locations when queasiness hits.

• Keep a spare set of sheets and blanket in each child's room — perhaps in the top drawer of his dresser. This prevents pawing around in the linen closet in the dark trying to find a sheet that fits without waking anyone else up.

While being prepared to clean up the mess will reduce your workload, offering a comforting cuddle and perhaps a story or two to help him settle back to sleep are the things that will make coping with that barfy feeling a little easier for your toddler.

Preventing dehydration
"Any time a child vomits more than once, you need to be thinking about dehydration," says Michelle Ponti, chair of the Canadian Paediatric Society's Community Paediatrics Committee. Parents should pay attention to whether their child is keeping any fluids down, if she is peeing normally, if her lips seem dry and if tears appear when she cries.

"Don't give your child a big drink of water or other liquids," she adds. "If your child gulps it all down, it's likely to come right back up. Instead, you want to give her small amounts frequently."

One way to make that easy: frozen drinks. (No, not daiquiris.) If your child has weaned, you could try watered-down-juice or Pedialyte freezies.

*Name changed by request.