What Is Nausea?
Nausea is that uncomfortable, queasy feeling in the stomach that makes your child feel like they might throw up—even if they don't actually vomit. It's very common in children and teens and usually isn't serious, but it can make your child feel miserable and affect their ability to eat, drink, and do normal activities.
Common Causes of Nausea in Kids and Teens
Infections and Illnesses
- Stomach bugs (viral gastroenteritis) - often comes with diarrhea and mild fever
- Infections outside the stomach like ear infections, urinary tract infections, or pneumonia
- Food poisoning
Digestive Issues
- Acid reflux (heartburn)
- Constipation
- Food intolerances (like lactose intolerance)
- Eating too much or too fast
- Functional nausea - when the stomach is sensitive but no specific disease is found
Other Common Triggers
- Motion sickness (car, boat, or plane travel)
- Migraines or headaches
- Anxiety and stress (especially common in school-age children and teens, see below for more details to manage anxiety-related nausea)
- Medications or vitamins (especially on an empty stomach)
- Lack of sleep or poor sleep quality
- Dehydration
- Skipping meals or low blood sugar
Home Treatment and Comfort Measures
What Your Child Can Eat and Drink
- Offer small, frequent sips of clear fluids (water, diluted juice, or electrolyte drinks)
- Start with bland foods when they're ready to eat: crackers, toast, rice, bananas, applesauce
- Avoid greasy, spicy, or very sweet foods
- Let them eat cold foods if hot foods make the nausea worse
- Don't force eating—it's okay if they eat less for a day or two as long as they're drinking
Comfort Strategies
- Have your child rest in a quiet, cool room
- Fresh air can help—open a window or go outside
- Avoid strong smells (perfumes, cooking odors)
- Try deep, slow breathing exercises
- Distraction with calm activities (reading, listening to music, watching a show)
- A cool washcloth on the forehead or back of the neck
- Loose, comfortable clothing around the waist
Natural Remedies
- Ginger (ginger ale with real ginger, ginger tea, or ginger candies) may help older children
- Peppermint tea or sucking on peppermint candies
- Small amounts of lemon water
When to Call Your Doctor
Contact your child's doctor if your child has:
- Nausea lasting more than 24-48 hours
- Signs of dehydration (dry mouth, no tears when crying, urinating less than usual, dark urine)
- Severe or worsening stomach pain
- Headache that won't go away or is getting worse
- Nausea that keeps coming back over weeks or months
- Weight loss or refusing to eat for several days
- Nausea that interferes with school or daily activities
- Delayed period or possible pregnancy in adolescent females
When to Seek Emergency Care
Go to the emergency room or call 911 if your child has:
- Green or yellow vomit (bilious vomiting)
- Blood in vomit or vomit that looks like coffee grounds
- Severe abdominal pain or a hard, swollen belly
- Signs of severe dehydration (extreme sleepiness, confusion, very dry mouth)
- Severe headache with stiff neck, fever, or confusion
- Recent head injury followed by nausea
- Difficulty breathing
- Chest pain
What to Expect at the Doctor's Office
Your child's doctor may:
- Ask detailed questions about when the nausea started, what makes it better or worse, and other symptoms
- Do a physical exam
- Check for signs of dehydration
- Order blood tests or urine tests if needed
- Consider imaging tests (like an ultrasound or X-ray) only if there are concerning symptoms
- Discuss whether anxiety, stress, or other emotional factors might be contributing
In many cases, especially with chronic nausea, the doctor may diagnose "functional nausea," which means the nausea is real but no specific disease is causing it. This is common and can often be managed with lifestyle changes, stress management, and sometimes medication.
Medications for Nausea
Over-the-counter medications for nausea are generally not recommended for children without talking to your doctor first. If your child's nausea is severe or persistent, your doctor may prescribe medication. The most commonly prescribed medication for children is ondansetron, which is safe and effective for reducing nausea in many situations.
Important: Never give your child adult nausea medications without your doctor's approval, as some can be harmful to children.
Prevention Tips
- Encourage regular meals and healthy snacks
- Make sure your child gets enough sleep
- Help manage stress and anxiety (talk about worries, practice relaxation)
- Stay hydrated throughout the day
- For motion sickness: sit in the front seat (if age-appropriate), look at the horizon, avoid reading in the car
- Identify and avoid food triggers if certain foods seem to cause problems
The Bottom Line
Most nausea in children and teens is temporary and will get better with rest, fluids, and time. Trust your instincts as a parent—if something doesn't seem right or your child isn't improving, don't hesitate to contact your doctor. Chronic or recurring nausea should always be evaluated by a healthcare provider to make sure nothing serious is being missed and to help your child feel better.
How to Recognize Anxiety-Related Nausea
Your child may have anxiety-related nausea if:
- Nausea occurs before stressful events (school, tests, social situations, performances)
- Symptoms improve when the stressful situation is over or avoided
- Your child also has other anxiety symptoms like excessive worry, difficulty sleeping, restlessness, or avoiding certain activities
- Nausea is accompanied by other physical signs of anxiety: rapid heartbeat, sweating, dizziness, headaches, or muscle tension
- Medical tests have ruled out other causes
- Symptoms have lasted for weeks or months and interfere with daily activities
Evidence-Based Treatments That Work
Cognitive Behavioral Therapy (CBT)
CBT is the first-line treatment for anxiety-related nausea in children and teens. This is a structured, short-term therapy (usually 12-20 sessions) that teaches your child practical skills to manage both anxiety and physical symptoms.
What CBT includes:
- Understanding the connection: Learning how thoughts, feelings, and body sensations are connected
- Cognitive restructuring: Identifying anxious thoughts (like "I'm going to throw up in front of everyone") and replacing them with more realistic, helpful thoughts
- Relaxation techniques: Deep breathing, progressive muscle relaxation, and guided imagery to calm the body's stress response
- Gradual exposure: Slowly facing feared situations in a safe, controlled way to build confidence and reduce avoidance
- Homework practice: Practicing new skills at home and in real-life situations
Studies show that CBT helps about 60% of children with anxiety disorders achieve significant improvement, and it can be delivered individually, in groups, or even online.
Gut-Directed Hypnotherapy
Hypnotherapy specifically designed for stomach problems has shown excellent results for children with chronic nausea. In one study, 60% of children with functional nausea improved with hypnotherapy, with particularly strong results in the first 6 months of treatment. This approach uses relaxation and guided imagery to help the brain and gut communicate better and reduce symptoms.
Relaxation and Mindfulness Techniques
These techniques help reduce the body's stress response and can be practiced at home:
- Deep breathing: Slow, deep belly breathing (breathe in for 4 counts, hold for 4, breathe out for 6)
- Progressive muscle relaxation: Tensing and relaxing different muscle groups to release physical tension
- Guided imagery: Imagining peaceful, calming scenes
- Mindfulness: Paying attention to the present moment without judgment
Research shows these techniques can significantly reduce stress, anxiety, and physical symptoms like nausea in children and adolescents.
What You Can Do at Home
Help Your Child Identify Triggers
- Keep a simple diary noting when nausea occurs and what was happening before it started
- Look for patterns related to school, social situations, family events, or other stressors
- Talk openly about worries and fears without judgment
Teach and Practice Coping Skills
- Practice deep breathing together during calm times, so it's easier to use when anxious
- Create a "calm down kit" with items that help your child relax (stress ball, favorite music, calming scents)
- Encourage your child to use coping skills before anxiety gets too high
Avoid Reinforcing Avoidance
- While it's natural to want to protect your child from distress, avoiding anxiety-provoking situations can make anxiety worse over time
- Work with your child to gradually face feared situations with support
- Praise effort and courage, not just outcomes
Maintain Healthy Routines
- Regular sleep schedule (8-10 hours for school-age children, 8-12 for teens)
- Consistent meal times, even if appetite is reduced
- Regular physical activity, which helps reduce anxiety
- Limit caffeine, which can worsen both anxiety and nausea
Validate Feelings While Encouraging Coping
- Acknowledge that the nausea is real and uncomfortable
- Express confidence in your child's ability to manage it
- Avoid excessive focus on symptoms, which can increase anxiety
When to Seek Professional Help
Consider consulting a mental health professional if:
- Nausea and anxiety are interfering with school attendance or performance
- Your child is avoiding important activities or social situations
- Symptoms are not improving with home strategies
- Your child seems depressed, withdrawn, or talks about self-harm
- Family stress or conflict is contributing to symptoms
What to Look For in a Therapist
- Licensed mental health professional (psychologist, licensed clinical social worker, or licensed professional counselor)
- Training and experience in cognitive behavioral therapy for children and adolescents
- Experience treating anxiety disorders and/or pediatric functional gastrointestinal disorders
- Good rapport with your child—therapy works best when your child feels comfortable
Medication Options
For moderate to severe anxiety that doesn't improve with therapy alone, medication may be helpful. The most commonly prescribed medications for childhood anxiety are selective serotonin reuptake inhibitors (SSRIs), which have been shown to be safe and effective.
Important points about medication:
- Medication works best when combined with therapy, not as a replacement for it
- Studies show that 81% of children improve with combined CBT and medication, compared to 60% with CBT alone and 55% with medication alone
- Medications are typically continued for 6-12 months after symptoms improve, then gradually tapered
- Your child's doctor will discuss potential benefits and risks
Never start or stop anxiety medication without consulting your child's doctor.
The Role of Diet and Gut Health
The gut-brain connection means that what your child eats can affect both mood and nausea:
- Encourage a balanced diet with regular meals and snacks
- Some children benefit from probiotics, though more research is needed
- Avoid skipping meals, which can worsen both anxiety and nausea
- Stay hydrated throughout the day
- Limit foods that seem to trigger symptoms
School Accommodations
If anxiety and nausea are affecting school performance, consider requesting a 504 Plan or accommodations that might include:
- Permission to leave class if nausea becomes severe
- Access to a quiet space for relaxation techniques
- Extended time for tests to reduce pressure
- Gradual return to school if there has been significant absence
- Communication plan between school and home
Long-Term Outlook
With appropriate treatment, most children and teens with anxiety-related nausea improve significantly. The skills learned through therapy—understanding the mind-body connection, managing anxious thoughts, using relaxation techniques, and facing fears gradually—are valuable life skills that will benefit your child well beyond the current symptoms.
Remember that recovery isn't always linear. There may be setbacks, especially during stressful times, but these don't mean treatment isn't working. Continued practice of coping skills and ongoing support are key to long-term success.
Key Takeaways
- Anxiety-related nausea is real and common in children and teens
- The gut-brain connection means that treating anxiety can improve nausea
- Cognitive behavioral therapy is the most effective treatment and should be tried first for mild to moderate symptoms
- Relaxation techniques, mindfulness, and hypnotherapy can all help
- Medication may be helpful for more severe symptoms, especially when combined with therapy
- Avoiding anxiety-provoking situations makes symptoms worse over time
- With proper treatment and support, most children improve significantly
Resources for Parents
- Anxiety and Depression Association of America (ADAA): www.adaa.org
- Association for Behavioral and Cognitive Therapies: www.abct.org (find a therapist directory)
- Child Mind Institute: www.childmind.org (resources on childhood anxiety)
- Call our office to schedule a visit with our Behavioral Health Clinician to assess for anxiety or begin therapy or with a medical provider if therapy is not sufficient
- See also our Anxiety Page
