No more flat ginger ale: Caring for a child with vomiting and diarrhea
By: Corrine Langill, RN, BScN, Manager, Health Promotion, CHEO, Stephanie Poirier, RN, BScN, Clinical Manager, Emergency Department, CHEO
Most parents have a gruesome story to tell about a time when their child threw up at a party, on their mother-in-law’s new carpet or at a wedding. Often called ‘stomach flu’, vomiting and diarrhea are almost always caused by viruses. They can make your child feel miserable, but thankfully, the worst is usually over in a few days. Because there is no ‘quick fix’, no medicine to cure the viruses that cause vomiting and diarrhea, parents have to focus on making sure children are comfortable, and don’t lose too much body fluid (dehydration). This is especially important for babies and young children, who can become dehydrated quickly.
How can I take care of my child at home?
- Replace the fluids your child loses from vomiting or diarrhea.
- Replace fluids a little bit at a time. Giving a lot at once can cause more vomiting.
- Breast milk or Oral Rehydration Solutions, or ORS (like Pedialyte® or Gastrolyte®) are the only fluids you should use to replace fluid losses. You’ll find them in the drugstore. This means no pop, sports drinks, tea, kool-aid, fruit juice or drinks, broth, water or rice water.
- If you’re breastfeeding, nurse more often, for less time.
- Use a spoon or medicine dropper to give oral rehydration solution if your child won’t drink from a bottle or cup.
- Babies under 2 years should have at least 4 wet diapers a day.
- Children over 2 should pass urine (pee) 3 or 4 times a day.
- Do not give your child over-the-counter medicines to stop vomiting or diarrhea. These medicines stop your child’s body from getting rid of the infection.
- Solid food. Don’t worry if you child doesn’t eat for a few days. It is more important for your child to get enough fluids. If your child is eating solid food, you can keep offering this.
- Treat fever to keep your child comfortable.
- Give acetaminophen (Tylenol®, Tempra®) or ibuprofen (Advil®, Motrin®). Do not give ibuprofen to babies under 6 months of age.
- Use rectal suppositories (a form of medicine that is placed in the rectum, or bum) if your child is vomiting.
- Check about prescription medicines. Call your doctor if your child is taking a prescription medication and throws up more than one dose.
- Prevent the spread of viruses. Clean your hands and your child’s hands often, especially after using the toilet or changing a diaper. Use soap and warm water, or hand sanitizer. If hands are dirty, hand sanitizers won’t work-you’ll need to wash with soap and water first.
You can keep breastfeeding if your child has diarrhea too. Breast feed more often to keep up with the fluid losses from diarrhea. Give children who are not breast fed ORS to replace fluids lost in diarrhea, and keep giving the ORS until the diarrhea stops.
Call your family doctor or bring your child to hospital if your child:
- Is 3 months old or younger, and has a fever (temperature higher than 38°C or 100.4°F rectally)
- Is less than 3 months old and has had diarrhea for more than 2 days (48 hours)
- Has a fever for more than 2 days (temperature higher than 38.5°C or 101.5°F rectally)
- Has bloody or black stools (poop)
- Vomits blood or green bile
- Still has diarrhea after 10 days
- Has abdominal pain that won’t go away or is getting worse
Shows signs of dehydration (fluid loss) like:
- Less than 4 wet diapers in 24 hours for babies under 2 years
- Less urine (pee) or no urine in 8 hours in babies or children over 2 years
- Dry mouth and tongue
- Sunken eyes or sunken soft spot on the head
- No tears when crying
- Grayish skin
- Very sleepy and hard to wake up
Your child can slowly return to her usual diet once the vomiting has settled down (including formula or milk, if she was taking these before the vomiting and diarrhea started). Start with small amounts of food, more often. Most children are back to their usual diets in a day or two. It can take the bowel a little time to heal, so your child may have very soft stools for up to 10 days.
Where can I get more information?
Telehealth Ontario 1-866-797-0000
Health Information from Registered Nurses, 24 hours a day, 7 days a week