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Vomiting & Diarrhea

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What causes vomiting & diarrhea?

Vomiting (throwing up) and diarrhea (watery stools or poop!) are often caused by a virus (a kind of germ). Although there is no medicine to cure these infections, your child’s body will get rid of the virus in a week or 10 days. While your child is fighting the virus, you need to make sure she doesn’t lose too much body fluid.

Why can vomiting & diarrhea be such a problem for babies and young children?

Babies and young children can lose a lot of water and important salts when they are vomiting or have diarrhea. The loss of too much water and important salts is called dehydration, and this can be very serious for a baby or young child.

How can I care for my child at home?

1. 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.
  • If you’re breastfeeding, nurse more often, for less time.
  • Use a spoon or medicine dropper to give oral rehydration solution (ORS) 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

STOP!    

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.

2. 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 food, you can keep offering this.

3. Treat fever to keep you 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.

4. Check about prescription medicines. Call your doctor if your child is taking a prescription medication and throws up more than one dose.

If your child is vomiting...(with or without diarrhea)

Don’t worry if your child vomits only once or twice. If your child vomits a third time, you can follow these guidelines:

If you are breastfeeding:

  • Keep breastfeeding, but for less time, more often (for example, if your baby usually nurses for 10 minutes on each side every 3 hours, try 5 minutes each side every hour and a half)
  • Once the vomiting settles down (for example, no vomiting for 4-6 hours), you can try breastfeeding as much as your baby wants.

If your baby or toddler vomits again:

Wait 30 minutes, then switch to ORS (Oral Rehydration Solution-see next page) by spoon for a few hours. Give 1 tablespoon (15ml) of ORS every 10 minutes

If you are not breastfeeding:

  • Give 1 tablespoon (15 ml) or ORS every 10 minutes by spoon

If your child has diarrhea (with no vomiting):

Diarrhea means watery stools (poop) that happen more often than usual. The guidelines below are the same for babies or children of any age.

If you are breastfeeding:

  • Keep breastfeeding as usual
  • If your child has started other foods, slowly begin to give your child her usual diet. Start with small amounts more often.
  • Breastfeed often to keep up with the fluid loss through the diarrhea.

If you are not breastfeeding:

  • Slowly begin to give your child her usual diet (like formula or milk). Start with small amounts, more often.
  • Give ORS to replace the fluids lost in the diarrhea

Oral Rehydration Solutions

ORS (like Gastrolyte® or Pedialyte®) are the only fluids you should use (besides breastmilk) to replace fluids lost through vomiting and diarrhea.

Oral Rehydration Solutions are:

  • Fluids made with the right balance of sugars, salts and water to replace the fluids lost from vomiting and diarrhea. (for example: Pedialyte®, Gastrolyte®)
  • The only fluid you should use (besides breastmilk) to replace fluid losses
  • Available in most drug stores. They are covered through the Ontario Drug Benefit plan for families receiving social assistance.
  • Sometimes in powder form and must be mixed with water-follow directions carefully
  • Available in different flavours, and taste better cold, or on ice. You can make popsicles with it, or buy ready made ORS freezies or popsicles

Speak to your nurse if the cost of ORS will be difficult for your family.

While your child is sick, do not give:

  • Kool Aid, pop or sports drinks
  • Fruit juice or fruit drinks
  • Broth or rice water
  • Jell-O
  • Tea
  • Plain water

Getting better after vomiting and diarrhea

  • When vomiting stops, you can slowly start giving your child the foods she usually eats. Start with small amounts of food or fluids, more often. Most children can go back to their usual diets in a day or two.
  • Keep giving ORS until the diarrhea stops.
  • It takes a little time for the bowel to heal, so you might notice that your child’s stools stay quite soft for up to 10 days after the diarrhea.
  • If diarrhea or cramping lasts after 5-7 days, your doctor may suggest lactose free milk for a little while.

Sample Menu for Babies and Toddlers

Breakfast: Iron fortified infant cereal, toast, breastmilk, formula or milk

Lunch or Supper: Plain meat or fish, pasta, potato, vegetable or fruit, breastmilk, formula or milk.

Call your family doctor or go to the hospital if your child:

  • Is 3 months old or younger, and has a fever (temperature higher than 38oC or 100.4o 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 38.5o C or 101.5o 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

Numbers to know:

Telehealth Ontario 1-866-797-0000

Health Information from Registered Nurses, 24 hours a day, 7 days a week

TTY: 1-866-797-0007 

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