Acute gastroenteritis is a very common problem in infants and children and is usually caused by a stomach virus, such as the rotavirus, or food poisoning. Symptoms include a fever, stomachache, vomiting and diarrhea. Although the vomiting typically lasts only two to three days, the diarrhea can last for one to two weeks before it finally resolves.
There is no cure or medicine to treat gastroenteritis, but there are many things that can be done to help your child through this illness.
The main problem from having diarrhea and vomiting is that it can lead your child to getting dehydrated. The first sign of dehydration is that your child will urinate less frequently (your child should be urinating every six to eight hours). Other signs include a dry mouth, not having tears when crying, sunken eyes, weight loss, and decreased activity or increased irritability. If your child has persistent diarrhea and vomiting, but is still urinating regularly and has a moist mouth then there is little danger that he is getting dehydrated.
Fluids for Gastroenteritis
Fluids that are good for children with diarrhea and vomiting include unflavored or flavored oral rehydration solutions, such as Pedialyte, Infalyte or Kaoelectrolyte (also available as popsicles). These fluids have the right amount of water, sugar and salt that your child needs.
Other choices, such as soft drinks, juices or Kool-Aid have too much sugar and can make the diarrhea worse. Also do not give just plain water, tea, or chicken broth.
Juices with a high sorbitol content, like apple juice and pear juice, should be especially avoided, as they can also make the diarrhea worse. White grape juice is a better alternative if you child won't tolerate an oral rehydration solution.
Treatment for Diarrhea
If your child has diarrhea and is not vomiting or has only vomited a few times, then you can continue his usual diet (including breastfeeding or formula), but do give 2-4 ounces of extra fluid every time that he has a large watery diarrhea. Although your child will not be able to digest everything that he eats as well as he normally would, by eating a regular diet your child will continue to get the nutrition he needs to get well.
If your child does not want to eat the first day then you can try the typical BRAT diet (bananas, rice, applesauce and toast) with lots of fluids, and then advance his diet as quickly as he will tolerate it.
If your child has had prolonged diarrhea, then he may rarely develop a temporary lactase deficiency and may not be able to tolerate dairy products. You can try a soy formula or soy milk for a few weeks if your child's diarrhea becomes worse after drinking dairy products.
Treatment for Vomiting
If your child has persistent vomiting and isn't keeping anything down, check him for signs of dehydration (less frequent urination, dry mouth, no tears, and sunken eyes). If he is not dehydrated, then you can give him a break from drinking for an hour or so and then slowly begin to give him fluids again as described below. The most common error is giving a thirsty child too much to drink too soon, which causes them to continue vomiting.
We recommend giving very small amounts (1-3 teaspoons or medicine droppers) of an oral rehydration solution every five or ten minutes. Even though their stomach is very upset, most children with persistent vomiting are able to keep this down and over an hour or two they end up drinking quite a bit of fluid that can keep them from getting dehydrated.
Once your child is keeping a few teaspoons of fluid down at a time without vomiting for a few hours, you can then increase him to 2-3 tablespoons every five to ten minutes and after keeping this down for a few hours he can then drink an ounce or two at a time.
You should continue to give the oral rehydration solutions in small amounts until the vomiting improves and then restart his usual diet with extra fluid every time that he has diarrhea or vomiting.
- Be Patient: This is a common illness that can last a week or two before resolving on its own.
- Avoid giving just Pedialyte for more than 12-24 hours.
- Avoid medications: Medicines for diarrhea and vomiting have not been shown to improve symptoms in children and can make them worse.
- Call your pediatrician if your child is becoming dehydrated (decreased urination, dry mouth, not having tears when crying, sunken eyes, and decreased activity or increased irritability), if your child is vomiting blood, if the diarrhea is not improved in two weeks or if there is blood or pus in the diarrhea. Also call if your child is vomiting and has a high fever, severe headache or stomachache.