“Mommy, I don’t feel well. I think I’m going to throw up.”
Most children will go through at least one episode of vomiting and diarrhea. Health professionals call these illnesses gastroenteritis, or “gastro”. The most common causes of gastro are viruses. Although it is often called “the flu”, influenza doesn’t cause just vomiting and diarrhea and the flu vaccine will not prevent it.
Rotaviruses are the most common cause of severe diarrhea in children under 2 years old. Fortunately, there is a very effective vaccine that protects children from getting extremely sick if they do get the virus. Most children receive three doses of the vaccine by their 6-month check-up. While it doesn’t prevent infection entirely, it lessens the amount of diarrhea and the length of the illness. Before the vaccine was available, many infants and toddlers needed to be admitted to the hospital because of dehydration. The vaccine has made these admissions much less common. Rotavirus is most common from November to March.
Another family of viruses, the Astroviruses, infects mostly infants and children younger than 4 years old. These illnesses occur most often in the winter.
Caliciviruses are a third family of viruses that cause gastro in both children and adults. Among these is the Norwalk-like virus or norovirus. These viruses cause problems year-round. They are often spread from person to person.
Most cases of viral gastro are not serious, but your child may feel very sick. In addition to vomiting and diarrhea, your child may have a fever, abdominal pain, headache, muscle aches and just generally feel tired and irritable. Depending on the cause, these symptoms start 1 to 4 days after catching the virus and can last up to 14 days.
The diagnosis is usually made by the symptoms of the illness and by examining the child. Most viral gastro will improve without treatment; antibiotics don’t help and may even make the diarrhea worse.
The most important thing to do is keep your child hydrated and as comfortable as possible while the immune system takes care of the virus. Encourage your child to rest.
If your child is vomiting, allow her stomach to rest by not giving anything to eat or drink for two to three hours after the last episode of vomiting. Then offer 1 ounce of an oral rehydration solution like Pedialyte every half hour for 2 hours. If there is no further vomiting, increase to 2 ounces every half hour for another hour. After that, small amounts of clear liquids like Popsicles and Jell-O can be offered. After 12 to 24 hours, small amounts of solid foods may be given. If at any time vomiting reoccurs, go back to resting the stomach and try again in two to three hours.
If your child has diarrhea but is not vomiting, encourage her to drink lots of fluids, including some oral rehydration solution like Pedialyte. Your child can continue to eat her regular diet, but be careful of juices that can increase the diarrhea. Using a barrier cream like Desitin if your child is in diapers can prevent diaper rash.
The most serious complication of gastro is dehydration. Signs of dehydration include: increased thirst, less urine, dry mouth, fewer tears, less playful, sunken soft spot in an infant and sunken eyes. Call your pediatrician if you suspect your child is dehydrated, continues to vomit for over 24 hours, has severe abdominal pain, refuses to eat or drink, has a fever over 102 degrees F, is excessively sleepy, if you see blood in the stool or vomit or if you have other concerns.
Sources: www.aap.org, www.healthychildren.org
