The stomach bug, how do you know when to keep your child at home, and how do you know when you need to bring them into the doctor? That's what we're going to discuss today. I'm Dr. Cindy Gellner, on The Scope.
We all have at one point or another and we'll all have it again at one point or another and we're seeing a lot of it going around lately. It's the stomach bug. It's not the flu. Everyone says, "I've got the stomach flu." Well it's not the flu; it's not caused by the influenza virus. There are a lot of other viruses though that can cause vomiting and diarrhea, including rotavirus, and adenovirus, and a bunch of other viruses we could name. But the bottom line is it's no fun, and it's a big risk for kids who can sometimes get dehydrated.
Vomiting & Diarrhea
When do you know when to bring your child in for vomiting and diarrhea? Most vomiting is caused by the stomach bug. It's usually not caused by food poisoning that often. However if more than one person gets sick at the exact time, food poisoning is something that you want to consider.
If your child has vomiting without diarrhea and it lasts for several days or you see blood in it, that's the time to get checked out urgently, because that could be something much more serious than the stomach bug.
But vomiting usually stops in about six to 24 hours. If you have a baby and they are vomiting and it's like across the room shooting, that's not the stomach bug going around either. But most kids who vomit, if they are a baby they can spit up some, or you know, if they do catch this virus from somebody, then you're going to know. It's going to be a different form of vomiting than reflux or these other scary things.
So when your child has vomiting you can usually expect diarrhea to come also, and usually within 24 hours. How do you take care of your child who has vomiting and diarrhea? The most important thing with vomiting is you need to make sure your child is hydrated. That means they have enough fluid in them so that they have a moist mouth, they are still making tears, and they can have a wet diaper or use the bathroom to pee at least once every eight hours. If they are not doing any of those things, then they are dehydrated.
Should I Make My Child Eat?
When your child is vomiting, you do not want to make them eat. That's a very common misconception that I have parents make. They think, well my child's vomiting. They don't want to eat because they are vomiting, so I need to make sure they get food because otherwise they're going to lose weight.
It's okay, we expect your child to lose a little bit of weight with the stomach bug. Don't make your child eat if they're not hungry, because if you do make them try to eat something before they are ready, they are going to bring it right back up and you're going to be cleaning it up. Just make sure they have small amounts of clear fluids and no solid foods for about eight hours once they start vomiting.
Keep Them Hydrated
Clear fluids are important, but don't give them milk. Their stomach won't be able to digest milk. That's going to come right back up, too. You want to give babies Pedialyte, and you want to give older kids ice chips, or water, or you can give them some of the low sugar versions of Gatorade, like G-2 or Powerade Zero. But you want to make sure that it's clear fluid.
You want to also make sure you give small amounts. If your child just guzzles a whole bunch, because they are really thirsty, their stomach is just going to bring that all right back up again. So you need to make sure it's a small amount, just a couple of sips. You want to make sure that they keep it down, because the more hydrated they are the less likely they will be to vomit. Kids who are dehydrated, these are the kids that end up going into the emergency room. The ones that have been throwing up so much they are dehydrated and they cannot keep anything down, and it's a vicious cycle. They'll try to keep something down, but it comes back up, on and on.
After your child has gone for eight hours without vomiting them you can start bland foods. These are like bananas, crackers, breads, applesauce; things like that that are very bland and not going to be hard on the stomach.
Should I Give My Child Medicine?
As far as medicines, there are not any really good medicines for kids to get them to stop vomiting that we recommend on a regular basis. There are some cases where the kids are in the emergency room they can get some anti-nausea medicines, but a lot of those have side effects. So we usually don't give them in an outpatient setting.
What Can My Child Eat to Help With Diarrhea?
What about the diarrhea? It doesn't matter what you give your child to eat for the diarrhea. If they've stopped vomiting your child can have their normal foods. Now the only exception is babies. If they have gone for several days with the diarrhea, and it's severe diarrhea, and they are on a milk-based formula, sometimes the digestive system isn't able to process milk proteins so well after several days of diarrhea. So you can switch to a soy formula for about one or two cans. And after that that will help you child's digestive system get back on track.
The old BRAT diet, yes, there is some controversy as to whether it still works or not. I usually still recommend it. It's bananas, rice, applesauce, toast, things like that will help. Bananas and apples quite often are constipating, so those the foods that you want to give when your child has diarrhea.
Yogurt is also great, because it has probiotics in it. The probiotics will actually help your stomach fight off the virus, and it will slow down the diarrhea. You can also buy over-the-counter probiotics, like Culturelle or Fluorogen. Those also help a lot for diarrhea.
And so while the vomiting can last only 24 hours, diarrhea can last up to two weeks, so don't be surprised if it lingers. The first few days are the worst, but it can still linger for awhile.
When Do I Need to Bring Them to the Doctor?
So when do you need to bring your child to the doctor? Well if your child just has vomiting and they are still hydrated, they are still able to be woken up even if they just want to lie around and sleep. That's not anything you need to bring them in for. Because we're just going to tell you exactly what I just mentioned, all of the advice I just mentioned.
The same with the diarrhea; if they are having it for a couple of days, but they are still happy and playful and running around, you don't need to bring them in.
If your child looks really dehydrated, their mouth is dry, they are not peeing anything like that, and you're really worried, then it's time to bring them in. If they look really sick and you can't wake them up; their mouth is really, really dry, no tears. They haven't peed for over 12 hours, then it's actually time to go to the emergency room, because they might need the IV fluids to help rehydrate themselves.
But the stomach bug is one of those things that there is not a whole lot that can be done for it, other than supportive care. So the best thing to do is to keep your kids home, let them rest, and if they are looking really sick you can always call your pediatrician for advice, and we can tell you if the office is the best place, or if the emergency room is.
updated: May 3, 2018
originally published: August 22, 2014
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