Vomiting and diarrhea are common in children. Together, they are sometimes called gastroenteritis by your doctor and “stomach flu” by others. It is not the real “flu,” which is caused by the influenza virus. Most of the time, vomiting and diarrhea is caused by a virus, which may also bring a fever, and resolves on its own. You can usually treat your child at home.
The biggest concern with vomiting and diarrhea in infants and children is the risk of dehydration. It is fine if your child does not want to eat during this time but he or she needs to keep drinking fluids. Fevers can often worsen dehydration. Some symptoms of dehydration include:
- Mild dehydration:
- Thirst and a slightly dry mouth
- Moderate or severe dehydration:
- Decreased urination (more than 6-8 hours between wet diapers or urine output)
- No tears when crying
- Dry mouth
- Eyes that appear to be sunken
What can I do when my child has vomiting or diarrhea?
Keep your child hydrated, but take it slow. In gastroenteritis, passage through the stomach and upper intestine is slowed down. When your child gulps a large amount of fluid because he or she is thirsty, the fluid stays in the stomach for a longer time and can cause nausea and vomiting.
The “trick” behind oral rehydration is to give your child very small amounts of fluid very frequently. This small amount is absorbed by the stomach lining and does not lead to nausea. You can almost always avoid a trip to the emergency room using this method.
For infants who are breastfeeding, continue to breastfeed. If your baby is vomiting, however, you may need to breastfeed more frequently. You can try breastfeeding every 30 minutes for only 5 minutes. If your baby does well with that schedule for 2–3 hours, resume normal feeding. If your baby does not want to take breast milk, give 5 milliliters of Pedialyte or oral rehydration solution every 5 minutes for a couple of hours. It is easiest to give with a syringe. If your baby tolerates this, try breastfeeding again but for only 5 minutes at a time.
If your infant takes formula, try giving 5 milliliters of Pedialyte or oral rehydration solution every 5 minutes for 2–3 hours. Give with a syringe. If your baby does well with that, restart regular formula, again initially giving small amounts at a time. You can also try mixing Pedialyte with formula if your baby tolerates this better.
Don’t forget about skin care. Wash your baby’s bottom often in the sink or tub to clean it well. Allow your baby’s bottom to air dry as well. Apply a barrier cream (Vaseline, Desitin (purple box), A&D, etc.) to your baby’s bottom with every diaper change to protect the skin.
Toddlers and school-age children
Give your child 1 teaspoon (5 milliliters) of fluid every 5 minutes in a small cup or syringe. If you give your child a cup of fluid and tell him or her to “sip,” he or she will probably drink too much too fast.
Give your child clear liquids only. Pedialyte or oral rehydration solution is a great option. These contain the appropriate number of electrolytes (salts) to keep children’s sugar and salt levels in a normal range. If your child does not like the taste, you can mix it with a small amount of juice or drink flavoring.
You can also give sports drinks to older children but try to dilute these with water as the high sugar content may worsen diarrhea. You can also give occasional popsicles or Jell-O if your child will eat them.
If your child vomits, take a break for 30 minutes and start again. When your child has not vomited for 8 hours, he or she can slowly return to a regular (bland) diet. Avoid high fat foods initially.
If your child has a fever and can’t keep down Tylenol or Motrin, you can use a rectal suppository, such as Feverall.
When should my child see a doctor for vomiting and diarrhea?
Call your pediatrician or seek medical attention if you are worried or if:
- Your infant is under 3 months of age and has a fever or vomiting and diarrhea
- Your child has signs of dehydration: no urine in over 8 hours, no tears, dry mouth, etc.
- Your child has been vomiting for more than 48 hours
- Your child is vomiting blood
- Your child’s stools contain blood
- Your child is acting confused or is difficult to awaken
- Your child is immunocompromised or has other chronic health problems
Updated September 2018