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Vomiting And Diarrhea

Vomiting: the act of bringing up stomach contents; must be distinguished from “usual” spit up.

Diarrhea: stools that are abnormal in amount (frequency) & consistency (loose & watery).

When your child has vomiting and diarrhea, there is a risk that too much water will be lost from the body.  This is known as dehydration.  Most cases of vomiting/diarrhea are limited and children do not get too dehydrated.  If you notice any of the following signs that indicate that dehydration is getting worse, call your doctor:

  • No tears, drool, spit

  • Dry tongue (and your child has not been breathing through his/her mouth)

  • Sunken eyes or soft spot (if still open)

  • No urine for 12 hours or more

  • Slow capillary refill (as demonstrated in the office) on a warm finger or toe

  • Poor responsiveness to surroundings

What To Do

The goal of therapy is to keep your child well hydrated.

If vomiting is the major problem, give frequent small amounts of liquid.  You may use Pedialyte or clear liquids for the first 24 hours.  Do not use just Pedialyte for more than 24 hours unless directed to do so by your doctor.  You may need to use a dropper, syringe or spoon to put small amounts of Pedialyte or liquid into his/her mouth every 5 to 10 minutes.  If your child drinks readily, only allow small amounts (1-2 ounces) at a time.  If your child does not throw up, you can offer another few ounces in 20 to 30 minutes.  After 24 hours, you may start advancing the diet with bland food and complex carbohydrates (see below).  Call your doctor if signs of dehydration occur or your child is not getting better after several days.

If diarrhea is the major problem, encourage a lot of liquids (avoid large amounts of juice).  You may continue the child’s general diet, but try to eliminate milk and milk products until the stool firms up.  With frequent stooling, your child’s skin on his/her bottom may become irritated.  Try to prevent diaper rash with frequent diaper changes and using A & D or similar ointment to keep the stool away from the skin.  Another method that may help is topically applying an over the counter ant-acid (like Maalox).  If the skin on the buttocks does become irritated despite the above measures, call your doctor.  Continue to watch for signs of dehydration.  Sometimes, with stomach illnesses, children do not want to drink.  However, it is very important to get liquids into your child even if you must give small amounts with a medicine dropper or spoon.

clear liquids:

(less than 1 year of age)

  • Pedialyte (or similar electrolyte solution)

(greater than one year of age)

  • Pedialyte (or similar electrolyte solution)

  • caffeine free soft drinks (dark soda is good-Coke or Pepsi)

  • weak Kool-Aid (not red)

  • Jello or gelatin (not red) water (1 pkg. with 4 C. water)

  • Popsicles-look for Pedialyte popsicles (not red)

bland foods/complex carbohydrates:

  • rice or rice cereal, breakfast cereals

  • fruit (apples, applesauce, bananas)

  • toast or crackers

  • lean meat, chicken

  • potatoes, pasta

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