Vomiting and Diarrhea

General Overview:
 

Vomiting and/or diarrhea are usually caused by viral infections.  Vomiting often lasts for less than 1 day and diarrhea may last up to 10 days.  As with all viral illnesses, no specific treatment is required for resolution; however, there are ways to help keep your child comfortable, prevent dehydration and speed up his or her recovery.

Symptom Management:

Below are some ways to help reduce vomiting and/or diarrhea and to keep you child comfortable and adequately hydrated:

Clear Liquids
With active and repetitive vomiting, only clear liquids should be offered to your child. For formula fed infants, Pedialyte® may be given if formula is not well tolerated. For breastfed infants continue to breastfeed unless the vomiting is severe and prolonged.  Breastfed infants may need to feed more often for a shorter amount of time per feed.  In Children, water, Gatorade, Pedialyte® or warm chicken broth are good options.
 
Rehydration
Do not give your child any fluids when they are vomiting, as this often makes vomiting worse and results in more dehydration. It is best to wait 30-60 minutes after vomiting resolves prior to offering clear liquids.  Initially offer small amounts of fluids, 1-2tsp every 2-3 minutes.  If this is tolerated for an hour or two you can gradually increase the volume and frequency of fluid intake.
 
Bland Diet
If your child has not vomited in many hours, approximately 8,you may try a small amount of bland foods.  Bland foods also help diarrhea improve.  Common easy to digest foods include: crackers, toast, rice, bananas, apple sauce, boiled or mashed potatoes and pasta. 
 
Probiotics
Probiotics are the “good bacteria” in the stomach that help healthy people digest foods and prevent illnesses.  Some providers recommend taking probiotics with vomiting and/or diarrhea as they may reduce the duration of viral stomach illnesses.  If you are thinking of starting a probiotic please call our office for further advice and suggestions.
 
Liquids and Foods to Avoid
In a child with vomiting and/or diarrhea milk and juice are best avoided as they may make symptoms worse.  Foods high in fat, fiber and dairy should also be avoided in children with active diarrhea or within the first few days after vomiting resolves. 
 
Medications
There is almost never a reason to use medication of any kind in the treatment of diarrhea or vomiting in children. Acetaminopen (Tylenol®) is an exception and can be used if your child has fever or pain in addition to these symptoms. Acetaminophen is available as a suppository (Feverall®) for those who can't keep it down. 

 

Signs of Dehydration:

The above information is useful in preventing dehydration, but sometimes children with vomiting and/or diarrhea may become dehydrated anyways. The following are signs to look for:

  • Dry mouth or lips
  • No tears when crying
  • Urinating less than every 6 hours or dark urine
  • Dizziness and/or lightheadedness
  • Sunken eyes
  • Marked lethargy

When to Call:

If your child has any of the above symptoms, call us to discuss possible dehydration. Please call also if your child has blood in the stool or vomit, a stiff neck, a severe headache, severe abdominal pain or if he or she is difficult to awaken.

Takeaway Message:

Vomiting and/or diarrhea are usually caused by viruses and resolve without treatment.  Primary management of vomiting and diarrhea is aimed at reducing dehydration and maintaining comfort.  Please call our office with any concerns if you child is vomiting or has diarrhea.

Additional Resources:

Information on managing Vomiting and Diarrhea from the American Academy of Pediatrics