Vomiting and Diarrhea in Children

Can vomiting and diarrhea be dangerous to my child?

Vomiting (throwing up) and diarrhea (frequent, watery bowel movements) can cause dehydration if too much fluid is lost from the body. Some signs of dehydration are dry mouth, increased thirst, sunken eyes, lack of tears when crying, irritability and reduc ed urination. If dehydration becomes severe enough, death may occur.

How can I keep my child from getting dehydrated?

If your child has had several bouts of vomiting or diarrhea, he or she will need an oral rehydration solution (ORS). The ORS contains the right mix of salt, sugar, potassium and other elements to help replace lost body fluids.

Many brands of ORS are available as premixed liquids. Talk to your family doctor to find out which ORS you should use.

How effective are home remedies for dehydration?

Generally, home remedies for dehydration-such as apple juice, chicken broth, cola, Gatorade, ginger ale or tea-shouldn't be given to children under two years of age. These drinks don't contain the right balance of sugar, salt and other elements. Soft drin ks that have caffeine in them shouldn't be given, because caffeine increases the loss of water and salt. Even plain water can cause problems, such as lowering the amount of salt or sugar in the blood. Talk to your family doctor about whether it's safe to give home remedies to your older child.

How should I give the oral rehydration solution?

If your child has diarrhea and isn't vomiting, don't limit how much ORS your child drinks. You can give the ORS in a dropper, a spoon, a boffle or a cup. Your doctor will probably tell you the minimum amount your child should drink.

If your child is vomiting (with or without diarrhea), try giving small amounts of the ORS often, such as one teaspoon a minute. When your child is able to keep the drink down, slowly increase the amount of ORS you give.

If your child keeps vomiting, wait 30 to 60 minutes after the last time he or she vomits and then give him or her a few sips of the ORS from a spoon or a few drops from a dropper. Small amounts every few minutes may stay down better.

What should I do when the vomiting stops?

When your child stops vomiting, you can increase the amount of ORS you give each time and lengthen the time between when you give the drink to once every three or four hours. Keep giving the ORS until your child's stools return to normal.

Should I feed my child during sickness?

Breast feeding and formula feeding may continue while you're using an ORS. Talk to your doctor about the best approach, especially if your child's diarrhea seems to be getting worse.

Children who have been eating regular food should begin eating as soon as they want. Avoid foods and drinks that contain a lot of sugar, such as ice cream, juice, soda pop and candy. Starchy foods, such as noodles, bread, rice and potatoes, may be especia lly helpful.

Should I give my child medicine to stop the diarrhea?

Medicine usually isn't needed, since diarrhea generally doesn't last very long. If the diarrhea is caused by an infection, medicine may interfere with the body's efforts to get rid of the infection. Talk to your family doctor if you think your child needs medicine.

Will my child need to go to the hospital?

This depends on how dehydrated your child is. Your child may need to be given special fluids intravenously (through a vein). This is the quickest way to replace fluids lost through vomiting and diarrhea.

Call your doctor if your child is vomiting and/or has diarrhea and he or she:

• Is less than six months old, or is over six months old and has a temperature above 101.4°.
• Has signs of dehydration.
• Has been vomiting longer than eight hours or is vomiting with great force.
• Has stools that are bloody or slimy.
• Has blood or green slime in the vomit.
• Is bloated.
• Hasn't urinated in eight hours.
• May have swallowed something that could be a poison.
• Has a stiff neck.
• Is listless or unusually sleepy.
• Has had abdominal pain for over two hours.

This handout is provided to you by your family doctor and the American Academy of Family Physicians. It is adapted from "Vomiting and Diarrhea: Helping Your Child Through Sickness," a brochure in the AAFP patient education brochure series, Health Notes fr om Your Family Doctor.

This information provides a general overview on vomiting and diarrhea in children and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor.

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