Also: Vomiting, Diarrhea, Dehydration

Waking up in the middle of the night to the sound of your child vomiting will strike fear in the heart of any parent! But don’t fret, most cases of stomach viruses can be handled at home with a little bit of loving care and patience. The following is a basic approach to stomach bugs, including when you need to have your child seen.

Infants 0-4 Months

If your young infant is vomiting with every feed, having multiple episodes of diarrhea, or acting ill, you should make an appointment. Do not try to handle this at home. Young infants get dehydrated quickly and should be seen to rule out other causes of vomiting.

Infants 5 Months – 12 Months: Vomiting OR Vomiting and Diarrhea

  • Stop formula and breastmilk until vomiting has slowed down dramatically
  • Give “clear” fluids
    • A mixture of 1/2 Pedialyte or Gatorade (any flavor) and 1/2 water is a good clear fluid to offer at any age
    • Infants over 9 months can be offered plain water as well
    • Start by giving sips – no more than an ounce, every 20-30 minutes
    • Once your child is holding down that volume, increase to 2oz clear fluids every 1-2 hours
  • If your child holds down 2oz clear fluids for at least 2 “feeds” you can try offering formula or breastmilk in small volume – about 1oz to start

For older infants that are on solids, you might want to defer milk altogether for the first day, and just offer clear fluids and, once holding down clears, offer bland food like crackers, bananas, toast, etc. Gradually work your way back to a regular diet – sometimes this can take 24-48 hours.

Keep in mind: infants and toddlers can have mild gastroenteritis symptoms for several days, even with occasional episodes of vomiting off and on. As long as they aren’t having repeated vomiting, it’s okay to continue to progress their diet.

Your child needs an AVERAGE of an ounce of fluids per hour to stay hydrated. Your child should be having an AVERAGE of 3 wet diapers per day to ensure he/she is hydrated.

Children 1 Year and Older

Follow the same strategy as above, but you can follow your child’s cues a little more at this age.

  • Offer sips of water every 15 minutes.
  • Once tolerating those sips of water, okay to increase to larger volumes of water
  • Once tolerating larger volumes of water, progress to bland foods

BRAT diet: Bananas, Rice, Apples, Toast (basically, a bland diet without fatty/spicy foods) Okay to progress to a normal diet once no longer vomiting for about 24 hours.

Children over 18 months can be offered anti-nausea medications – call the office and a prescription can be sent in if appropriate.

Diarrhea WITHOUT Vomiting

Children who are experiencing ONLY diarrhea can be given a normal diet as long as they feel up to it. However, copious watery diarrhea results in a loss of electrolytes and can result in dehydration, so it is recommended to offer electrolyte replacement.

Electrolyte Replacement = A mixture of 1/2 Pedialyte or Gatorade (any flavor) and 1/2 water. A good rule of thumb is: 2oz electrolyte replacement for every large watery stool.

Signs of Dehydration

If these are occurring – have your child seen!

  • Fewer than 3 wet diapers or 3 urinations in 24 hours (1 every 8 hours)
  • Markedly decreased energy level
  • Decreased interest in drinking and not taking in at least small sips of fluids every 15-20 minutes
  • Recurrence of vomiting after it seemed to have stopped for over a day