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Information from Your Family Doctor
Treating Gastroenteritis and Dehydration in Your Child
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Am Fam Physician. 1999 Dec 1;60(9):2565-2566.
See related article on acute gastroenteritis.
What is gastroenteritis?
Gastroenteritis can cause vomiting and diarrhea (very frequent, watery bowel movements). This illness is very common in children.
Gastroenteritis is usually caused by a virus. It can also be caused by bacteria (germs) or parasites.
Most children with gastroenteritis get better without medicine in a few days. However, it is very important to prevent dehydration.
What is dehydration?
Dehydration is the “drying out” of the body that happens when your child loses more fluids than he or she is able to drink.
Dehydration happens quickly in infants and very small children. These children have less “extra” fluids in their bodies to lose.
How do I prevent dehydration in my child?
If you breast-feed your baby, keep on doing this, and try to breast-feed more often.
If you bottle-feed, keep using the regular formula, and try to feed your child more often.
If your child is older, make sure that he or she drinks enough liquids to replace the fluids that are lost in diarrhea and vomiting.
An older child who is not nauseated (feeling like throwing up) or vomiting can keep eating regular foods. Encourage your child to drink as much liquid as he or she can. Any liquids your child will drink are OK, as long as your child eats some solid foods, too. Fatty foods and drinks that are high in sugar (such as juices and soft drinks) might make the diarrhea a little worse. It helps to feed your child solid foods like noodles or rice, along with meat that isn't fatty. Fruits and vegetables and yogurt may be the best choices.
If your child is nauseated but not vomiting, give him or her small sips of liquid every few minutes. This is less likely to cause vomiting than drinking a lot at once. If your child will not eat any solid foods, is vomiting over and over, or will not drink liquids, you should try one of the special “Oral Rehydration Solution” drinks described on the next page.
How do I know if my child is getting dehydrated?
You can suspect dehydration if your child has had vomiting or diarrhea and has any of these signs:
Feeling thirsty but drinking liquids makes the child vomit
Dry lips and mouth
A dark color or a strong smell to the urine (and not urinating very often or very much)
Feeling dizzy when sitting or standing up (in older children)
Little or no tears when crying (in babies)
Sunken eyes (in babies and toddlers)
Not paying attention to toys or television, or even being difficult to wake up (this is a sign of very bad dehydration)
Vomiting up everything he or she drinks or eats
How do I treat dehydration?
If the dehydration isn't too bad, you can care for your child at home with help from your doctor. It takes a lot of care and time. It is best to use special liquids called “Oral Rehydration Solutions” (or “ORS” for short). These are drinks designed for children who are dehydrated. They contain water, sugar and a special mix of mineral salts like sodium and potassium.
Other “clear liquids” like soft drinks, tea, apple juice, Jello-water, chicken broth or “sport drinks” like Gatorade don't have the right mix of water, sugar and mineral salts. They might even make the diarrhea worse.
Drug stores and grocery stores carry several brands of ORS, with brand names like Pedialyte, Infalyte, Rehydralyte, Resol and Naturalyte. You might also find “generic” brands of ORS. They all work the same and are safe when you follow the directions.
Start by giving your child one or two teaspoons every one or two minutes. This adds up to over a cup an hour. Even if your child vomits again, quite a lot of this fluid will stay down. That helps fix the dehydration.
If your child does well, you can slowly give bigger sips a little less often—every 5 minutes. When your child is no longer dehydrated and isn't nauseated or vomiting, you can start giving regular food and drinks again.
Can I use medicine for diarrhea?
Medicines for diarrhea don't work very well. The best treatment is to prevent or treat dehydration.
When should I call my doctor?
In general, if your child is under two years old and has vomiting and diarrhea for more than 12 hours, you should take him or her to your doctor. This is very important if the child is vomiting often, or if the amount of diarrhea is large, or if the child also has a fever. Call your doctor right away if your child:
Has pain in the stomach along with the vomiting
Has blood in the diarrhea
Is under six months of age
Has any of the signs or symptoms of dehydration mentioned in the list above.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 1999 by the American Academy of Family Physicians.
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