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Vomiting and Diarrhea in Children
Am Fam Physician. 2001 Feb 15;63(4):775-776.
What causes vomiting and diarrhea?
Vomiting (throwing up) and diarrhea (frequent, watery bowel movements) can be caused by viruses, bacteria, parasites, foods that are hard to digest (such as too many sweets) and other things.
Can vomiting and diarrhea be dangerous for children?
They can be. Vomiting and diarrhea can be harmful to children because they can cause dehydration. Dehydration occurs when too much fluid is lost from the body. Young babies can become dehydrated very quickly, but dehydration can occur in a child of any age. Signs of dehydration include:
Not eating as well as usual
Not urinating (“peeing”) as often as usual
Urine that is darker than usual
Thirst (babies may show thirst by crying and being irritable and eager to drink when something is offered)
No tears when crying
Sunken soft spot in babies younger than 18 months
Skin that isn't as springy as usual
How can I prevent dehydration?
If your child has had several bouts of vomiting or diarrhea, he or she will need to drink fluids to replace those lost with vomiting and diarrhea. Encourage your child older than two years to drink water and other clear fluids. Ask your doctor about giving your baby or toddler oral rehydration solution (ORS), which contains the right mix of salt, sugar, potassium and other elements to help replace lost body fluids.
What can I give my older child to drink?
Children older than two years can have drinks such as apple juice, chicken broth, sports drinks (Gatorade), ginger ale or tea. Plain water can cause problems, such as lowering the amount of salt or sugar in the blood.
Should I give my child ORS?
If your child is younger than two years and you are worried that he or she is dehydrated, ask your doctor about using ORS. ORS comes as a powder that you mix with water, or a liquid that is already mixed and as frozen popsicles.
Brands of ORS include Pedialyte, Rice-Lyte, Rehydralyte and the World Health Organization's Oral Rehydration Solution (WHO-ORS). Ask your doctor about which one to use.
Should I feed my child during sickness?
Yes. Even though eating may cause the amount of diarrhea to increase, your child will be able to get some nutrients from the food. This may prevent your child from losing too much weight and help your child get better quicker.
Breast-fed babies. If you are breast-feeding, keep breast-feeding while you give ORS.
Formula-fed babies. If you have been giving your baby formula, some doctors suggest switching from formula to ORS for up to 12 to 24 hours and then switching back to giving formula. Talk to your doctor about what to do.
Children on food. Children should begin eating within about 12 to 24 hours after starting to take ORS. Avoid foods with a lot of sugar and fat, such as ice cream, gelatin, pudding and fried foods.
If your child has had diarrhea, dairy products are best avoided for three to seven days. Sometimes bland foods are recommended for the first 24 hours. Foods that are bland include bananas, rice, applesauce, toast and unsweetened cereals. If these foods don't bother your child, other foods can be added over the next 48 hours. Most children can return to normal eating habits in about three days after the vomiting and diarrhea stop.
Should I give my child medicine to stop diarrhea?
This usually isn't needed. Diarrhea doesn't usually last long. If it is caused by an infection, diarrhea is a way for the body to get rid of the infection. Giving medicines that stop diarrhea may interfere with the body's efforts to get rid of the infection. Antibiotics are usually not necessary either. Talk to your family doctor if you think your child needs medicine.
Call your doctor if your child is vomiting or has diarrhea and:
Is younger than six months.
Is older than six months and has a fever higher than 101.4°F.
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.
Hasn't passed urine in eight hours.
Could have swallowed something that could be a poison.
Has a stiff neck.
Is listless or unusually sleepy.
Has had tummy pain for more than two hours.
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 © 2001 by the American Academy of Family Physicians.
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