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Am Fam Physician. 2019;99(3):online

See related article on gastroenteritis in children

What is gastroenteritis?

Gastroenteritis (GASS-tro-EN-ter-EYE-tiss) is another name for stomach flu. Children with stomach flu get diarrhea. They may also have upset stomach, vomiting, or fever. It is caused by germs, food poisoning, or unclean water.

Is it serious?

The main worry is losing too much fluid from diarrhea or vomiting. This causes dehydration. Dehydration means the body is drying out. It can be serious if it is not treated.

How do I know if my child is getting dehydrated?

Children with dehydration will pee less often, and it will be darker than usual. Your child may also be tired and not as active.

How do I treat dehydration?

You should give your child more fluids.

Children younger than one year should get special fluids called oral rehydration solutions, or ORS for short. You can buy them at the drugstore or supermarket. Continue breastfeeding or bottle feeding after giving your child the ORS. Do not dilute feedings with water.

Children older than one year can drink their favorite drinks, mixed half-and-half with water. The drink can be apple juice, clear soup, or clear soda. After drinking, they can eat normal food if they want to.

How much fluid should I give?

Using a syringe, spoon, or cup, give a small amount every five minutes for three to four hours. Your doctor can tell you the exact amount. It depends on how much your child weighs.

When should I give the fluid?

Give your child fluids every time he or she has diarrhea or vomiting.

When should I call the doctor?

Call the doctor if your child is not better 24 hours after starting to drink more fluids or if he or she keeps vomiting up the fluids.

Also call the doctor if your child:

  • Has bloody diarrhea

  • Has sunken eyes or less tears than usual

  • Is very sleepy or grumpy

  • Has a fever (more than 100.4°F in children younger than three months or more than 101°F in older children)

  • Is younger than six months or weighs less than 18 pounds

How can I keep my child from getting the stomach flu again?

You can't always prevent it, but there are things that can help:

  • Children who breastfeed are less likely to get it.

  • Children should get the vaccine (shot) to prevent rotavirus, which is a common cause of stomach flu.

  • Make sure children wash their hands often to help get rid of germs that can cause the stomach flu.

  • Clean surfaces that have been touched by a sick child.

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