VOMITING AND DIARRHEA
Vomiting is the forceful emptying of stomach material through the mouth. Vomiting is not the quieter "spitting up" that is very common in young babies. In diarrhea stools may be loose, mushy, or watery.
CALL FOR THESE SIGNS:
Dehydration:
(no tears with crying, mouth really dry, no urine/wet diapers for more than 12 hours)
- Blood in the vomited material, or in the stool
- Constant tummy pain and/or crying for more than 2 hours
- Fever over 105°
F
- Recent injury to the abdominal area
- Vomiting 3 or more times after a recent head injury
- Vomiting of clear liquids more than 3 times AND having diarrhea that is really watery (especially if under 2 yrs)
- Younger than 3 months and having:
- Fever over 100°
F if under 4 weeks old (axillary/under the arm)
- Fever over 101°
F if 4-12 weeks old (under the arm)
- Bile (yellow or green) in vomited material
- Vomiting 2 or more times
- Younger than 1 month and 3 or more large diarrhea stools
- Younger than 1 year and more than 8 diarrhea stools in the past 8 hours
Continue reading: if your child has none of the above signs, you may begin home care
HOME TREATMENT:
The most likely cause is a viral infection of stomach/intestines
Anti-diarrhea medicine can make the illness worse, DO NOT USE
Try to prevent diaper rash: wash gently after each stool and apply protective ointment (Desitin, Vaseline, etc.)
For breast-fed infants who are vomiting:
- nurse for short times (4-5 minutes) every 30 minutes (gradually increase nursing, as tolerated)
- if baby refuses the breast milk: use Pedialyte (small amounts, frequently; see next page)
- when no vomiting for about 4 hours, return to regular breastfeeding schedule
For breast-fed infants with diarrhea:
- If mild: continue regular breastfeeding
- If frequent watery diarrhea: breastfeed more often (use Pedialyte if baby refuses the breast milk)
For formula fed infants with vomiting:
- Pedialyte in small amounts (start with one teaspoon)
(it is VERY IMPORTANT to use SMALL amounts at first)
- Offer every 10 minutes
- Gradually increase amount of Pedialyte as tolerated
- After about 4 hours with no vomiting, start formula slowly
For formula fed infants with diarrhea:
- If diarrhea is moderate, continue formula
- If child has frequent, watery diarrhea:
- continue formula
- after each watery stool, offer Pedialyte to replace fluid losses
- Intestines need FOOD/(formula) to HEAL
For infants with both diarrhea and vomiting:
- Follow vomiting steps first, switch to diarrhea steps when vomiting clears up
For all infants who have started eating SOLIDS:
- When vomiting stops, begin regular food (important; intestines need food to heal)
- Begin with starchy foods (complex carbohydrates), avoid juice
- Examples: rice cereal, strained bananas, strained carrots, crackers, mashed
potatoes
- After the first 1-2 days encourage any age-appropriate foods
For children over 1 year old:
- Offer small amounts (1 Tablespoon) of liquids every 10 minutes
- Pedialyte (may also try Pedialyte popsicles)
- small, frequent amounts VERY IMPORTANT while still vomiting
- Gradually increase liquids as tolerated (avoid full strength juice and sports beverages)
- Food: when vomiting eases
Beginning food as soon as possible is very important; it helps the intestines heal. Begin with foods like: rice cereal, oatmeal, rice, wheat, pasta, bread, bagels, mashed potatoes, cooked carrots, bananas, applesauce, crackers, pretzels, and yogurt. After the first 1-2 days encourage the child to eat "regular" healthy foods; it is thought that foods with more fat content (cheese, peanut butter, etc.) can be helpful with the diarrhea.
CALL IF:
Signs of dehydration are seen
Vomiting lasts longer than 24 hours
Diarrhea is severe, and persists longer than
1 week
- Any signs above (under "call for these
signs", other page) occur