Kids get vomiting and diarrhea for many reasons, but it is most often caused by a stomach virus.
Whatever the cause, even if it is something your child eat or food poisoning, you will want to know how to best manage your child’s symptoms to help them feel better quickly and prevent them from getting dehydrated.
Vomiting and Diarrhea
Although most people associate vomiting and diarrhea with the “stomach flu,” the flu virus doesn’t usually cause vomiting and diarrhea.
Instead, there are a number of other viruses, bacteria, and parasites that do, including:
- rotavirus – a vaccine-preventable disease
- norovirus – the “cruise ship virus,” but very common elsewhere too
- Salmonella, Shigella, E. coli – food poisoning, animals
- C. diff – associated with recent antibiotic use
- Cryptosporidium – drinking contaminated water, swimming pools, water parks
If necessary, especially when diarrhea is associated with severe symptoms or is lingering, stool tests can be done to figure out the specific cause. Fortunately, diarrhea and vomiting often goes away on its own fairly quickly and these tests aren’t necessary. What will likely be necessary is keeping your child well hydrated until these symptoms stop.
Treating Vomiting and Diarrhea
For most kids with vomiting and diarrhea, you can:
- continue breastfeeding on demand
- continue their normal diet (feed through the diarrhea), including baby formula or milk, if they just have diarrhea and no vomiting or only occasional vomiting, giving extra fluids every time your child has diarrhea (about 3 ounces if your child is under 22 pounds and about 6 ounces if they are over 22 pounds)
- forget about eating and concentrate on drinking if your child has a lot of vomiting, but start by offering very small amounts of fluid, perhaps starting with a teaspoon (5ml) every 5 or 10 minutes, and then slowly working your way up to a tablespoon (15ml) and than an ounce (30ml) or two over a few hours
- take a break from drinking for 30 minutes if your child has a set back and begins vomiting again, and restart at 5ml, slowly working your way back up again as tolerated
- watch closely for signs and symptoms of dehydration, including weight loss, decreased urine output (fewer wet diapers or going to the bathroom less often), no tears, or dry mouth with no saliva or spit, etc.
In general, when talking about fluids, we mean an oral rehydration solution, like Pedialyte. If your older child won’t drink Pedialyte, you can offer something like Gatorade, but keep in mind that sports drinks have more sugar, so can sometimes make diarrhea worse.
But do you really make your child eat and feed through the diarrhea if he doesn’t want to? Of course not. The idea is that you don’t restrict your child’s diet if they want to eat. If they are complaining of a stomach ache, just don’t feel good, or feeding them their regular diet makes the diarrhea or vomiting worse, then move to more bland food.
Treating Hard to Control Vomiting and Diarrhea
What if your child continues to have vomiting and diarrhea?
You should still avoid treating your younger child with over-the-counter remedies to stop diarrhea, including those with loperamine (Imodium) or bismuth subsalicylate (Kaopectate).
A prescription medication, Zofran (ondansetron), might be appropriate for some children with persistent vomiting who are at risk of getting dehydrated.
If your child has persistent vomiting and diarrhea, ask yourself these questions and share the answers with your pediatrician:
- Does your child have any symptoms that might require immediate medical attention, such as high fever, bloody diarrhea, severe headache, severe abdominal pain, or signs of moderate to severe dehydration?
- Has your child with chronic diarrhea (diarrhea for more than four weeks) been losing weight, had fever, or regular stomach pains?
- Does your otherwise well toddler have chronic, watery diarrhea even though no one else has been sick, a possible sign of Toddler’s diarrhea?
- Do you have any pets or contact with pets that could put your child at risk for a Salmonella infection, including turtles, lizards, snakes, and frogs?
- Has your child visited a farm or petting zoo, which puts him at risk for a Salmonella or E. coli infection?
- Did your child recently take an antibiotic, which puts him at risk for a C. diff infection?
- Has your child been drinking raw milk or other high risk foods?
- Has your child traveled recently, which puts him at risk for traveler’s diarrhea?
- Did you put your child on the BRAT diet (bananas, rice, applesauce, and toast) even though they were eager to eat?
Have you tried giving your child a probiotic? - Does your child now only have diarrhea after drinking milk, perhaps a sign of a temporary lactose deficiency?
- Is your child better, with much less vomiting, but you are just frustrated that the diarrhea hasn’t gone away yet?
- Is your child better, with much less vomiting, but you are just frustrated that she is still vomiting at least once each day?
While you should certainly call your pediatrician if your child’s symptoms are lingering, remember that almost everything about the idea of the “24 hour stomach flu” you have heard is probably wrong. In addition to the fact that it isn’t caused by the flu virus, the symptoms typically last more than 24 hours, at least in kids. The vomiting may get better in 24 hours, but diarrhea can easily linger for a week or two.
It is also important to keep in mind that most causes of vomiting and diarrhea are very contagious and can easily spread through the whole house if you aren’t careful. Remember to always wash hands, rinse fruits and vegetables, clean and disinfect contaminated surfaces, and don’t share food or drinks, etc. If you just do it when your kids are sick, it will be too late, as many illnesses are contagious even before you show symptoms.
What To Know About Treating Hard to Control Vomiting and Diarrhea
Even when they don’t linger, it can be frustrating for parents to treat their kids with vomiting and diarrhea. Get the latest treatment recommendations to help you get through these very common infections quickly.
More Information On Treating Hard to Control Vomiting and Diarrhea
- AAP – Surviving the Stomach Bug: Truths & Tips for Parents
- AAP – What’s the best way to treat diarrhea?
- AAP – Treating Vomiting
- AAP – Drinks to Prevent Dehydration in a Vomiting Child
- CDC – Managing Acute Gastroenteritis Among Children
- Diarrhoea and vomiting in babies and children
- Cochrane – Anti-sickness medication for vomiting in acute stomach upsets in children
- GI Kids – Acute Diarrhea
- GI Kids – Chronic Diarrhea
- GI Kids – Toddler’s Diarrhea
- CDC – Prevent the Spread of Norovirus
Last Updated on December 4, 2016 by Vincent Iannelli, MD
