Viral Gastroenteritis (Vomiting &/or diarrhoea)
Signs & Symptoms
Vomiting is the forceful ejection of a large portion of the stomach's contents through the mouth. By contrast, regurgitation is the effortless spitting up of one or two mouthfuls of stomach contents that are commonly seen in babies less than 1 year of age.
The vomiting may be followed by diarrhoea (watery loose stools) and abdominal cramps. There may also be a fever. There is often a history of contact with other children or adults with similar symptoms.
When would I expect it to stop?
The vomiting usually stops in 6 to 24 hours. Dietary changes usually speed recovery. If diarrhoea is present, it usually continues for several days.
What causes it
Many types of illnesses and medicines can cause vomiting or diarrhoea.
Most vomiting is caused by a viral infection of the stomach (viral gastritis) or eating something that disagrees with your child.
About the condition
Viral gastroenteritis is an intestinal infection caused by several different viruses. The main symptoms are vomiting and diarrhoea.
Often, the viral type is associated with diarrhoea. As such, no antibiotic is required unless it is a bacterial infection. Some antibiotics also causes nausea and diarrhoea, hence their use is not advisable.
When does my child need to stay in the hospital?
When the child has the following symptoms/signs:
- Any signs of dehydration (no urine in over 8 hours, very dry mouth, etc)
- Any blood or green fluid appears in the vomited material
- Abdominal pain develops and lasts more than 4 hours
- Your child starts acting very weak.
- Vomiting continues for more than 24 hours in children under age 2 or for more then 48 hours if over age 2
Diagnosis and Treatment Options
Common mistakes in treatment of vomiting
A common error is to give as much clear fluid as your child wants rather than gradually increasing the amount. This almost always leads to continued vomiting. Keep in mind that there is no effective drug or suppository for vomiting and that diet therapy is the answer.
Discontinue all medications for 8 hours. Oral medications can irritate the stomach and make vomiting worse. If your child has a fever, use paracetamol suppositories.
For Bottle-Fed Infants (less than 1 year old)
Offer oral rehydration solutions (ORS) for 8 hours.
- For vomiting once, offer half-strength formula
- For vomiting two or more times, offer ORS
- Give small amounts (1 teaspoon) every 10 minutes
- After 4 hours without vomiting, increase the amount
- After 8 hours without vomiting, return to formula
- For infants more than 4 months old; also return to cereal, strained bananas, etc.
- A normal diet is okay in 24 - 48 hours.
For breast-fed infants
- Reduce the amount per feeding.
- Provide breast milk in smaller amounts. Your goal is to avoid filling the stomach.
- If your baby vomits twice, nurse on only one side every 1 to 2 hours.
- If he vomits more than 2 times, nurse for 4 to 5 minutes every 30 to 60 minutes.
- After 8 hours without vomiting, return to regular breast-feeding.
For older children (more than 1 year old)
- Offer clear fluids in small amounts for 8 hours.
- Water or ice chips are best for vomiting without diarrhoea because water is directly absorbed across the stomach wall.
- Other options: isotonic solutions and Popsicles are recommended. However, stir until the fizz is gone because the bubbles can inflate the stomach.
- Give small amounts (1 tablespoon) every 10 minutes.
- After 4 hours without vomiting, increase the amount.
- For severe vomiting, rest the stomach completely for 1 hour, and then start over with smaller amounts.
- For older children (more than 1 year old), add bland foods after 8 hours without vomiting.
- Stay on bland, starchy foods (any complex carbohydrates) for 24 hours.
- Start with saline crackers, white bread, rice, mashed potatoes etc.
- A normal diet is okay in 24 to 48 hours.
Help your child go to sleep. Sleep often empties the stomach and relieves the need to vomit. Your child doesn't have to drink anything if he feels nauseated.