Vomiting and/or diarrhea happen when the lining of the stomach or intestines is irritated. Vomiting and/or diarrhea with fever are usually caused by an infection. The infection is usually caused by a virus and will improve in a couple of days to a week. Changes in diet, reactions to antibiotics, and food poisoning are some other causes.
The caregiver who examined your child decided that you can treat this illness safely at home. To make your child feel better you need to rest the stomach and intestines and help prevent more vomiting and diarrhea. This can be done by giving your child clear liquids and foods that are easily digested. Limiting milk and solid food may be necessary to help control vomiting. The main goal is to give enough fluids to prevent dehydration.
Do not use only plain water. The clear liquid solutions below replace water and some of the important electrolytes ("salts") and sugar lost with the vomiting and diarrhea.
Do not continue giving only clear liquids for longer than 24-48 hours without talking to your caregiver. Infants and children also need calories and nutrition provided by breast milk, formula, milk, and/or an age-appropriate diet.
Do not use over the counter vomiting or diarrhea medicines unless instructed to do so by your caregiver.
Milk and milk products may not be tolerated after having a long diarrhea illness. It may be recommended to eliminate these from the diet for a few weeks and use soy based formulas or products.
Treatment
First day
For vomiting alone or vomiting with diarrhea: Give your child nothing to eat or drink for 1-2 hours. Then feed small amounts (1 tablespoon or 1/2 ounce) of clear liquids every 15 minutes and double the amount every hour. Once your child is not vomiting for 2-3 hours, allow your child to take as much of the clear liquid as desired every 1-2 hours.
For diarrhea alone: Your child should receive lots of fluids and may have a bland diet – bananas, rice, applesauce, toast, and crackers. Advance to regular diet as long as they are not vomiting.
Hydration Solutions
Infants:
* If you are breastfeeding, continue to do so. Offer Pedialyte or Infalyte between feedings if your baby is urinating less
* If your child is on formula or milk, give only clear fluids such as Pedialyte, Infalyte, Lytren, Resol, or Rehydralyte
Children:
* Electrolyte solution such as Pedialyte
* Gatorade or PowerAde
* Apple juice diluted with water - half strength
* Seven Up or ginger ale with bubble stirred out
* Clear soup or broth (weak)
* Popsicles
Second Day
After 24 hours of clear liquids, and if your child is improving, continue the clear liquids and gradually start to feed mild and solid foods as suggested below:
Infants:
* If you are breastfeeding, continue to do so
* If your child is on formula or milk, begin full strength baby formula or milk. The diarrhea may initially increase slightly but as long as your child is drinking well, the formula should be continued
* Banana flakes, bananas, rice cereal, applesauce, and strained carrots may be added
Children:
* Regular milk, bananas, cooked rice, applesauce, grated apple, toast, crackers, mashed potatoes, lean meats, and Jell-O
If better after 48 hours, your child may go back to a regular diet.
Common Signs of Dehydration:
- Sunken eyes with no tears when crying
- Dry, sticky lips/mouth
- Irritability/sleepiness/weak looking
- Infants may have a sunken soft spot
- Urine may be darker yellow or have a strong odor
- Fewer wet diapers or fewer trips to the bathroom
- Rapid weight loss
Call your doctor when:
- Your child does not start to get better in 24 hours or if vomiting lasts more than 24 hours
- Your child starts to get worse at any time
- There is blood in the bowel movements or vomit
- The vomit is green or dark brown
- Your child has not had a wet diaper or urinated in the past 8 hours
- You have questions or concerns
Home Care Notes:
- Wash hands after each diaper change or contact with stool
- Dispose of soiled diapers appropriately
- If diarrhea is caused by an infection, it can be given to others -- so, limit other children’s contact with child or child’s belongings until diarrhea is gone
- Clean soiled clothes thoroughly and keep toilet bowel cleaned with disinfectant cleaner
- Protect the diaper area with zinc oxide or other ointment to prevent diaper rash
