Gastroenteritis

Vomiting and Diarrhea and what you can do to prevent dehydration.

These are recommendations for simple pooping and puking, the most common cause of which is Rotavirus. If there is blood in the stool or the stool has a bunch of mucous in it, just call us and quit reading this. Plus, if the child is less than one month old or has had more than 10 days of diarrhea, again, just call us.

So we are talking about diarrhea, without blood, and vomiting (without blood) along with it, lasting less than 10 days. Almost all of this kind of pooping and puking is viral and goes away by itself. Mind you, it's my least favorite disease to care for as a parent (who do you clean up first? You? The floor? The kid?) and as always, there is a bunch of over the counter stuff that's available, is probably useless and may cause side effects.

There is no significance to stool color unless it is red, white or blue! None!

Keep the child hydrated

If it's just the diarrhea, then keeping up with the "losses" from the diarrhea by orally pushing fluids is the right thing to do. I have gotten lots of questions about Pedialyte and other oral rehydration solutions this winter. I don't think Pedialyte is necessary for just diarrhea. It tastes bad and contains lots of sugar. That amount of sugar can actually pull more water into the stool and keep the diarrhea coming. (Very delightful when the Pedialyte is grape flavor). It probably helps short term (like less than 24 hours) when you have vomiting along with it. Pedialyte is not necessary when there is no sign of dehydration!!

Medicines

There are lots of over the counter and prescription anti-vomiting and anti- diarrhea medicines to buy. DO NOT USE ANY OF THEM. The side effects can be toxic and dangerous and there is no proven benefit to them. Even if they say they are safe for kids, don't use these products.

When and what to start eating again

Children who have diarrhea but are not dehydrated should be fed what they are usually fed. If they need fluid because they are dehydrated, then re-hydrate and then get them back on their diets. Early feeding after diarrhea helps bulk up the stool and decrease the amount of time that kids have the diarrhea. Keep in mind, however, that as adults, when we are sick, we don't usually enjoy food, so if your child doesn't want solids for a few days, it's OK. Just keep the fluid coming. There is a lot of tradition but little evidence for the BRAT (bananas, rice, applesauce an toast) diet.  My kids didn't like it and it's more folklore than science.

What to eat: rice, wheat, potatoes, bread, cereal (complex carbohydrates), lean meats, yogurt, fruits and vegetables and breastmilk

What to stay away from: fatty foods and foods high in sugar.

Some kids with diarrhea may have a temporary lactose intolerance from the diarrhea, but 80% of children with diarrhea can tolerate milk. You don't need to worry about changing formula, or stopping nursing (eee gads!) or taking the kids off milk, usually. We can make that decision together.

Vomiting

The stomach is a muscle and like any muscle, when it's stretched, it wants to go back to the way it was before. If you are vomiting, and you stretch the stomach muscle with liquids, then it will contract and usually will contract forcefully and you vomit. So, the idea is to fool the stomach into thinking that there is nothing in it. That's where the recommendation for 1-2 teaspoons of liquid to be given every 1-2 minutes comes in. You get a steady influx of fluid, but no stretching the stomach. It's pretty time intensive, but it works.

Rotavirus

The most common diarrheal illness of childhood. Everybody gets it, more than 70,000 children get hospitalized for it and over 100 children each year die from the dehydration that it brings. It starts with a fever and vomiting and progresses to frequent foul smelling explosive stools. The vomiting and fever are usually gone in 1-2 days but the diarrhea sticks around for 5-7 days, sometimes longer. Dehydration can happen rapidly.

Signs of Dehydration

call us if your child