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