Gastroenteritis is an infection that causes vomiting and diarrhea. Many cases are caused by a virus, such as Norovirus.
Think of your child as a closed fluid container. What comes out must be gradually replaced or they will eventually become dry. Most of the vomiting illnesses cause intense vomiting in the beginning that gradually dissipates over the first twenty-four to forty-eight hours. If we can keep ahead of the fluid loss during that time, usually the vomiting will pass and the threat of dehydration passes with it.
Do the following to prevent dehydration from excessive vomiting:
- After your child vomits, do not give fluids for 30 minutes.
- Use Pedialyte for infants (<1 year old) and Pedialyte or Gatorade for older children (>1 year old).
- Give 5 mL per sip every 5 minutes for 30 minutes (even if your child is crying for more fluids, you must pace them or they will throw-up).
- After 30 minutes of sipping every 5 minutes, wait 30 minutes without drinking fluids. If they do not vomit during this time you can allow them to begin drinking Pedialyte/Gatorade freely.
- If at any time they vomit again, repeat the above cycle.
- Advance quantity slowly as your child demonstrates tolerance to fluids, then try other drinks.
- Dairy should be attempted only after tolerance of other fluids has been demonstrated.
- Once tolerating fluids (generally 12oz of fluids without vomiting), advance to breads, pastas, crackers, soups, and then other bland foods such as baked chicken or baked potatoes without much seasoning or fat. Use the chart on the back for further guidance.
Call the office if:
- Your child is dehydrated (look for the following signs):
- Urine output is less than every 6 hours in infants or 3 times per day in older children.
- Your child has decreased saliva, poor skin tone or inability to form tears.
- Your child just lies around, has difficulty giving responses, is not talking to you, and is unable to walk around.
- Your child has severe abdominal pain or pain localized to right lower quadrant.
- There is bright green or bloody emesis.
- Your child begins sustained heavy breathing for greater than an hour.
- Your child has taken only Pedialyte for longer than twenty-four hours.
- There are other symptoms such as ear pain or burning with urination.
- Your child has had recent head trauma or has ingested something toxic.
- Always call if you are worried about the condition of your child and need more guidance.
For mild stomach pain you can use Liquid Antacid (Mylanta).
Children 1-2yrs: 2.5 mL, four times a day. Do not take more than 10 mL in a 24 hour period.
Children 2-6yrs: 5 mL, four times a day. Do not take more than 20 mL in a 24 hour period.
Children >6yrs: 10 mL, four times a day. Do not take more than 40 mL in a 24 hour period.
Adults: 10-20 mL, four times a day. Do not take more than 80 mL in a 24 hour period.
|FOODS||FOODS TO USE||FOODS TO AVOID|
|Milk and milk products
|1 % -2% milk or skim milk; low fat yogurt after first 24 hours.
PediaSure or other appropriate supplement; Lactaid milk; all infant formulas (Isomil DF or Lactofree for the first 24 hours)
|If lactose intolerance is suspected, avoid all regular milk and milk products.|
|Meat, poultry, fish, eggs, legumes, peanut butter and cheese||Low fat, grilled or baked meat, fish or poultry; low fat cheese; boiled or poached eggs; any boiled or baked legumes with added fat; peanut butter in small amounts (||High fat or fried meats, fish, poultry and/or cheese; fried eggs; peanut butter in large amounts (>2 Tbsp.)|
|Soups||Low fat soups and broth with other allowed foods.||High fat creamed soups or chowders|
|Breads, cereals, starches||Breads, cereals, rice, baked or mashed potatoes, pasta||Fried potatoes, French fries, doughnuts, muffins, chips; cereal with nuts, coconut, granola, wheat germ; bran cereals and muffins; popcorn|
|Fruits and fruit juices||Canned (packed in own juice) peaches, pears, applesauce, banana; include one serving of Vitamin CUP fruit daily.|
|Vegetables and vegetable juices||All as tolerated; include one serving dark green or yellow vegetable daily||Fruit vegetables; vegetables cooked in butter, margarine, oils or sauces|
|Fats||Minimal amounts of all fats; low fat or fat free products such as salad dressing, sour cream and cream cheese||Limit large amounts of all fats including margarine, butter, oils, gravies, cream sauces, salad dressings, sour cream, cream cheese, etc; nuts, olives, coconut, etc.|
|Desserts and Sweets||Angel food cake, vanilla wafers, graham crackers, and other low fat cookies, cakes and desserts; diet jello in limited quantities||Ice cream, sherbet, pies, popsicles, puddings, chocolate, and other high fat desserts
|Beverages||Gatorade, electrolyte solutions, e.g., Pedialyte; diet sodas in limited quantities||Regular soft drinks; caffeine containing drinks; fruit juices, high sugar containing drinks i.e. Kool-Aid, Hi-C, etc.|
|Miscellaneous||Spices, salt, mustard, ketchup, pickles in limited amounts||Highly seasoned foods; cream sauces; sugar, honey, jelly, syrup|