Diarrhea and Vomiting in Children

This information is about diarrhea and vomiting in children. It covers diarrhea and vomiting problems, how to deal with diarrhea and vomiting, and when you should call your pediatrician.

Diarrhea is the occurrence of five or more watery stools a day. Diarrhea is sometimes accompanied by cramps: Cramps are not like steady abdominal pain. They are severe one minute and much milder the next.

Vomiting is a forceful ejection of the stomach contents, accompanied by retching and gagging. Vomiting is quite different from simply spitting up. (Some babies spit up every day, and it may take many months before an entire feeding stays down.) For babies, spitting up is normal;vomiting is not.

The treatment for diarrhea and vomiting is about the same. For all children, from approximately 1 year to adolescence, the first step is to change their diet. Stop all solids and milk products. For the first twelve hours, give only weak tea, rice, water, flat ginger ale, 7-Up or Gatorade (Remove most of the carbonation bubbles by stirring with a spoon.) Instead of letting the child drink large amounts, give drinks in small, frequent portions. If the diarrhea orvomiting have not reoccurred during the first twelve hours, add rice or rice cereal to the liquid diet for the next eight hours. Do not add milk or butter. If this works, you can then add ripe banana, dry toast, baked potato, white chicken meat, and/or Jell-O. If the problem does not start again, you can gradually add foods, starting with bland foods. But avoid fats, milk, and fresh fruits, except bananas, for at least three days.

For infants under twelve months, you can give preparations such as Pedialyte or Rice-a-lite available without prescription at any pharmacy. Follow the directions on the label. If the infant is breast feeding only, continue breast-feeding. If the infant is also taking solids, discontinue the solid foods but continue breast-feeding.

Here are some guidelines for contacting your child’s health care provider. Call if abdominal pain changes from cramps to steady pain, or if the pain becomes worse after twelve hours. You should also call if diarrhea is severe or if the stools contain blood. If the child is having more than ten liquid bowel movements a day, and is unable to hold down liquids, dehydration is possible, and you should call your pediatrician. After office hours, follow your pediatricians’s policy for after hours care.

With vomiting, if it has not stopped within twelve hours and the child cannot even hold down one tablespoon of liquid; call. In other cases, if your child vomits after receiving a blow to the head, call at once. After office hours, follow your physician’s policy for after hours care. When you call, please have the following information ready:

• What is the child’s temperature?
• How many bowel movements has your child had in the last 24 hours?
• What do they look like? Do they have blood or pus in them?
• Is your child vomiting, as well as having diarrhea?
• Is the child putting out as much urine as usual?
• Do the eyes sunken? In general, does the child look sick? The answers to these questions can help your health care provider give you appropriate advice.

Remember these key points:

• Diarrhea and vomiting are treated by adjusting the child’s diet.
• Call your pediatrician if abdominal pain becomes steady, severe, or persistent, or if the child has ten liquid bowel movements a day and cannot hold down any fluids.
• Always call your pediatrician at once if the vomiting follows a blow to the head.
• When you call, have complete information ready about your child’s appearance and condition.