Topic: Diseases & Conditions
This handout was written to answer some of the questions most often asked about what kind of food and liquids you can feed a child who has vomiting and/or diarrhea. Feel free to ask your doctor or nurse to go over any information you do not understand.
WHAT IS VIRAL GASTRITIS OR GASTROENTERITIS?
♦ Viral gastritis is an infection of the stomach resulting in vomiting.
♦ Viral gastroenteritis is an infection of the stomach and intestines resulting in vomiting and diarrhea.
WHAT ARE THE SYMPTOMS OF VIRAL GASTRITIS/GASTROENTERITIS?
Symptoms include:
♦ Vomiting
♦ Diarrhea (with gastroenteritis)
♦ Mild stomach cramping or pain
♦ Low-grade fever
♦ Dehydration which results in weight loss, sunken eyes with dark area around eyes, dry mouth, increased thirst, decreased urine output (fewer wet diapers), sunken soft spot in infants
WHAT SHOULD I FEED MY CHILD WHILE HE OR SHE IS VOMITING?
For bottle fed infants (less than one year old):
♦ Start feeding with an oral rehydration solution (ORS) such as Pedialyte®, Lytren®, Ricelyte®or KaoLyte®.
♦ Give small amounts of fluid (one teaspoon) frequently.
♦ Over the next several hours, gradually increase the amount of fluid given.
♦ After eight hours without vomiting, return to formula. For infants more than four months old also return to cereal, strained bananas, etc. A normal diet is okay in 24-48 hours.
♦ If your infant won’t take the oral rehydration solution (ORS), make a mixture of half ORS and half Kool-aid®.
For breast-fed infants:
♦ Reduce the amount per feeding by providing breast milk in smaller amounts. If your baby vomits twice, nurse only on one side every one to two hours.
♦ If your baby vomits more than two times, nurse for four to five minutes every 30 to 60 minutes. If your baby continues to vomit and will take a bottle, refer to the bottle-fed instructions above.
♦ After eight hours without vomiting, return to regular breast-feeding.
For older children (more than one year old):
♦ Stop all solids.
♦ Start feeding with an oral rehydration solution such as Pedialyte®, Lytren®, Ricelyte® or KaoLyte®.
♦ If your child won’t take the oral rehydration solution, alternative fluids include half-strength clear liquids such as lemon-lime soda, popsicles, Kool-aid®, Gatorade® or water.
♦ Give small amounts of fluids (one tablespoon) frequently.
♦ Over the next several hours, gradually increase the amount of fluid given.
♦ For severe vomiting, rest the stomach completely for one hour then start over with small amounts (one to two ounces).
♦ After eight hours without vomiting, add bland starchy foods such as saltine crackers, white bread, rice, applesauce, noodles, mashed potatoes, broth, etc. Avoid greasy, fried foods or mild products at first. A normal diet is okay in 24-48 hours.
WHAT FLUIDS SHOULD BE AVOIDED?
♦ Milk (unless breast-fed)
♦ Orange juice
WHAT IS THE MOST COMMON MISTAKE IN THE TREATMENT OF VOMITING?
The most common mistake is to give as much clear fluid as your child wants rather than gradually increasing the amount. This almost always lead to continued vomiting. Fluids should be given in small amounts and increased gradually.
HOW CAN I TELL IF MY CHILD IS TOLERATING FOODS AND FLUIDS?
Your child is tolerating foods and fluids if his or her signs of dehydration improve and if vomiting is less than one half of the foods and fluids given over an hour. Your child can have some vomiting and still be tolerating his or her foods and fluids.
SHOULD I CONTINUE TO GIVE MY CHILD MEDICATION?:
Discontinue all over-the-counter medicines for eight hours. Contact your doctor about what to do with prescription medicines that your child is on. If your child has a fever, use an acetaminophen suppository (Example: Tyleon®). The dose of an acetaminophen suppository for your child is given every four hours rectally.
WHAT SHOULD I DO IF MY CHILD HAS SEVERE DIARRHEA?
Continue clear liquids until the diarrhea is resolved. Avoid fluids with high sugar content.
For bottle or breast-fed infants (less than one-year old):
♦ For breast-fed infants, continue feeding but at more frequent intervals.
♦ For bottle-fed infants, switch to a soy formula until the diarrhea is gone for three days.
♦ If urine production is decreased (fewer wet diapers), offer an oral rehydration solution such as Pedialyte®, Lytren®, Ricelyte® or KaoLyte® in between feedings for the next 24-48 hours.
For older children (more than one-year old):
♦ Give starchy foods such as cereals, oatmeal, bread, noodles, mashed potatoes, carrots, applesauce, strained bananas, saltine crackers, pretzels, etc.
♦ If solids are being taken, you may offer water or half strength Kool-aid® for the next 24-hours.
♦ If your child is not taking solids, offer an oral rehydration solution (ORS) such as Pedialyte®, Lytren®, Ricelyte® or KaoLyte®. If he or she will not take the ORS, offer half-strength clear liquids such as lemon-lime soda, popsicles, Kool-aid®, Gatorade® or water.
♦ Avoid fruit juice or other drinks with fructose.
♦ Avoid mild for 2-3 days.
DIAPER RASH FROM DIARRHEA
The diarrhea may “burn” your child’s skin in the diaper area.
♦ Wash your child’s bottom with water after each bowel movement.
♦ Use a thick layer of petroleum jelly, Desitin® or A&D® ointment after each bowel movement.
♦ Mixing the ointment with Maalox® to form a thinner paste will help protect the skin.
♦ Leaving your child’s bottom open to air dry will help the skin heal more quickly.
WHEN SHOULD I CONTACT THE DOCTOR?
Contact your doctor if:
♦ Signs of dehydration occur (these are listed on the front page under “What are the Symptoms of Viral Gastritis/Gastroenteritis?).
♦ Any blood appears in the vomited material.
♦ Stomach pain worsens or develops and lasts for more than four hours.
♦ Your child is acting very sick.
♦ The vomiting continues for more than 24-hours in children under the age of two-years or more than 48-hours if over the age of two years.
♦ You have other concerns or questions.
PDF: Child Health Information - TREATMENT FOR VOMITING AND DIARRHEA
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