Vomiting & Diarrhea

Vomiting and diarrhea are common symptoms associated with many childhood diseases. Though unpleasant for the child, these symptoms are not typically serious, are short lived and are generally controllable by diet. Vomiting will almost always cease if food and drink are withheld for 2-3 hours. Diarrhea will decrease if milk products and solid foods are withheld from the child’s diet for a day or two. Either vomiting or diarrhea by itself rarely leads to dehydration of a child.

When a child vomits, many parents immediately give medicine or sips of fluids to “prevent dehydration”. This usually causes more vomiting and worsens the child’s condition. Please closely follow our suggestions listed on the following:

Vomiting

Give nothing by mouth, including water, until there has been no vomiting for 1 hour (infants) or 2 hours (older children). Then begin offering fluids in frequent, small amounts.

First 8-12 Hours

Under 1 year: Oral electrolyte solution (Pedialyte, etc.)*
½ oz. every ½ hour for 3 times then,
1oz. every ½ hour for 3 times, then increase the amount as tolerated.

Over 1 year: Gatorade, half-strength Sprite or 7-Up, Popsicles
1oz. every ½ hour for 3 times then,
2oz. every ½ hour for 3 times, then increase the amount as tolerated.

Breast-feeding: Nurse every ½ hour for 5 minutes, alternating breasts. Increase feeding time as tolerated. May supplement with an oral electrolyte solution (Pedialyte, etc.)*.

If vomiting recurs, return to previous step in fluid introduction.

Next 12-18 Hours

After 12 hours with no vomiting, formula and solids may be added to the liquid diet. Offer small infrequent feedings at first.

Under 1 year: Formula, rice cereal, bananas, crackers, applesauce.

Over 1 year: Bananas, crackers, applesauce, toast, Jell-o, potatoes, soup.

Breast-feeding: Breast milk plus the above solid foods.

After 48 hours

After 48 hours with no vomiting, your child may return to a regular “light” diet, avoiding spicy and high fat foods. If vomiting recurs, then temporarily return to a liquid diet. If necessary, a child may go several days without eating solid foods without harm. The child’s intake of fluids is more important than the intake of solid foods.  If vomiting persists, contact our office for advice.

*To improve the taste, ¼ teaspoon of pre-sweetened, sugar-free Kool-Aid powder may be added to 8 ounces of an oral electrolyte solution.

Diarrhea

With infection, diarrhea often follows vomiting. If the child is having fewer than four bowel movements per day, a regular diet should be continued, with gradual improvement expected. With four or more loose bowel movements per day, dietary changes may be helpful.

First 12 Hours – No solid foods in diet

Under 1 year: Offer electrolyte solution* such as Pedialyte.

Over 1 year: Clear liquids, such as Gatorade, 7-Up, Sprite, Cola, Popsicles.

Breast-feeding: Continue breast milk without solid foods.

After 12 Hours – Begin solid foods and formula

Under 1 year: Soy formula with cereal, bananas, crackers, and applesauce.

Over 1 year: Bananas, crackers, applesauce, toast, Jell-o, potatoes, soup.

Breast Feeding: Continue breast milk, plus cereal, bananas, applesauce, crackers.

After 48 hours

The child should return to a regular diet, even if the bowel movements are loose and frequent. Formula fed infants should continue the soy formula until the bowel movements have returned to normal, typically within 5 days. Fruit juices should be avoided until bowel movements have returned to normal.

The stool may be somewhat loose 3-5 days, but their frequency should decrease to 2-3 stools per day. If profuse diarrhea persists or blood is noted in the stools; contact our office for advice.

The major complication of vomiting and diarrhea is the loss of body fluids resulting in dehydration. Signs of this condition include infrequent urination (less than three voids in 24 hours), dry mouth, lack of tears when crying, or excessive drowsiness. Contact our office if your child is displaying any of these signs.

*To improve the taste, ¼ teaspoon of pre-sweetened, sugar-free Kool-Aid powder may be added to 8 ounces of an oral electrolyte solution.

Posted in: Pediatric Topics