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Jonathan Jassey, DO, is a board-certified private pediatrician at Bellmore Merrick Medical in Bellmore, New York.
Parents often get confused about what to do when their kids start having vomiting and diarrhea. Do they give more to drink since they just vomited and are thirsty, even though they will probably just throw that up too? Or do they not let them drink, even though continued vomiting and diarrhea can quickly lead to kids getting dehydrated?
In general, when your child is vomiting a lot or has diarrhea from something like a stomach virus (gastroenteritis), you should:
Parents often give water or juice to their kids when they have diarrhea or vomiting, but it is best to use an oral rehydration solution (ORS) instead.
Oral rehydration solutions have the right mix of sugar and electrolytes to best help your child, while the high amount of sugar and lack of sodium in other fluids, like apple juice, might actually make your child worse. Similarly Gatorade's high sugar content makes it controversial when used for diarrhea or vomiting.
Although the World Health Organization Oral Rehydration Solution (WHO-ORS) is the gold standard for managing acute gastroenteritis, many parents and pediatricians use commercially available solutions such as Enfalyte or Pedialyte.
They are available in most supermarkets and drug stores without a prescription and come in good-tasting flavors, although some brands do taste better than others.
The biggest mistake that parents make when their kids have diarrhea and vomiting, next to giving the wrong fluids, is being too aggressive and giving their children too much to drink at one time.
If your child is vomiting frequently, limit fluids to a teaspoon at a time, using a syringe, medicine dropper, or actual teaspoon to measure the dose. Gradually increase the amount you give at each time as your child begins to keep it down.
A good starting point is a teaspoon (5ml) or tablespoon (15ml) of fluid every five or ten minutes for the first hour or two, increasing to a few tablespoons at a time once the vomiting decreases and your child is keeping the fluids down well.
If your child can't or won't drink anything else, a Pedialyte popsicle can be a good alternative to prevent dehydration.
The total amount of fluids you should aim to give depends on how dehydrated your child is.
Children with:
Gastroenteritis can typically be treated at home, however, you should call the pediatrician if your child:
It is often recommended that parents not feed their child, offer a BRAT diet (bananas, rice, applesauce, and toast), or otherwise limit their child’s diet when they are sick. Unless your child is vomiting a lot or simply doesn’t want to eat, you do not need to limit their diet.
Especially if your child just has diarrhea and/or occasional vomiting, you should:
What about probiotics? Although often used, they are likely often overused when kids have vomiting and diarrhea.
Zofran, an anti-vomiting medicine is an option for some kids who are vomiting to help avoid dehydration.
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Dehydration and diarrhea. Paediatr Child Health. 2003;8(7):459-68. doi:10.1093/pch/8.7.459
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American Academy of Pediatrics. Clinical Report—Probiotics and Prebiotics in Pediatrics. PEDIATRICS Volume 126, Number 6, December 2010.
CDC. Managing Acute Gastroenteritis Among Children. Oral Rehydration, Maintenance, and Nutritional Therapy. MMWR. November 21, 2003 / 52(RR16);1-16
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