Vomiting and Diarrhea

Vomiting and diarrhea are common childhood illnesses, particularly in toddlers, which may result from intestinal viruses, other infections, or irritating food substances. More than five or six loose bowel movements per day is considered diarrhea. These intestinal symptoms usually run their course in a few days without harm to your child, although occasionally symptoms may last one to two weeks. IF YOUR CHILD IS HAVING A FEW LOOSE STOOLS PER DAY AND HIS APPETITE IS UNIMPAIRED, THERE IS NO NEED TO CHANGE OR RESTRICT YOUR CHILD’S DIET. However, if your child’s appetite is reduced, if he is vomiting or has fever, if he is urinating less frequently, if the stools are very liquid and greatly increased in number and volume, or if your child feels very ill, TEMPORARILY changing your child’s diet, as suggested below, may help. Breast fed infants may continue to nurse throughout their illness.

FOR RECURRENT VOMITING
For severe vomiting without diarrhea, give your child nothing by mouth for two hours, and then start offering a REPLACEMENT SOLUTION, such as Pedialyte. Offer one teaspoon of REPLACEMENT SOLUTION every 10 minutes for one hour. Wait 1/2 hour. If no vomiting recurs, offer one ounce every 1/2 hour and increase up to two ounces every 1/2 hour of REPLACEMENT SOLUTION as tolerated by your child. If vomiting does not recur, continue REPLACEMENT SOLUTION for 12 hours. You may then begin other clear liquids for an additional 12 hours. After this first 24 hours of fluid, advance to a diet appropriate for age: breast milk or formula for infants; bland foods when older to include rice cereal, bananas, breads, pastas, potatoes, bland meats, soups, etc. A fully normal diet for age should be possible within a few days. If vomiting continues in spite of small amounts of REPLACEMENT SOLUTION, please call the office.

CLEAR LIQUIDS include flat soda, ginger ale, gatorde, clear soup and ice chips. Avoid any red colored liquid. Avoid butter, fried or greasy foods. Adding table salt or sugar to fluids given to children with intestinal illnesses is NOT advised, nor should boiled milk or goat’s milk be offered.

FOR DIARRHEA
INFANTS who are breast fed and/or taking infant formula may continue to do so if they are experiencing SIMPLE UNCOMPLICATED DIARRHEA (alert comfortable infant with reasonable appetite, no vomiting, low grade or no fever, normal urinary voiding pattern and loose stools without blood, less than 10 times per day). This permits optimum nutrition to encourage healing of bowel function.

If the appetite for breast milk or formula is significantly decreased, you may supplement with R.S. Infants who refuse breast milk or formula during the initial period of diarrheal illness should temporarily drink Pedialyte for the first 12 hours. Then resume nursing or formula feeding.

OLDER INFANTS on solid foods, TODDLERS, and OLDER CHILDREN with uncomplicated diarrhea (see above) may continue to eat a normal diet. Avoid apple or prune juice, which can increase the water content of stool and produce unwanted laxative effects. Avoid any red juice for red jello so as not to confuse the stool color with blood. Your older child may have clear liquids to drink, solid, starchy foods such as cereal, crackers, bananas, applesauce are absorbed best. As the diarrhea subsides, you can continue a normal diet even if the stools are not fully formed. STOOLS PROBABLY WILL REMAIN UNFORMED FOR 7-14 DAYS IN UNCOMPLICATED DIARRHEA REGARDLESS OF DIETARY CHANGES.

TODDLERS AND OLDER CHILDREN with significant loss of appetite and nausea associated with frequent diarrhea should discontinue milk products for the first 24 hours, but otherwise continue a normal diet as tolerated. Again, avoid apple, prune or red juice.

We advise discontinuing MILK PRODUCTS when watery diarrhea persists for more than four of five days because the lactose sugar in milk is sometimes temporarily indigestible during intestinal illness, Lactose reintroduced into the diet prematurely can often increase diarrhea. Lactose-free soy formulas can provide a transitional formula until bowel function returns to normal in young infants - usually within 2-3 weeks time.

You may notice that as you reintroduce milk products in uncomplicated diarrhea, the loose stools temporarily increase. Continue feeding your child as above. The stool should improve. GOOD NUTRITION during diarrheal illness is important because nutrients help repair the intestinal lining.

PLEASE CALL THE OFFICE IF:

  • Your child is less than three months of age.
  • After 24 hours of the above regimen there is NO decrease in the number of large volume loose stools or the stools are more frequent than 10 per day.
  • Your child’s stools have not returned to their previous normal condition after two to three weeks on a normal diet. Your child starts to vomit blood or pass blood in the stools.
  • Your child develops excessive irritability, crying or fussiness.
  • Your child develops significant lethargy (drowsiness), sunken eyes, no tears when crying, dry mouth (absent saliva on the tongue), or does not urinate in 12 hrs.
  • Your child develops a high fever (greater than 103 degrees F) or painful abdominal
    cramps.
  • Your child continues to vomit despite treatment. New symptoms appear that you don’t understand. 
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