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How can I prevent dehydration in my child with the "stomach flu"?

Vomiting and diarrhea are almost always the result of a viral infection. The most serious side effect from vomiting and diarrhea is dehydration because of the loss of fluid and salt from the gastrointestinal tract. Younger children tend to be less tolerant of this fluid loss and may become dehydrated sooner than older children. Dehydration can be avoided in many cases by following the treatment plan outlined below. This plan may seem labor-intensive. Intravenous fluids are rarely part of the treatment plan if your child is tolerating any fluid. This method of management is reserved only for the seriously ill child who cannot tolerate any fluid for an extended amount of time usually more then 6-8 hours.

Initially your child will start with repetitive vomiting for 3-6 hours then progress to diarrhea and intermittent vomiting.

This illness is almost always a virus which means there is NO TREATMENT but TIME, FLUIDS, and PATIENCE.    Do not panic!

Here is the plan for rehydration….

1. Do not give any food or liquid for 1 hour after the last episode of vomiting
2. Start with 1 tsp or 1/2 ounce of a clear liquid every 15 minutes
3. Double the amount of clear liquid every hour for 2-3 hours
4. After 3 hours without any vomiting, offer as much clear liquid as desired every 1-2 hours
5. If vomiting occurs during this time period, restart at step 1
6. After 6-8 hours and your child is improving, reintroduce their normal diet including milk.

Additional treatment and helpful hints:

• Avoid giving water - it may worsen vomiting
• You must get the clear liquids in - use a spoon, dropper, cup, bottle or play a game if needed
• Your child will be thirsty and want to gulp - do not let him
• You may give acetaminophen if your child has a fever
• Do not give your child any Pepto Bismol, Imodium or other similar products for diarrhea

Clear Liquid Diet:

Best options (try these first):

• Oral electrolyte solution - Pedialyte, Gerber Liquilytes, other oral rehydrating solution
• Oral electrolyte popsicles - Pedialyte Popsicles
• Breast milk is good for nursing babies
• Make your own electrolyte solution…1/3 cup Sprite, 1/3 cup bottled (if traveling internationally) water, ½ tsp salt, and ½ tsp baking soda!

Other alternatives to oral electrolyte solutions:

• Gatorade
• Clear soup broth
• Half strength Jello water (1 pkg/1 Qt water)
• Seven-Up, Sprite or ginger ale with the bubbles stirred out
• Half strength clear fruit juice
• Popsicles

Good First Foods with Stomach Flu: (Always offer age appropriate foods)

Infants

• Full strength baby formula
• Strained bananas, applesauce
• Rice, rice or barley cereal, oatmeal, Cheerios
• Strained carrots, squash, potatoes

Children

• Bananas, applesauce, apples
• Rice, potatoes, unsweetened cereal, crackers, pretzels, toast
• Cooked lean meats
• Reintroduce milk and dairy

Avoid giving….

• Eggs, butter, bacon, pork
• Peanut butter
• Spicy or seasoned foods

Call our office if your child:

• Has a fever over 104 degrees
• Has a seizure or convulsion
• Has blood in diarrhea or vomit
• Urine output is decreased; no urine in 6-8 hours
• Mouth seems dry of saliva/extreme thirst
• No tears are produced when crying
• Unusually drowsy or fussy
• Shows no improvement in 24 hours or is getting worse
• Vomits longer than 24 hours
• Continues having diarrhea for more than 3 days
• Seems particularly cranky or quiet