Well, tonight’s post wrote itself when friends of mine called to make sure they were doing the right thing for their daughter that had been vomiting all day. I saw kids of all ages today that had nausea, vomiting and diarrhea.  So, it sounds like the best parenting advice right now would be on managing that nasty stomach virus also know as gastroenteritis.

Poor little Maddie has been vomiting all day.  Her brother had vomiting and diarrhea a few days ago, and now it sounds like it’s her turn.  One question her Dad had; could it be something else? Well, maybe…but, probably not.  Dad told me he had been giving Maddie about a 1/2 ounce of Gatorade every 20 minutes or so.  She had been doing fairly well, then started having really bad stomach cramps. It seems that Maddie took a big drink of Mom’s tea, which wasn’t a good idea, but who can blame her, she was probably really thirsty.  Maddie probably had more than her stomach was able to tolerate.  It probably didn’t help that the tea had caffeine in it, which can be irritating to an empty stomach.  Drinking too much or eating or drinking the wrong thing can cause the pain and vomiting to start again. With rest and small amounts of fluids, Maddie will probably get throght this stomach virus just fine.  Slowly staying hydrated, and then eating small amounts of bland foods.  No doubt, she will be back to her happy playful self, and keeping up with that brother of hers.

Most vomiting spells will usually last 8-12 hours, but can come and go for a few days.  If your child vomits for more than 24-48 hours, you might want to consider having them evaluated by their pediatric provider.

Most children will have diarrhea with or after vomiting. This is just another way for the virus to exit the body.  Do not give children medication to stop the diarrhea or vomiting.  If this is necessary, medication should be prescribed and supervised by your provider.

Dehydration is usually the worst complication of gastroenteritis. Keeping your child hydrated after the initial vomiting spell is very important.  If your child is vomiting, don’t give anything by mouth the first couple hours; then give small sips of pedialyte or Gatorade (1/2 oz.) every 15-20 minutes.  For young children, Pedialyte popsicles can be really helpful.

If children tolerate fluids after several hours, try bland foods such as saltine crackers and toast.  Slowly, increase the diet with bland, salty foods over the next few days.  Do not give your child milk products, acidic products, or greasy foods. French fries and chicken nuggets are NOT a good idea.  Yes, too many parents of 3 or 4 years old children will come into my office and say, “Well, she said she would eat chicken nuggets” (or hot dogs, you can fill in with either)…. I want to scream “Are you kidding me?”   Fortunately, I learned to bite my tongue a few years back.  Trust me, it took some practice, I usually say what I think, but have learned that I just can’t do that sometimes.  Those of you that know me are smiling and laughing right now, no doubt. 😉

So, What else could it be??

• Some people are concerned that their child could have appendicitis.  Believe me, that is the first thing I want to make sure a child doesn’t have either.  Appendicitis does need to be ruled out if a child is having severe or ongoing abdominal pain.  Appendix pain is usually in the lower right quadrant of the abdomen, but the pain can radiate elsewhere.  If you are worried your child may have signs of appendicitis, please see your provider.  This is not an easy diagnosis to make, even with physical exam.
• Sometimes children will have vomiting, with a fever, sore throat and headache; beware, this can be strep throat.  Some children with strep throat will vomit.  My poor Joshua is one of these kids.  He has only had strep twice in his life,  first, with pneumonia.  Then, a few years ago he presented as fever, nausea and sore throat.  The poor kid vomiting for over 8 hours, he was pitiful.  If I hadn’t seen the positive strep test myself, I would have really thought it was a stomach virus.  It’s always safest to check if you have any doubt.  Strep throat cannot be confirmed without a throat culture, and MUST be treated with an antibiotic.

Again, I want to stress the importance of HYDRATION! Slow but steady hydration is the key to avoiding dehydration. If your child does not urinate at least once in 12 hours, please have him evaluated for dehydration.  Fever, along with vomiting and diarrhea can increase the risk for dehydration.  For more advice on fevers or hydration, please see my related posts.

Remember, sick kids need a little more patience, understanding, and TLC.

At some time or another, a vomiting child is something we all deal with….kind of like a rite of passage. Every Mom or Dad has a gross vomiting story to tell. Good luck with the vomiting thing when you experience it along your parenting journey.