VOMITING AND DIARRHEA 

This is a season when many children contract gastroenteritis, causing vomiting, diarrhea or both. This is usually viral in origin and therefore the treatment is symptomatic. Our concern with vomiting and diarrhea, either alone or in combination, is dehydration. Signs of dehydration to watch for are dry mouth, no tears, no urine for 8-10 hours, listlessness or weight loss.

The key to treatment of vomiting is letting the stomach "rest." This means there should be no intake of liquids or solids for at least 2-3 hours after the child vomits. Then he or she may begin sucking on sweets or drinking sips of clear fluids (Pedialyte, Gatorade, white grape juice). If this stays down after 30-45 minutes, give one half to one ounce of fluid. Once several hours have passed, the amount may be gradually increased. Do not allow the child to drink quickly—this may begin the vomiting again. For most children, other than young infants, it is better to have no oral intake for several hours than to have the vomiting precipitated again. If the vomiting starts again, the whole process must start over. After your child has kept down clear fluids for 8-12 hours, you may start bland foods.

If an infant has projectile vomiting (forceful vomiting in which the stomach contents may be ejected a distance of several feet), there may be an intestinal blockage and you should call our office.

Diarrhea is frequent loose, watery stools (more than 6 stools in 24 hours). Unlike vomiting, diarrhea rarely causes dehydration. Also, unlike vomiting, the treatment is to "feed" the diarrhea. If the diarrhea has lasted for less than 2 days, children may continue their regular diet. Breast-fed babies should continue to nurse. Formula fed babies may be fed a soy formula if the diarrhea lasts more than 3-4 days. Older children should avoid milk, milk-based products, juice and highly sugared foods, as these may exacerbate the loose stools. They should have foods that are more binding , the so-called BRAT diet—bananas, rice and toast, or bread or pretzels. Usually it is unnecessary to give medications to stop the diarrhea and it can be dangerous. If your child has blood in the stool, fever greater than 101 degrees or looks dehydrated or "sick," please call our office.



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