It's a situation most parents and caregivers are familiar with. Your little one starts to feel a bit 'off', and next thing you know they're running for the toilet, a bucket or you with diarrhoea or to vomit.
Gastroenteritis, or gastro, is a common condition which causes inflammation in the stomach and intestinal tract. The most common symptoms of gastro are diarrhoea and vomiting, and infected people may also experience fever, stomach cramps, body aches and headaches. Gastro can be caused by viruses (such as norovirus and rotavirus), bacteria like those that cause food poisoning, or parasitic infections.
While gastro is very common, it can be dangerous if it leads to dehydration. Babies, children and the elderly are most at risk of dehydrating quickly due to gastro. Below are steps to take if you are caring for a baby or child who has gastro.
Monitor the symptoms and seek medical help if required
Most gastro infections resolve themselves without medical treatment, with symptoms lasting between 24 hours to five days, but sometimes it can take longer. If your child is drinking fluids and is alert and responsive, they can be looked after at home.
Babies and children must be monitored closely while they are unwell as their condition can go downhill quickly if dehydration occurs. See your doctor immediately if the child you are caring for shows any signs of dehydration including:
- dry skin, mouth and tongue
- or reduced number of wet nappies or urination.
In severe dehydration, symptoms also include:
- tiredness and lethargy
- sunken eyes with no tears when crying
- cold hands and feet
- loss of skin tone (skin will not seem as elastic as usual when pinched between the fingers)
- or sunken fontanelle (soft spot on babies head).
You should seek medical advice if the baby or child:
- shows signs of dehydration (mentioned above)
- has blood in their vomit or poo
- has green coloured vomit
- has a temperature over 38ºC
- has bad stomach pain
- is vomiting frequently and unable to keep down any fluids
- has very frequent diarrhoea (more than eight watery motions in one day)
- or if you are concerned about your child's condition for any other reason.
Babies under six months may need to be checked again by your doctor after six - 12 hours.
If you are concerned about your child's health, call 13 HEALTH (13 43 25 84) to speak with a registered nurse or see your doctor.
Rehydrate to replace lost fluids
When vomiting and diarrhoea occur, the body loses fluids that contain salts and minerals called electrolytes. Replacing these fluids prevents dehydration.
Mild gastroenteritis can be treated at home by giving frequent small amounts of cool, clear fluid – which are less likely to be vomited back up - to drink. You can also try giving your child the fluid as an ice block. If your child is breastfed, continue to do so but offer feeds more frequently.
While drinking plain water does help replace fluids, 'oral rehydration solutions' will help replace the lost electrolytes, too. Oral rehydration solutions can be bought from the pharmacy, and can be mixed with water to create a drink or purchased as frozen iceblocks to help cool children on a hot day or with a fever. It is important to follow the instructions exactly when mixing and giving the solutions.
Other fluids such as fruit juices, soft drinks and Lucozade, or similar products, should be avoided if possible as they contain high amounts of sugar or carbohydrates and may actually increase the diarrhoea or vomiting. If these fluids must be given, they should be very well diluted to at least one-quarter strength (1:4 – one part fluid to four parts water). Slow sips of liquid are best.
Sports drinks and energy drinks should not be given to children with gastro.
Rehydration for babies
If your child is breastfed, continue to do so but offer feeds more frequently. Offer babies a small drink every time they vomit to help maintain hydration.
Babies can also be given water that has been boiled and then cooled or oral rehydration solutions, remembering to follow the instructions carefully.
Babies that are being fed with infant feeding formula can be given boiled water and oral rehydration solutions.
Give food when hungry
In the past, it was thought that not giving a child food for a day after they had vomited would help with their recovery.
These days it's recommended to feed children when they are hungry after vomiting or having diarrhoea. Solid food should gradually be restarted within 24 hours. This may help shorten the duration of diarrhoea symptoms. Some children may not feel like eating soon after being sick: give them the food they want when they ask for it.
If your child is less than 12 months old and formula fed, their usual milk formula should be reintroduced after 24 hours. There is no need to water down the formula. Some children become temporarily lactose-intolerant after a gastro illness and your doctor may suggest a lactose-free formula is given for a period of time.
Stop the spread by practising good hygiene
Gastro is highly contagious, which means it can spread easily from person to person. Children are more at risk of catching gastro as they are more likely to come into frequent close contact with people and surfaces.
Careful cleaning with warm water and detergent while your child is unwell with vomiting and diarrhoea is essential, as well as when they have recovered. It is important to clean all surfaces and objects soiled or possibly soiled during the illness with warm soapy water, rinsing well before drying. This may include toilets, benches, showers, floors, toys, wash basins, taps and door handles. It is very important to keep unwell children at home and away from other children to help stop the gastro germs spreading further.
Hand washing and good hygiene practices are essential. Hands should be washed with soap and running water for at least 15 seconds and dried thoroughly on a disposable or clean towel before preparing food or eating, after going to the toilet and after cleaning up vomit or diarrhoea. Sick children should be helped with washing their hands to prevent spread.
Safe food handling can help prevent food poisoning. Keeping raw meats separate from cooked food or food to be eaten raw, cooling and reheating food thoroughly if necessary and preparing food in a clean space can help eliminate the bacteria that cause food poisoning.
For more information, visit Queensland Health.