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Somehow, it always happens in the worst place: Your toddler barely touches his breakfast, and five minutes later he throws up all over the living-room rug. Or your baby wakes up wailing in the middle of the night after puking up her whole dinner in the crib. It's almost a given that stomach flu will strike your family sometime this season. And while this highly contagious illness usually doesn't require a trip to the pediatrician, most parents don't know all the facts about how best to treat their child at home. Read on for the latest on making your little one feel better fast.
It's Not Really the Flu
Although everyone refers to vomiting and diarrhea as stomach flu, these problems are usually caused by a gastrointestinal
virus (a true "flu" is influenza, a respiratory infection). Rotavirus is the most common culprit in young children; by age 3, almost all kids will have had at least one run-in with this very contagious bug. Stomach-flu symptoms can also be caused by bacteria, parasites, or mild food poisoning.
The First Is the Worst
A child's first stomach virus often strikes between 6 months and 24 months. And since her immune system hasn't yet had to fight back against one of these bugs, the first infection will probably be her worst, says Charles Kantrow, M.D., a pediatrician at Ochsner Clinic Foundation, in New Orleans. The virus is passed through saliva or feces; your child may get it from a sibling, at day care, or at a birthday party. Vomiting and a low-grade fever (under 102°F) are the initial symptoms, followed by lingering diarrhea.
You're Not Paranoid If You Call Your Pediatrician
Though there's nothing your doctor can prescribe to make your child feel better, it's a good idea to check in with her when your child has the stomach flu, just to let her know how long it's been going on, says Julia McMillan, M.D., a professor of pediatrics at Johns Hopkins University Children's Center, in Baltimore. The younger your child is, the faster he can become seriously dehydrated. "About 1 in 50 children gets sick enough to need to see the doctor," Dr. Kantrow says.
The "24-Hour Bug" Is a Myth
Don't panic if your child is sick longer than you expect. "It's a misconception that stomach bugs last only 24 hours," says Sue Langbehn, M.D., an assistant professor of family medicine at the University of Iowa, in Iowa City. In fact, kids may throw up or feel nauseated for three days and then have diarrhea for a week, she says. How long each bout lasts depends on the particular virus and on how your child's intestines react to it.
Kids Need More Fluid Than You Think
When your child is vomiting, your biggest concern should be keeping him hydrated. And water's not good enough. Give babies and toddlers a teaspoonful of electrolyte solution every twenty minutes or so to replace the nutrients they've lost. "For a bigger child, measure an ounce of electrolyte solution into a Sippy cup. If she keeps that down for fifteen minutes, then give another ounce," says Dr. Langbehn. These small, frequent drinks will rehydrate a child over a few hours. At this point, don't worry about getting her to eat food.
You Don't Have To Stop Breastfeeding
Breastfeeding babies don't need electrolyte solution and should continue to nurse right through the illness. In fact, nursing babies tend to get less sick from stomach bugs, perhaps because of protective antibodies from Mom's milk. Formula-fed babies should go back on the bottle once they stop vomiting.
Juice Isn't Best For Babies and Toddlers
Your child may balk at the taste of an electrolyte solution since it's not as sweet as juice. Try making a slushie (freeze the liquid partially, then stir it and serve with a spoon), or try offering a frozen electrolyte-solution pop. Unlike juice (which is mostly sugar) or sports drinks (which have a lot of salt), electrolyte solutions contain the right mix of sugars and minerals to help babies' and toddlers' delicate intestines absorb liquid. And this matters--stomach bugs attack the lining of the intestines so that they can't do their job as well. Juice, flat soda, and sports drinks are fine for kids ages 5 and up, Dr. McMillan says. Get liquid into an older child any way you can.
Don't Freak Out About Fever
There's no rule against giving children's acetaminophen to your little one if she has a low-grade fever, but there's also no point in giving it if she's vomiting. And ibuprofen may irritate the stomach further, so avoid it until your child's nausea has passed.
It's Not Over When the Barfing Stops
Your child will start to feel better when he stops throwing up, but he may develop diarrhea. At this point, try to get him to eat, which will bulk up his stools. "If you give him only electrolyte solution or juice for several days without much food, then you can actually make diarrhea worse," Dr. Kantrow says. Offer small servings of plain, easy-to-digest foods--bananas, pasta, toast, rice, crackers, or applesauce. If these stay down, add other low-fat, low-sugar foods, including meats and dairy products. Milk is a key source of nutrition for toddlers and preschoolers, experts say. But since a stomach bug can cause a temporary bout of lactose intolerance, start with yogurt, which is easier to digest. Offer milk a day or so later. "Feeding your child well really does help him get over the illness more quickly," Dr. Kantrow says.
You Need To Watch the Bottom Line
If your child is still in diapers, expect some diaper rash or irritation from the diarrhea. "When your child's bottom is sore, stop using wipes," Dr. Langbehn says. "Instead, use a soft paper towel moistened with plain water, or just rinse her off in the shower and let her air-dry." Once she's dry, apply a diaper-rash ointment containing zinc oxide, which will protect against further irritation. If the irritation seems severe, call your pediatrician, who can prescribe a high-dose zinc-oxide ointment.
Medication Might Be Dangerous
Don't use over-the-counter antidiarrhea or upset-stomach remedies, advises Anthony Olive, M.D., a pediatric gastroenterologist at Baylor College of Medicine and Texas Children's Hospital, in Houston.These medicines don't cure diarrhea; they just slow down the intestines, which in rare cases can lead to an overgrowth of the normally harmless bacteria that live in the gut. Additionally, remedies like Pepto-Bismol contain salicylates, an aspirin-like compound that can lead to a serious condition called Reye's syndrome in children under 17.
Throwing Up For More Than Three Days Isn't Normal
Check in again with the doctor if vomiting lasts more than three days, if diarrhea lasts more than seven days, or if fever lasts more than two days, says Dr. Olive, or if the vomit is green or your child has severe abdominal pain. Keep in mind that if your child is vomiting and has diarrhea at the same time, or if she has a prolonged fever (which uses up the body's water), she'll be more susceptible to severe dehydration. And call the doctor right away if you see any blood in your child's stools--occasionally rotavirus can cause this, but more often it signals a bacterial infection, which may require immediate attention.
You Can Beat the Bugs
Cut down on the number of infections your child gets by showing him how to wash his hands correctly and by making sure that family members always wash their hands after they use the bathroom and before they sit down to meals. It's smart to avoid sharing food, cups, utensils, towels, and other personal items, especially when a family member has a virus. "You can't prevent the spread of bugs completely, but when someone in your family is sick, it helps to be more vigilant," Dr. Langbehn says. With any luck, you'll get a nice long break before your child's next bout with stomach flu.
Dehydration Red Flags
If your child shows these signs of serious dehydration, call your doctor immediately.
• Lethargy
• Dry mouth and cracked lips
• Sunken-looking eyes
• In babies, a sunken fontanel (soft spot on the head) or no wet diapers for eight hours
What Else Could It Be?
Stomach flu in kids is almost always due to a virus, but the following bugs can also cause vomiting and diarrhea.
• Giardia lamblia, a parasite, is spread through contaminated lake or pool water or from person to person. It may cause protracted but mild diarrhea and can be treated with antibiotics.
• E. coli, salmonella, staphylococcus, and other bacterial infections are most often contracted from foods. They're rare but serious. Symptoms are similar to a viral infection, only more intense. Signs include blood in the stools, a very high fever, diarrhea that gets better then worse, and excessive sleepiness. plus thrush
It's Not Really the Flu
Although everyone refers to vomiting and diarrhea as stomach flu, these problems are usually caused by a gastrointestinal
virus (a true "flu" is influenza, a respiratory infection). Rotavirus is the most common culprit in young children; by age 3, almost all kids will have had at least one run-in with this very contagious bug. Stomach-flu symptoms can also be caused by bacteria, parasites, or mild food poisoning.
The First Is the Worst
A child's first stomach virus often strikes between 6 months and 24 months. And since her immune system hasn't yet had to fight back against one of these bugs, the first infection will probably be her worst, says Charles Kantrow, M.D., a pediatrician at Ochsner Clinic Foundation, in New Orleans. The virus is passed through saliva or feces; your child may get it from a sibling, at day care, or at a birthday party. Vomiting and a low-grade fever (under 102°F) are the initial symptoms, followed by lingering diarrhea.
You're Not Paranoid If You Call Your Pediatrician
Though there's nothing your doctor can prescribe to make your child feel better, it's a good idea to check in with her when your child has the stomach flu, just to let her know how long it's been going on, says Julia McMillan, M.D., a professor of pediatrics at Johns Hopkins University Children's Center, in Baltimore. The younger your child is, the faster he can become seriously dehydrated. "About 1 in 50 children gets sick enough to need to see the doctor," Dr. Kantrow says.
The "24-Hour Bug" Is a Myth
Don't panic if your child is sick longer than you expect. "It's a misconception that stomach bugs last only 24 hours," says Sue Langbehn, M.D., an assistant professor of family medicine at the University of Iowa, in Iowa City. In fact, kids may throw up or feel nauseated for three days and then have diarrhea for a week, she says. How long each bout lasts depends on the particular virus and on how your child's intestines react to it.
Kids Need More Fluid Than You Think
When your child is vomiting, your biggest concern should be keeping him hydrated. And water's not good enough. Give babies and toddlers a teaspoonful of electrolyte solution every twenty minutes or so to replace the nutrients they've lost. "For a bigger child, measure an ounce of electrolyte solution into a Sippy cup. If she keeps that down for fifteen minutes, then give another ounce," says Dr. Langbehn. These small, frequent drinks will rehydrate a child over a few hours. At this point, don't worry about getting her to eat food.
You Don't Have To Stop Breastfeeding
Breastfeeding babies don't need electrolyte solution and should continue to nurse right through the illness. In fact, nursing babies tend to get less sick from stomach bugs, perhaps because of protective antibodies from Mom's milk. Formula-fed babies should go back on the bottle once they stop vomiting.
Juice Isn't Best For Babies and Toddlers
Your child may balk at the taste of an electrolyte solution since it's not as sweet as juice. Try making a slushie (freeze the liquid partially, then stir it and serve with a spoon), or try offering a frozen electrolyte-solution pop. Unlike juice (which is mostly sugar) or sports drinks (which have a lot of salt), electrolyte solutions contain the right mix of sugars and minerals to help babies' and toddlers' delicate intestines absorb liquid. And this matters--stomach bugs attack the lining of the intestines so that they can't do their job as well. Juice, flat soda, and sports drinks are fine for kids ages 5 and up, Dr. McMillan says. Get liquid into an older child any way you can.
Don't Freak Out About Fever
There's no rule against giving children's acetaminophen to your little one if she has a low-grade fever, but there's also no point in giving it if she's vomiting. And ibuprofen may irritate the stomach further, so avoid it until your child's nausea has passed.
It's Not Over When the Barfing Stops
Your child will start to feel better when he stops throwing up, but he may develop diarrhea. At this point, try to get him to eat, which will bulk up his stools. "If you give him only electrolyte solution or juice for several days without much food, then you can actually make diarrhea worse," Dr. Kantrow says. Offer small servings of plain, easy-to-digest foods--bananas, pasta, toast, rice, crackers, or applesauce. If these stay down, add other low-fat, low-sugar foods, including meats and dairy products. Milk is a key source of nutrition for toddlers and preschoolers, experts say. But since a stomach bug can cause a temporary bout of lactose intolerance, start with yogurt, which is easier to digest. Offer milk a day or so later. "Feeding your child well really does help him get over the illness more quickly," Dr. Kantrow says.
You Need To Watch the Bottom Line
If your child is still in diapers, expect some diaper rash or irritation from the diarrhea. "When your child's bottom is sore, stop using wipes," Dr. Langbehn says. "Instead, use a soft paper towel moistened with plain water, or just rinse her off in the shower and let her air-dry." Once she's dry, apply a diaper-rash ointment containing zinc oxide, which will protect against further irritation. If the irritation seems severe, call your pediatrician, who can prescribe a high-dose zinc-oxide ointment.
Medication Might Be Dangerous
Don't use over-the-counter antidiarrhea or upset-stomach remedies, advises Anthony Olive, M.D., a pediatric gastroenterologist at Baylor College of Medicine and Texas Children's Hospital, in Houston.These medicines don't cure diarrhea; they just slow down the intestines, which in rare cases can lead to an overgrowth of the normally harmless bacteria that live in the gut. Additionally, remedies like Pepto-Bismol contain salicylates, an aspirin-like compound that can lead to a serious condition called Reye's syndrome in children under 17.
Throwing Up For More Than Three Days Isn't Normal
Check in again with the doctor if vomiting lasts more than three days, if diarrhea lasts more than seven days, or if fever lasts more than two days, says Dr. Olive, or if the vomit is green or your child has severe abdominal pain. Keep in mind that if your child is vomiting and has diarrhea at the same time, or if she has a prolonged fever (which uses up the body's water), she'll be more susceptible to severe dehydration. And call the doctor right away if you see any blood in your child's stools--occasionally rotavirus can cause this, but more often it signals a bacterial infection, which may require immediate attention.
You Can Beat the Bugs
Cut down on the number of infections your child gets by showing him how to wash his hands correctly and by making sure that family members always wash their hands after they use the bathroom and before they sit down to meals. It's smart to avoid sharing food, cups, utensils, towels, and other personal items, especially when a family member has a virus. "You can't prevent the spread of bugs completely, but when someone in your family is sick, it helps to be more vigilant," Dr. Langbehn says. With any luck, you'll get a nice long break before your child's next bout with stomach flu.
Dehydration Red Flags
If your child shows these signs of serious dehydration, call your doctor immediately.
• Lethargy
• Dry mouth and cracked lips
• Sunken-looking eyes
• In babies, a sunken fontanel (soft spot on the head) or no wet diapers for eight hours
What Else Could It Be?
Stomach flu in kids is almost always due to a virus, but the following bugs can also cause vomiting and diarrhea.
• Giardia lamblia, a parasite, is spread through contaminated lake or pool water or from person to person. It may cause protracted but mild diarrhea and can be treated with antibiotics.
• E. coli, salmonella, staphylococcus, and other bacterial infections are most often contracted from foods. They're rare but serious. Symptoms are similar to a viral infection, only more intense. Signs include blood in the stools, a very high fever, diarrhea that gets better then worse, and excessive sleepiness. plus thrush