Gastroenteritis

Gastroenteritis is an infection in the stomach that causes diarrhea and sometimes vomiting. It is common in babies and children. It is caused by a virus or bacteria in the intestinal tract (bowels). Bacteria or viruses get to the intestinal tract by putting dirty hands, toys or other objects near or into the mouth.

It is more serious in babies and young children than it is in adults because the diarrhea can cause dehydration. Diarrhea and vomiting can cause the loss of important fluids and minerals from the body (dehydration).

  • Diarrhea (frequent, loose, watery stools) lasting 2-3 days but usually no more than a week
  • Nausea and vomiting lasting 1-2 days
  • Abdominal pain (belly pain)
  • Fever (sometimes)

Babies

  • Breastfeed or bottle-feed more often, and for shorter amounts of time. If diarrhea continues, offer 2-3 ounces of Pedialyte or a generic brand to prevent dehydration after each episode of diarrhea or vomiting.
  • Continue feedings with regular formula or breast milk. Pedialyte can be alternated with regular feedings.
  • With ongoing vomiting, you may need to decrease feeding size to one to one-half ounce every hour.

Children

  • Give liquids in small amounts and frequently.
  • Your child may be better able to handle food in smaller, more frequent feedings.

Warning: Do not give your child medicine to stop the diarrhea.  Talk with your doctor before giving your child any medicines.

Other diet suggestions

  • Usually, the diarrhea and vomiting only last a short time. The child's diet may not need to change if the diarrhea is mild. If your baby is breastfeeding, continue to feed on demand.
  • If your baby is bottle-fed, continue feeding as usual with full-strength formula. Older children can continue their normal diet, but should avoid foods that may make the diarrhea worse, such as apple or pear juice.
  • Do not limit your child’s intake to the BRAT (bananas, rice, applesauce, toast) diet. This diet is not recommended because it does not provide enough nutrition during this illness and does not make the symptoms go away any faster.
  • Foods that are good for your child are cereals, bread, potatoes, lean meats, plain yogurt, bananas, applesauce and vegetables.
  • Avoid giving your child juices, carbonated drinks, Jell-O water or sports drinks. These contain sugars and when taken in large amounts may make the diarrhea worse.
  • Oral rehydration solutions (ORS) come in a variety of flavors and come in liquid form and freezer pops. ORS can be found at grocery stores and pharmacies.
  • Children with mild diarrhea may not like the salty taste of Pedialyte because their bodies haven't lost enough salt yet for them to crave salts.

Early signs:

  • No urine output in 8-12 hours (babies usually have 6-8 wet diapers in 24 hours)
  • Less active than normal, unusually sleepy, or hard to arouse
  • The urine is dark yellow and may smell "strong" like ammonia
  • Mouth saliva is thick and sticky rather than thin and watery
  • No tears when crying

Later signs:

  • All of the signs above
  • Baby's soft spot is sunken
  • Child's eyes are sunken
  • Baby or child has no energy and is hard to wake up

It is not possible to keep a child from being exposed to the germs that cause gastroenteritis. Proper hand washing by the whole family is the best way to prevent the spread of disease.

Encourage everyone in the family to wash their hands with soap and water after using the bathroom, after handling diapers and before handling food or preparing food or drink.

  • Avoid diaper wipes.
  • Clean the diaper area gently and thoroughly with soap and water and pat dry with a clean towel.
  • Apply a zinc-based ointment (e.g., Desitin) thickly after cleaning the bottom. This keeps the diarrhea stool away from your child's skin.
  • Wash hands and diapering surfaces well after each diaper change.
  • You are unable to get fluids into the child and diarrhea lasts longer than 24 hours
  • You are able to get fluids into the child but diarrhea lasts more than 7-10 days
  • Your child shows any of the following signs:
    • No urine output in 8-12 hours
    • No tears when crying
    • Unusually drowsy or fussy
    • Inside of the mouth or lips are dry
    • Eyes appear sunken
    • Child is extremely thirsty
    • Blood is present in the diarrhea or vomit
    • Bile (dark green) is present in the vomit
    • Baby's soft spot is sunken

Your doctor may ask to see your child or have your child seen in the emergency department. Your child will be examined and watched for signs of dehydration. The nurse or assistant will measure how much fluid goes in and comes out of your child. Your child will be weighed.

You may be asked to help care for your child by giving him or her Pedialyte. This replaces the fluid lost from diarrhea and vomiting and allows you to be active in your child's care. This may keep your child from needing an IV.

If the diarrhea and vomiting continue and your child refuses fluids by mouth, he or she may need an IV. An IV will let special fluids go into your child through a vein.


Last Updated 07/2012