Vomiting And Diarrhea

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Vomiting (throwing up) and diarrhea (frequent, watery bowel movements) can be caused by viruses, bacteria and parasites. Foods that are hard to digest (such as too many sweets) and undercooked (still partially raw) meat or fish can also cause vomiting and diarrhea. These conditions can present serious problems for children unless given proper attention/

Can vomiting and diarrhea be dangerous for children?
Vomiting and diarrhea can be harmful because they can cause dehydration. Dehydration occurs when you lose too much fluid. Young children can become dehydrated quickly, but dehydration can occur at any age.

Signs of dehydration are listed in the box below.

How can I prevent dehydration?
If your baby or child has had several bouts of vomiting or diarrhea, he or she will need to replace lost fluids and electrolytes.

If you are breastfeeding, continue to give your baby breast milk. Breast milk has fluids and electrolytes needed to prevent dehydration. Your doctor may also want you to give your baby an oral rehydration solution (ORS).

If you feed your baby formula, try switching to one that is lactose free while your baby is sick. Lactose can make diarrhea worse. Your doctor may also suggest switching from formula to an ORS for 12 to 24 hours, and then switching back.

For toddlers and young children, use an ORS, which contains the right mix of salt, sugar, potassium and other nutrients to help replace lost body fluids. Children older than 1 year may also have clear soups, clear sodas or juice mixed with water to help prevent dehydration. You should avoid giving your child plain water and dark sodas. Water alone does not contain enough salt and nutrients to help with dehydration. Dark sodas are typically very high in sugar and can irritate your child’s stomach.

Signs of dehydration
•    Little or lack of urine, or urine that is darker than usual
•    Urinating less frequently than usual (fewer than 6 wet diapers a day for infants and 8 hours or more without urinating for children)
•    Thirst (babies may show thirst by crying, being irritable and eager to drink when something is offered)
•    Irritability
•    Not eating as well as usual
•    Weight loss
•    Dry mouth
•    No tears when crying
•    In babies who are younger than 18 months old, sunken soft spots on the top of their heads
•    Skin that isn’t as springy or elastic as usual
•    Sleepiness

What is an ORS?
An oral rehydration solution, or ORS, is a great way to replace fluids and nutrients lost through vomiting and diarrhea. An ORS is safe for babies and older children. An ORS can come in several forms, including a powder that you mix with water, a liquid that is already mixed and as frozen popsicles.

Brands of ORS include Pedialyte, Ricelyte, Rehydralyte and the World Health Organization’s Oral Rehydration Solution (WHO-ORS). You can purchase these at most grocery stores and drugstores. If you don’t have access to store-bought ORS, you can mix 8 teaspoons of sugar and 1 teaspoon of salt in a quart (4 cups) of water. This mixture lacks potassium but is otherwise a good ORS. You can supply some potassium by adding a cup of orange juice to your homemade ORS or feeding your child some banana.

If your child is vomiting, try giving him or her small amounts of an ORS often, such as 1 teaspoonful every minute. When your child is able to keep the drink down, slowly increase how much you give.

If your child keeps vomiting, wait 30 to 60 minutes after the last time he or she vomited, and then give him or her a few sips of an ORS. Small amounts every few minutes may stay down better than a large amount all at once.

When your child stops vomiting, you may increase how much of the ORS you give each time and add clear broths or clear sodas. Remember, small amounts are less likely to upset your child’s stomach.

If your child has diarrhea and isn’t vomiting, give him or her an ORS and other liquids. Your doctor may ask you to keep track of how much your child drinks. You can use a dropper, a spoon or a measuring cup to help you keep track.

Should I feed my child when he or she has diarrhea?
Yes. Older children should begin eating within 12 to 24 hours after starting to take an ORS. Avoid foods with a lot of sugar and fat, such as ice cream, gelatin, pudding and fried foods. These may irritate your child’s stomach and digestive tract. It’s best to avoid dairy products for 3 to 7 days.

Your doctor may recommend that you give your child bland foods for the first 24 hours. Bland foods include bananas, rice, applesauce, toast, saltine crackers and unsweetened cereals. If your child does well with these foods, you can add other foods over the next 48 hours.

Most children can return to their usual diet about 3 days after the diarrhea stops. If your child has been vomiting, wait 6 hours after the last time he or she vomited before offering food. Try offering small amounts of bland foods. Do not force your child to eat. Your child may not feel very hungry for a few days after vomiting.

Should I give my child medicine to stop diarrhea?
Probably not. Diarrhea usually doesn’t last long. If it’s caused by an infection, diarrhea is a way for the body to get rid of the infection. Giving medicines that stop diarrhea may actually interfere with the body’s efforts to heal. Antibiotics are usually not necessary either. Talk to your family doctor if you think your child needs medicine.

Will my child need to go to the hospital/Emergency Room/Urgent Care Center?
Probably not, unless dehydration becomes severe. In this case, your child may need to be given fluids intravenously (through an IV) to replace fluids lost through vomiting or diarrhea. Call your doctor if you notice any of the signs in the box below.

Call your doctor if your child is vomiting or has diarrhea and:
•    Is younger than 6 months old.
•    Is older than 6 months old and has a fever higher than 101.4°F.
•    Has signs of dehydration (see box above).
•    Has been vomiting longer than 8 hours or is vomiting with great force.
•    Has blood in his or her stools.
•    Has blood in his or her vomit.
•    Has not urinated in 8 hours.
•    Might have swallowed something that could be poisonous.
•    Has a stiff neck.
•    Is listless or unusually sleepy.
•    Has had abdominal pain for more than 2 hours.

Can I help prevent vomiting and diarrhea in my children?
Vomiting and diarrhea may be caused by foods that are hard for your child to digest (such as sugar or by bacteria in undercooked meat). Make sure your child eats a healthy diet.

Most infections that cause diarrhea are caused by a virus found in feces. Help prevent infection by disposing of dirty diapers properly and by washing your hands after changing a diaper or going to the bathroom. Make sure your child washes his or her hands frequently, especially after going to the bathroom.

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