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Illnesses & Symptoms

Vomiting and Diarrhea

vomiting,-diarrhea,-and-abdominal-pain.pngQuick Facts:

  • Vomiting and diarrhea is usually from a virus, but there are other causes.
  • The flu shot does NOT protect against most cases of vomiting and diarrhea. It is usually NOT from influenza.
  • No medications should be used routinely to stop the vomiting.
  • Probiotics, available at your pharmacy, may shorten the course of diarrhea. They can also be used to PREVENT antibiotic associated diarrhea. See Clinical Guide to Probiotic Products for a searchable database of various brands indicated for different issues.
  • Clear liquids (electrolyte solutions) in small volumes offered frequently is the best treatment for vomiting. Infants will take Pedialyte, but older children prefer a lower-sugar sports drink.
  • Diarrhea can benefit from probiotics, avoidance of dairy (no cow's milk, but human milk or soy are okay), and a high fat/low carbohydrate diet. Diet can include meats, vegetables, and high fiber foods. Peppermint or chamomile tea might be soothing. Juice and other high sugar foods/drinks should be avoided because they worsen the diarrhea.
  • If dehydrated (no tears, no urine, too tired to drink), your child should be seen as soon as possible by a pediatric provider.
  • If diarrhea lasts more than 3 weeks, your child should be seen during office hours. (Read between the lines: it might normally last up to 3 weeks. Dairy often prolongs the symptoms, so be sure to stay off dairy.)
  • If there is blood in the diarrhea, your child should be seen during office hours, sooner at a pediatric facility if very pale, significant blood loss, or very irritable.
  • If vomiting is present, but your child is urinating more, your child needs to be seen immediately!
  • Click here for more information on chronic diarrhea. 

What do I do when my child has the stomach flu?

Keep an electrolyte solution at home in case of vomiting. Older children may resist the taste of the infant electrolyte drinks. In this case, sports drinks are better than plain water or juice because they have salts the body needs (but they have more sugar than recommended). Electrolyte popsicles are more palatable for many older children and work well because they take them slowly. For liquids, start by giving a teaspoon every 10 minutes. (Smaller amounts if even 1 teaspoon is not tolerated.) If no vomiting in 45-60 minutes, you can increase to 1/2 oz. every 15 minutes, then 1 oz. every 30 minutes. If vomiting resumes, go back to 1 tsp.

For infants, slowly advance to breast milk or 1/2 strength formula (make formula as usual, then mix with electrolyte solution). If diarrhea is predominant, you can use breast milk or soy formula. Milk based formulas (Similac Advanced, Enfamil Lipil, etc.) may make vomiting and diarrhea worse. If your baby is on foods, you can resume those when there is no vomiting for 8-12 hours. If vomiting returns, go back to the electrolyte solution. Your baby should have at least 4 wet diapers/day until 1 year, then at least 3 wet diapers per day after that. We should see your baby if he is not having enough urine, the tongue is dry or is unable to make tears.

For older children, avoid milk products (except yogurt) until all vomiting and most diarrhea is gone for 24-48 hours. You may introduce a regular diet except dairy once there is no vomiting for 6-8 hours. Once vomiting is gone, you may introduce yogurt to help the diarrhea. Make sure the child urinates once every 12 hours, has moist saliva and makes tears if crying.  If not, he may be dehydrated and needs to be evaluated.

Can I give something to help stop diarrhea or very loose stools?

You may use probiotics, or "good bacteria", to re-establish the gut's normal balance after vomiting is over. Probiotics come in a variety of brands and are available over-the-counter from your pharmacist. They are safe at all ages. For more information, visit USProbiotics. Staying off dairy also helps stop the diarrhea sooner. Cow's milk has large proteins that irritate the gut and cause more diarrhea. Stay off all cow's milk and formula made with cow's milk for 48 hours after the last diarrhea or vomiting episode. Your child can try soy products or breastfeed during this time.

What is electrolyte solution?

An electrolyte solution is a supplemental drink to replenish water and electrolytes, such as sodium and sugar. They are sold in pharmacies. Some are available as Popsicles or gelatin for older infants and children. Sports drinks are electrolyte solutions, but they have excess sugar and may worsen diarrhea.

What medications are recommended for stomach flu?

We do not recommend any medications for children with vomiting and diarrhea other than the above mentioned electrolyte drinks and probiotics. If your child also has a fever, you can use acetaminophen, either orally or rectally if unable to tolerate orally. Ibuprofen can be used in children over 6 months, but it tends to irritate the stomach more often. Please click here for more information on fever.

Read more about medication dosing.

Toddler's diarrhea

Toddler's diarrhea is common between 6 and 30 months and usually resolves by 4 years of age. Children with toddler's diarrhea have 2-6 watery stools daily, which may contain pieces of undigested foods. Treatment involves limiting carbohydrates, including fruit juice, high fructose corn syrup, and other high sugar foods. Increase the fat and fiber in the diet, which seems to help the diarrhea. Probiotics can help with many digestive problems. They can be found in your pharmacy in powder, capsule, chewable, and liquid forms. Ask your pharmacist which is right for your child.

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Illnesses & Symptoms