Viral Diarrhea (Child)

Outline of child showing digestive system.

Diarrhea caused by a virus is called viral gastroenteritis. Many people call it the stomach flu, but it has nothing to do with the flu or influenza. This virus affects the stomach and intestinal tract. It usually lasts 2 to 7 days.

Diarrhea means passing loose watery stools 3 or more times a day. Your child may also have these symptoms:

  • Abdominal pain and cramping

  • Nausea

  • Vomiting

  • Loss of bowel control

  • Fever and chills

  • Bloody stools

The main danger from this illness is dehydration. This is the loss of too much water and minerals from the body. When this occurs, body fluids must be replaced. This can be done with oral rehydration solution. Oral rehydration solution is available at drugstores and most grocery stores.

Antibiotics are not effective for this illness.

Home care

Follow all instructions given by your child’s healthcare provider.

Giving medicines to your child

  • Don’t give over-the-counter diarrhea medicines unless your child’s healthcare provider tells you to.

  • You can use acetaminophen or ibuprofen to control pain and fever. Or, you can use other medicine as prescribed. Only use medicines for children. Never give adult medicines to children.

  • Don't give aspirin to anyone under 18 years of age who has a fever. This may cause liver damage and a life-threatening condition called Reye syndrome.

Preventing the spread of illness

  • Washing hands well with soap and water is the best way to prevent the spread of infection. Always wash your hands before and after caring for your sick child.

  • Teach your child when and how to wash his or her hands.

  • Use alcohol-based hand sanitizer if soap and water are not available.

  • Clean the toilet after each use.

  • Keep your child out of day care until he or she is cleared by the healthcare provider.

  • Wash your hands before and after preparing food. Keep in mind that people with diarrhea or vomiting should not prepare food for others.

  • Wash your hands after using cutting boards, counter-tops, and knives that have been in contact with raw foods.

  • Keep uncooked meats away from cooked and ready-to-eat foods.

Preventing dehydration

The main goal while treating vomiting or diarrhea is to prevent dehydration. This is done by giving your child small amounts of liquids often.

  • Keep in mind that liquids are more important than food right now. Give small amounts of liquids at a time, especially if your child is having stomach cramps or vomiting.

  • For diarrhea: If you are giving milk to your child and the diarrhea is not going away, stop the milk. In some cases, milk can make diarrhea worse. If that happens, use oral rehydration solution instead. Don’t give apple juice, soda, sports drinks, or other sweetened drinks. Drinks with sugar can make diarrhea worse.

  • For vomiting: Start with oral rehydration solution at room temperature. Give 1 teaspoon (5 ml) every 1 to 2 minutes. Even if your child vomits, continue to give oral rehydration solution. Much of the liquid will be absorbed, despite the vomiting. After 2 hours with no vomiting, start with small amounts of milk or formula and other fluids. Increase the amount as tolerated. Don't give your child plain water, milk, formula, or other liquids until vomiting stops. As vomiting decreases, try giving larger amounts of oral rehydration solution. Space this out with more time in between. Continue this until your child is making urine and is no longer thirsty (has no interest in drinking). After 4 hours with no vomiting, restart solid foods. After 24 hours with no vomiting, resume a normal diet. If the vomiting can't be controlled with dietary measures, your doctor may prescribe an oral medicine to control vomiting.

  • Your child can go back to eating normally as he or she feels better. Don’t force your child to eat, especially if he or she is having stomach pain or cramping. Don’t feed your child large amounts at a time, even if your child is hungry. This can make your child feel worse. You can give your child more food over time if he or she can tolerate it. Foods that may be easier to digest include cereal, mashed potatoes, applesauce, mashed bananas, crackers, dry toast, rice, oatmeal, bread, noodles, pretzels, soups with rice or noodles, and cooked vegetables.

  • If the symptoms come back, go back to a simple diet or clear liquids.

Follow-up care

Follow up with your child’s healthcare provider, or as advised. If a stool sample was taken or cultures were done, call the healthcare provider for the results as instructed.

When to seek medical advice

Unless your child's healthcare provider advises otherwise, call the provider right away if any of the following occur:

  • Fever (see Fever and children, below)

  • Signs of dehydration:

    • Very dark urine

    • Dry mouth

    • Increased thirst

    • Urinating 1 or fewer times in 6 hours

    • No tears when crying

    • Sunken eyes

  • Abdominal pain that gets worse

  • Constant lower right abdominal pain

  • Repeated vomiting after the first 2 hours on liquids

  • Occasional vomiting for more than 24 hours

  • Continued severe diarrhea for more than 24 hours

  • Blood in vomit or stool

  • Refusal to drink or feed

  • Fussiness or crying that can't be soothed

  • Unusual drowsiness

  • New rash

  • More than 8 diarrhea stools within 8 hours

  • Diarrhea lasts more than 1 week on antibiotics

Call 911

Call 911 if your child has any of these symptoms:

  • Trouble breathing

  • Confusion

  • Extreme drowsiness or trouble walking

  • Loss of consciousness

  • Rapid heart rate

  • Stiff neck

  • Seizure

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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