Viral Gastroenteritis (Child)

Most diarrhea and vomiting in children is caused by a virus. This is called viral gastroenteritis. Many people call it the stomach flu, but it has nothing to do with influenza. This virus affects the stomach and digestive tract. It usually lasts 2 to 7 days. Diarrhea means passing loose or watery stools that are different from a child's normal pattern of bowel movements.

Your child may also have these symptoms:

  • Belly 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, your child's body fluids must be replaced. This can be done with oral rehydration solution. Oral rehydration solution is available at pharmacies and most grocery stores.

Antibiotics don't work against illness.

Home care

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

If giving medicines to your child:

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

  • You can give acetaminophen or ibuprofen to control pain and fever. Or you can give other medicine as prescribed.

  • 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.

To prevent the spread of illness:

  • Remember that washing your hands with soap and clean, running water or using alcohol-based sanitizer is the best way to prevent the spread of infection.

  • Teach all people in your home when and how to wash their hands Wet your hands with clean, running water. Lather soap on the backs of your hands, between your fingers, and under your nails. Scrub your hands for at least 20 seconds. If you need a timer, try humming the Happy Birthday song from beginning to end twice. Rinse your hands well and dry using a clean towel.

  • Wash your hands before and after caring for your sick child.

  • Clean the toilet after each use.

  • Dispose of soiled diapers in a sealed container.

  • Keep your child out of day care until your child's healthcare provider says it's OK.

  • Wash your hands before and after preparing food.

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

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

  • Keep in mind that people with diarrhea or vomiting should not prepare food for others.

Giving liquids and food

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

  • 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. Begin with oral rehydration solution at room temperature. Give 1 teaspoon (5 mL) every 5 minutes. Even if your child vomits, continue to give the solution. Much of the liquid will be absorbed, despite the vomiting. After 2 hours with no vomiting, begin 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.

  • You can resume your child's normal diet over time as they feel better. Don’t force your child to eat, especially if they are having stomach pain or cramping. Don’t feed your child large amounts at a time, even if they are hungry. This can make your child feel worse. You can give your child more food over time if they can tolerate it. Foods you can give 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.

Call 911

Call 911 if your child has any of these symptoms:

  • Trouble breathing

  • Confusion

  • Extreme drowsiness or loss of consciousness

  • Trouble walking

  • Rapid heart rate

  • Chest pain

  • Stiff neck

  • Seizure

When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

  • Belly pain that gets worse

  • Constant lower right belly pain

  • Repeated vomiting after the first 2 hours on liquids

  • Occasional vomiting for more than 24 hours

  • More than 8 diarrhea stools within 8 hours

  • Continued severe diarrhea for more than 24 hours

  • Blood in vomit or stool

  • Drinking less fluid than normal

  • Dark urine or no urine for 6 to 8 hours in older children, 4 to 6 hours for babies and young children

  • Fussiness or crying that cannot be soothed

  • Unusual drowsiness

  • New rash

  • Diarrhea lasts more than 10 days

  • Fever (see Fever and children, below)

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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