Viral Gastroenteritis (Child)

Front view of boy showing digestive tract.

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 intestinal 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 are not effective for this 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 use acetaminophen or ibuprofen to control pain and fever. Or, you can use 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 with soap and water and using alcohol-based sanitizer is the best way to prevent the spread of infection.

  • 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.

  • 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. Do not 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. Do not 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 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 he or she 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 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:

  • 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

  • More than 8 diarrhea stools within 8 hours

  • Continued severe diarrhea for more than 24 hours

  • Blood in vomit or stool

  • Reduced oral intake

  • 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

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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