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Vomiting & Diarrhea

by Sue Hubbard, M.D.

Over the years, I have talked a lot about vomiting.  In most cases of gastroenteritis, vomiting is either accompanied or followed by diarrhea.  I know, lovely topic to discuss…but the reality is we must.

Most of these episodes are typically caused by a viral infection and there are many viruses that may cause the same symptoms. Although people often think of V & D as “the stomach flu” it has nothing to do with influenza at all.

Diarrhea describes a stool that is loose and watery as well as frequent. Everyone can have a loose stool once in a while and that is not necessarily diarrhea.  But when the stools become more frequent (you will know) as well as watery, you have diarrhea.

It is interesting that day care centers may sometimes send a baby home because they have had more than 3 stools in a day, but some infants may have a loose stool more often than that and still not have what I would consider to be diarrhea. (Believe me; I get to look at a lot of dirty diapers!)

The most important part of treating a viral diarrhea is keeping your child hydrated. If they are having frequent watery stools you can typically “feed them through” the diarrhea.

If you are putting more in the mouth than comes out the bottom then you can typically maintain their hydration. This can be done with a child of any age. For babies and younger children you can use Pedialyte to maintain their hydration, but for older children who will no longer drink Pedialyte, give them Gatorade or a similar drink.  Just keep the fluids going.

It is also important to “feed your child” through diarrhea. By this I mean you can continue to offer foods, as long as there is no vomiting.  Years ago I was taught “rest the gut” and “only feed children a bland BRAT diet”. That is no longer the treatment for diarrhea, as it was found that the intestines need protein and nutrients to heal.

A well balanced diet with lean meats, vegetables as well as carbohydrates is a better choice.  If the diarrhea is persistent I might limit dairy but otherwise let your child eat. With that being said, they may not be as hungry since they are sick, but offer them meals and let them eat as they are feeling better.

Always watch hydration by looking for moist mouth (put your finger in a baby’s mouth and it should always come out wet), drooling, tears and wet diapers. It may be hard to tell if your child is having wet diapers as the diarrhea may soak into the diaper with the urine.

If your child is crawling, playing , running around and has drool and tears then I would not worry about the diaper being wet.  The only way to really tell if there is urine in a diaper is to weigh the diaper before putting it on and then later in the day. There are very few times this is necessary and those children are usually in the hospital as well.

The last thing to remember about diarrhea is HANDWASHING!!  The pesky “tummy flu” is easily spread by dirty hands, so make sure that everyone who comes into contact with the diaper and bathroom is washing their hands well. It is not infrequent to see an entire family, adults included, come down with diarrhea. So keep out the hand sanitizer and soap!

That’s’ your daily dose for today.  We’ll chat again tomorrow.

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