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Diarrhoea and vomiting
Feeling sick and then vomiting is usually the first sign that your child has a ‘tummy bug’. Diarrhoea tends to occur after your child has started vomiting and means passing frequent watery poos that are offensive in nature.
- Tummy bugs are extremely common in young children and are almost always caused by a virus. They are easily spread, resulting in outbreaks in nurseries and schools
- Babies under 1 year of age (and especially under 6 months of age) are at more risk of becoming dehydrated when they have a tummy bug than older children, which is why it is important to make sure that they are drinking enough
Operation Ouch - Diarrhoea and vomiting
When should you worry?
If your child has any of the following:
- Becomes pale, mottled and feels abnormally cold to touch
- Going blue around the lips or too breathless to talk / eat or drink
- Becomes extremely agitated, confused or very lethargic (difficult to wake)
- Develops a rash that does not disappear with pressure (the ‘Glass Test’)
- Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
You need urgent help
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
- Seems dehydrated: sunken eyes, drowsy, sunken fontanelle (soft spot on baby’s head) or not passed urine for 12 hours
- Has blood in the stool (poo)
- Tummy pain that doesn't go away
- Has completely stopped drinking or breastfeeding
- Is unable to keep down any fluids during this illness
- Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
- Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
- Continues to have a fever of 38.0°C / 100.4°F or more for more than 5 days
- If your child has diabetes, monitor their blood sugars closely
- Yellow around the eyes
You need to contact a doctor or nurse today
Please ring your GP surgery or call NHS 111 - dial 111
If none of the above features is present, most children with diarrhoea and / or vomiting can be safely managed at home
(Please note that children younger than 1 year may become dehydrated more quickly. If your child appears otherwise well but you still have concerns, please contact your GP surgery or call NHS 111)
Additional advice is also available to young families for coping with crying of well babies – click here
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
What should you do?
- Avoiding dehydration is important – give your baby/child extra fluids. Give your baby oral rehydration solution (ORS) in between feeds or after each watery stool. Little and often tends to work best – in hospital, babies are given 1 or 2 tablespoons (5-10 mls) of fluid to drink every 5-10 minutes. You can try using a syringe to give fluids to your child. Mixing the contents of the ORS sachet in dilute squash (not “sugar-free” squash) instead of water may improve the taste
- Do not stop giving your baby milk. If you are breastfeeding, continue doing so
- Do not worry if your child is not interested in solid food. If they are hungry, offer them plain food such as biscuits, bread, pasta or rice. It is advisable not to give them fizzy drinks as this can make diarrhoea worse
- To avoid spreading the virus, wash your hands with soap and water after changing nappies. Keep toilets clean and don’t share towels
- They should not return to school or any other childcare facility until 48 hours after the last episode of diarrhoea and / or vomiting
- You can get Oral Rehydration Solution from the pharmacy
How long will your child’s symptoms last?
- Vomiting tends to last for 1-2 days, and diarrhoea tends to last for about 5 days
- The charts below show how long diarrhoea and vomiting lasts in children when they have a tummy bug. The faces represent 10 children who have seen their GP with a tummy bug. Green faces are those children who have recovered within that time period
The diagrams above are taken from www.whenshouldiworry.com
Where should you seek help?
- If it is non-urgent, speak to your local pharmacist or health visitor.
- If your child has any of the above features, urgently contact your GP Surgery. For an urgent out-of-hours GP appointment, call NHS 111.
- You should only call 999 or go your nearest A&E department in critical or life threatening situations.
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.