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Vomiting and Diarrhoea
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.
Diarrhoea can often last between 5 – 7 days and usually resolves by 2 weeks. Vomiting generally stops within 3 days. If your child continues to be ill for longer than these periods, seek advice.
Severe diarrhoea and/or vomiting can lead to dehydration, which is when the body does not have enough water or the right balance of salts to carry out its normal functions. If the dehydration becomes severe it can be dangerous
- Children at increased risk of dehydration include:
- young babies under 1 year old (and especially the under 6 months)
- babies born at a low birth weight and those who have stopped drinking or breastfeeding during the illness
- children with faltering growth
Something to Watch Together
If your child has any of the following:
- Breathing very fast or breathing that stops or pauses
- Working hard to breathe, drawing in of the muscles below the rib, unable to talk or noisy breathing (grunting)
- Becomes pale, blue, mottled and/or unusually cold to touch
- Difficult to wake up, very sleepy or confused
- Weak, high-pitched, continuous cry or extremely agitated
- Has a fit (seizure)
- A temperature less than 36oC or temperature 38oC or more if baby is less than 3 months
- Develops a rash that does not disappear with pressure and seems unwell (see the 'Glass Test')
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
- Has blood in the stool (poo)
- Has constant tummy pain
- Is unable to keep down any fluids during this illness
- Breathing a bit faster than normal or working a bit harder to breathe
- Dry skin, lips, tongue or looking pale
- Not had a wee or wet nappy in last 12 hours
- Foreign travel and symptoms not settling
- Sleepy or not responding normally
- Crying and unsettled
- Poor feeding (babies) or not drinking (children)
- A temperature 39oC or above in babies 3-6 months
- Temperature of 38oC or above for more than 5 days or shivering with fever(rigors)
- Getting worse or you are worried about them
- Has diabetes and their blood sugar levels are to high or to low
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If none of the features in the red or amber boxes above are present you can use the advice on this page to care for your child at home.
Children under one year or those born with a low birth weight are at a higher risk of becoming dehydrated.
Self care
Using the advice on this leaflet you
can care for your child at home.
The most important advice is to
keep your child well hydrated.
If you feel you need more advice,
please contact your local pharmacy,
Health Visitor or GP surgery
You can also call NHS 111 for advice.
Caring for your child at home
If your child is not dehydrated (see warning signs above) and does not have any red or amber symptoms in the traffic light advice then you can care for your child at home. The most important thing is to replace fluid as your child will be losing it from their vomiting and/or diarrhoea.
Treatments
Oral Rehydration Solution (ORS) such as Dioralyte is made up from sachets of powder which have to be mixed with water. Oral Rehydration Solution should not be used in infants under 3 months without speaking to your GP. In children under a year it should be added to freshly boiled and cooled water according to the directions. In older children it can be added to full sugar squash to taste nicer (For example orange/blackcurrant works well). Do not given your child anti-diarrhoeal drugs as they can be dangerous.
What should you do?
- Encourage your child to drink plenty of fluids – little and often. Water is not enough and ideally oral rehydration solution (ORS) is best. ORS can be purchased over the counter at large supermarkets and pharmacies and can help prevent dehydration from occurring.
- Mixing the contents of the ORS sachet in dilute squash (not “sugar-free” squash) instead of water may improve the taste
- Continue to offer your child their usual feeds, including breast and other milk feeds. Do not make baby formula weaker - use it at its usual strength.
- 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
- Give fluids little and often, if they take too much at a time, it may cause them to vomit. Unwell children will often refuse fluids but can be persuaded, so it is important to persevere. Keep trying to give them drinks.
-
For a child under 1 year old you can give small sips every few minutes (or use a teaspoon or plastic syringe of 5 mls every 5 minutes). If using a plastic syringe, slowly aim the fluid into the side of the baby’s mouth so they can swallow it more easily.For old er children, you could try using ice lollies or encourage drinking through a straw.
- Your child may have stomach cramps; if simple painkillers such as paracetamol do not help please seek further advice
- Most children with diarrhoea and / or vomiting get better very quickly, but some children can get worse. You need to regularly check your child and follow the advice given to you by your healthcare professional and / or as listed on this page
How long does gastroenteritis last?
Diarrhoea usually lasts about five to seven days, but may continue for up to two weeks.
Vomiting does not usually last for more than three to four days.
If your child’s symptoms are taking longer than this to improve you should contact your GP Surgery
Aftercare
Once your child is rehydrated and no longer vomiting:
- continue breastfeeding, other milk feeds and fluid intake - give full strength milk straight away
- reintroduce the child’s usual food
- avoid giving fizzy drinks until the diarrhoea has stopped
- if dehydration comes back, start giving ORS again
- anti-diarrhoeal medicines (also called antimotility drugs) should not be given to children
- your child cannot return to nursery / school until 48 hours after the last episode of diarrhoea and/or vomiting
Preventing the spread of Gastroenteritis (diarrhoea and/or vomiting)
You and/or your child should wash your hands with soap (liquid if possible) in warm running water and then dry them carefully:
- After going to the toilet
- After changing nappies
- Before touching food
Your child should not:
- Share his or her towels with anyone
- Go to school or any other childcare facility until 48 hours after the last episode of diarrhoea and / or vomiting
- Swim in swimming pools until 2 weeks after the diarrhoea has stopped
For wear and tear, minor trips and everything in between.
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
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.
Contacting the School Nurse
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.
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
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.