I'm a mom of three, so when an awful stomach bug tore through my family, I thought I knew exactly what to do. But when my oldest son couldn't stop vomiting, I was mortified when our pediatrician asked, "You gave him how much water?" It turns out I'd made a classic error: Fearing that Jacob, 8, would get dehydrated, I'd let him gulp down a full cup each time he vomited, which caused him to get sick even more.
Such goofs are common when treating a gastrointestinal illness, which is usually caused by a virus and, less often, by a bacterial infection. "It's scary when your child is throwing up," says Tanya Remer Altmann, M.D., a pediatrician and author of Mommy Calls. "You're living this Exorcist moment, and you'll do anything to make it stop."
You do need to keep a close eye on your child because a stomach bug can be serious. The norovirus causes an estimated 18,500 children under age 5 to be hospitalized each year, according to the Centers for Disease Control and Prevention. And despite the recent vaccine that's led to an 80 percent decline in cases of rotavirus, the GI infection still sends another 15,000 kids to the hospital. Chances are, however, your child's troubled tummy will be fine within a few days to a week. All you need to do is make him feel as comfortable as possible, let the illness run its course, and steer clear of the following flubs.
You Give Her a Glass of Water After Vomiting
Wrong Move Immediately after your child throws up, she begs for a drink, so you let her chug a glass of water.
Better Bet Since her stomach is likely inflamed from vomiting, wait 15 to 30 minutes before giving her anything to drink. "Otherwise, it may come right back up," says Vipul Singla, M.D., a pediatrician at Advocate Illinois Masonic Medical Center, in Chicago. Start with a single teaspoon of water or an electrolyte drink (such as Pedialyte, which contains salt to help rehydrate the gut) every 15 minutes. If your child stops throwing up and holds down the liquid for an hour, you can increase the frequency to every ten minutes, and so on. After two to three hours, you can try ice pops, Jell-O, or applesauce, since the sweet taste may appeal to her. Don't assume she's on the mend just because she stops getting sick. With most stomach bugs, diarrhea can linger for up to a week, along with a low-grade fever (100?F to 101?F degrees), head-aches, chills, and body aches. Call your pediatrician if her symptoms don't start to subside within a day or two.
You Give Over-the-Counter Medicine for Diarrhea
Wrong Move Your child keeps having diarrhea, so you give him an OTC remedy to soothe his stomach.
Better Bet Never give your child any tummy medicine unless your doctor approves it. "Sometimes parents use whatever they have in their medicine cabinet," says Jennifer Shu, M.D., a Parents advisor and the editor of the American Academy of Pediatrics' Baby & Child Health. "But these drugs can cause side effects in children and make the illness worse." In particular, antidiarrheal meds such as original Pepto-Bismol and Kaopectate contain an aspirin-like substance called salicylate that can cause Reye's syndrome, a rare but potentially fatal disease, in kids under 18. While loperamide (the main ingredient in Imodium, Kaopectate I-D, and others) is FDA-approved for kids 6 and older, Dr. Shu doesn't advise using this medicine because it slows down digestion and keeps the bug in your child's gut longer. Check with your doctor before giving him Children's Pepto Chewable Tablets, which don't contain salicylate. Often, the best strategy is simply to keep your child hydrated and wait it out.
You're Too Quick to Reduce Her Fever
Wrong Move Your little one has a low-grade fever, so you give her something to bring it down.
Better Bet Weigh the pros and cons. An elevated temperature is a sign that your child's immune system is working to fight the infection, so why not let her body do the work on its own? If her temperature exceeds 101?F and she's feeling crummy, though, cooling her down might make her more receptive to drinking liquids. Stick with acetaminophen, since ibuprofen can further irritate the stomach. If your child is vomiting, Dr. Altmann suggests starting with half the recommended dose of acetaminophen for your child's age; give her the other half about an hour later (provided she keeps it down). If your child is old enough, you can also try acetaminophen tablets that easily dissolve in her mouth. If she can't keep the medicine down, another possible option (although not a favorite among kids) is using an acetaminophen suppository.
You Allow a Cup of Juice or Milk
Wrong Move Your child is keeping down liquids, so you give him a sippy cup of juice or milk.
Better Bet Avoid sugary liquids like fruit juice, which can aggravate your child's stomach symptoms. If he asks to drink something other than water, try an electrolyte drink such as Gatorade or Propel. Milk may be okay, but start with small amounts and see if his diarrhea gets worse after he drinks it. About 20 percent of the time, a stomach virus causes temporary lactose intolerance, which leads to abdominal pain, bloating, and cramping, according to Dr. Singla. If that happens with your child, switch to lactose-free milk until his stool returns to normal. You can also try feeding him probiotics or yogurt with live and active cultures, which will help restore the good bacteria in the intestines. It's fine to nurse, since breast milk contains antibodies and nutrients that help the tummy heal.
You Follow the BRAT Diet After Your Child Is Better
Wrong Move Your child is back to eating, so for the next few days you follow the BRAT (bananas, rice, apple-sauce, toast) diet.
Better Bet Doctors now say that kids should resume their regular eating regimen as soon as they seem to be feeling better. "More than one day on the BRAT diet is too long," Dr. Shu says. These foods do help restore normal digestion but lack the protein and other nutrients that she needs to recover. Still, avoid high-fat foods (such as chicken nuggets, fries, and pizza) for several days and make sure she continues to drink lots of liquids until her symptoms are completely gone.
You Forget to Be Vigilant About Sanitizing
Wrong Move You become lax about hand-washing and sanitizing once your child improves.
Better Bet Stay vigilant about good hygiene. The virus can remain in your child's intestine (and come out in his stool) for several weeks after his symptoms are gone. So have him sing "Happy Birthday to You" twice when he washes his hands to ensure he does a thorough job after every trip to the bathroom. If he's still in diapers, scrub your hands after each change. Don't share towels, drinks, or food with your child. And since germs can live on places like doorknobs and toys for several hours or even days, clean or disinfect them regularly.
6 Reasons to Call the Doctor
Your child's stomach will probably get better on its own, but speak to your pediatrician right away if you notice any of these symptoms:
- Your newborn is vomiting.
- Your child can't keep down even tiny amounts of liquid.
- He has signs of dehydration. He isn't peeing or his urine is very dark; his eyes seem sunken and his face is pale; he has dry lips or mouth; and he has no tears when he cries. The soft spot on the top of a baby's head (the fontanel) may also appear sunken.
- You see dark-brown particles in his vomit (which could be blood) or notice a reddish, jelly-like substance in his stool (which could be a sign of a serious intestinal blockage).
- Your child has diarrhea more than once every hour.
- Your newborn has a temperature of 100.4?F or above or your child (6 months or older) has a fever that exceeds 103?F.
Originally published in the December 2011 issue of Parents magazine.