Diarrhoea and/or Vomiting

(Gastroenteritis) - Advice for parents and carers of children

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If your child has any of the following

Becomes pale, mottled and feels abnormally cold to touch
Has blue 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’)
Has dark green or blood stained vomit
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.

please phone 999 or go to the nearest Hospital Emergency (A&E) Department

If your child has any of the following:

Seems dehydrated: ie. sunken eyes, drowsy, sunken fontanelle (soft spot on baby’s head) or no urine passed for 12 hours
Has blood in the stool (poo)
Has constant tummy pain
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
If your child has diabetes, monitor their blood sugars closely

You need to contact a doctor or nurse today.

Please ring your GP surgery or contact NHS 111 - dial 111 or for children aged 5 years and above visit 111.nhs.uk

If none of the above features is present, most children with diarrhoea and / or vomiting can be safely managed at home.

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 contact NHS 111 - dial 111 or for children aged 5 years and above visit 111.nhs.uk

Self care

Using the advice below you can provide the care your child needs at home

How can I look after my child?

Avoiding dehydration and low blood sugar is important – give your baby/child extra fluids and make sure that they contain sugar. In the hospital, diluted apple juice is often used. To make this, simply mix half apple juice and half water (50/50). Please give this between feeds or after each watery stool. Little and often works best – in hospital babies and young children are given 1 or 2 tablespoons (5-10ml) of apple juice to drink every 5-10 minutes. You can try using a syringe to give fluids to your child.
Continue to offer your child their usual feeds, including breast and other milk feeds.
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.
Your child may have stomach cramps; if simple painkillers such as paracetamol and ibuprofen 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 sheet

About Gastroenteritis

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 stops within 2 weeks. Vomiting usually 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

After Care

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 recurs, 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