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Sickness and Diarrhoea

There are several reasons why children get sickness and diarrhoea, such as gastroenteritis, food allergy, food poisoning, infection or appendicitis and unfortunately the symptoms can be very unpleasant. One of the most common causes of sickness and diarrhoea in babies and young children under the age of 5  is gastroenteritis and this is an infection of the gut caused by a bacteria or virus. It is unpleasant but most children will feel better in a few days.

One of the main problems with sickness and diarrhoea is that it can quickly cause dehydration which can become life threatening (NHS Choices, 2016). In most cases of sickness and diarrhoea, your child can be looked after at home, carefully ensuring that they are adequately hydrated as it important to replace the fluids that are being lost.

Home management

•  If your baby is vomiting, parents are advised to continue to bottle or breast feed.
• Children are advised to take sips of clear fluid such as water or clear broth. Fruit juices or fizzy drinks are not recommended. If your child is not dehydrated or lost their appetite, it is ok to eat solid foods.
• Children who are at risk of dehydration can be given an oral rehydration salt.
• Babies under 1 are more at risk of dehydration and parents should keep an eye on them and observe how many wet nappies they are having.
• Children and babies who have had diarrhoea and vomiting should not go to school or nursery or any childcare facility until 48 hours after the last episode of diarrhoea or vomiting (NHS Choices, 2016)

Recommendations for Prevention.

• Encouraging hand washing properly after going to the toilet and before eating.
• Cleaning the potty or toilet using disinfectant.
• Parents and carers are advised to clean their hands after each nappy change or dealing with the toilet/potty.
• Parents should not share child’s towels/ flannels or  cutlery with other members of the household.
• Children should not swim for 2 weeks following an episode of diarrhoea.

Sometimes, vomiting and diarrhoea can be a sign of something more serious and parents are advised to contact their GP if (NHS Choices, 2016):

• The child/infant is repeatedly vomiting and is unable to hold down fluids
• The child has symptoms of dehydration which can include a dry mouth, crying without tears, urinating less or not wetting many nappies or drowsiness.
• The child is lacking energy, irritable, or is not their usual self.
• The child is complaining of severe tummy pain.
• The child has a rash , headache or stiff neck (symptoms of a more serious illness)
• The child’s vomit is green or contains blood
• The child has been vomiting for more than 2 days.
• The child has had diarrhoea for more than 1 week.
• The child has blood or mucous in their stools.
• The child has recently been abroad.
• The child has a weakened immune system caused by an underlying health condition  such as acute leukaemia or if it is a side effect of a medical treatment such as chemotherapy.

If you can’t get hold of your GP then contact your local out of hours or hospital.

 When to attend A&E

If your child is presenting with Red Flag symptoms alongside the diarrhoea and vomiting then you are advised to go straight to A&E. Red Flag Symptoms include (NICE, 2009),

• A temperature  of 38C or higher in children younger than 3 months.
• A temperature of 39C or higher in children aged 3 months and above.
• Shortness of breath and rapid breathing
• Decreased or altered consciousness
• Neck stiffness
• Bulging fontanelle in babies.
• Non blanching rash ( a rash that is present when a glass is pressed against the skin)
• Blood and/or mucous in the stool.
• Green vomit
• Severe or localised abdominal pain