Gastroenteritis

Gastroenteritis is an infection in the stomach that causes diarrhea and sometimes vomiting.

It is common in babies and children.

It is caused by a virus or bacteria in the intestinal tract (bowels). Bacteria or viruses get to the intestinal tract by putting dirty hands, toys or other objects near or into the mouth.

Gastroenteritis is more serious in babies and young children than it is in adults because diarrhea and vomiting can cause the loss of important fluids and minerals from the body (dehydration).

Signs and symptoms of Gastroenteritis include:

  • Diarrhea (frequent, loose, watery stools) lasting 2-3 days but usually no more than a week
  • Nausea and vomiting lasting 1-2 days
  • Abdominal pain (belly pain)
  • Fever (sometimes)

Early signs of dehydration include:

  • No urine output in 8-12 hours (babies usually have 6-8 wet diapers in 24 hours)
  • Less active than normal, unusually sleepy, or difficult to arouse
  • The urine is dark yellow and may smell “strong” like ammonia
  • Mouth saliva is thick and sticky rather than thin and watery
  • No tears when crying

Later signs of dehydration include:

  • All of the signs written above
  • Baby’s soft spot is sunken
  • Child’s eyes are sunken
  • Baby or child has no energy and is difficult to wake up

To prevent dehydration in babies:

  • Breastfeed or bottle-feed more often, and for shorter amounts of time.
  • If diarrhea continues, offer 2-3 ounces of Oral Rehydration Solution (ORS) such as Naturalyte, Pedialyte, Rehydralyte, Infalyte, or a generic brand, after each diarrhea or vomiting.
  • Continue feedings with regular formula or breast milk. ORS can be alternated with regular feedings.
  • With ongoing vomiting, it may be necessary to decrease feeding size to one to one-half ounce every hour.

To prevent dehydration in children:

  • Give liquids in small amounts and frequently
  • Offer your child foods that he or she usually eats
  • Your child may be better able to handle food in smaller, more frequent feedings

It is not possible to keep a child from being exposed to the germs that cause gastroenteritis. Proper hand washing by the whole family is the best way to prevent the spread of disease. Encourage everyone in the family to wash their hands with soap and water after using the bathroom, after handling diapers and before handling food or preparing food or drink.

With Gastroenteritis, the diarrhea and vomiting usually only last a short time. The child’s diet may not need to change if the diarrhea is mild. If your baby is breastfeeding, continue to feed on demand. If your baby is bottle-fed, continue feeding as usual with full-strength formula. Older children can continue their normal diet, but should avoid foods that may make the diarrhea worse, such as apple or pear juice.

The BRAT (Bananas, Rice, Applesauce and Toast) diet alone isn’t recommended anymore because it does not provide enough nutrition for a child with Gastroenteritis and does not make the symptoms go away any faster. Foods that are good for your child are:

  • Cereals
  • Bread
  • Potatoes
  • Lean meats
  • Plain yogurt
  • Bananas
  • Applesauce
  • Vegetables

Avoid giving your child only clear liquids because they don’t replace necessary minerals lost from the diarrhea and vomiting. Also, avoid giving apple juice, carbonated drinks, Jell-O water, chicken broth, or sports drinks. These contain sugars or fat that may make the diarrhea worse and lack important minerals necessary for the baby or child who is dehydrated.

If the diarrhea gets worse, offer your baby or child an Oral Rehydration Solution to prevent dehydration. ORS come in a variety of flavors and come in liquid form and freezer pops. ORS can be found at supermarkets, pharmacies and discount stores. If your child is dehydrated, she/he may like the taste of ORS. Children with mild diarrhea and no signs of dehydration may NOT like the salty taste of ORS because their bodies haven’t lost enough salt yet for them to crave salts.

Warning: Do not use anti-diarrhea medications unless directed by your doctor.

If your child gets diaper rash from the diarrhea, you can treat it by:

  • Avoiding diaper wipes.
  • Cleaning the diaper area gently and thoroughly with soap and water and pat dry with a clean towel.
  • Apply a zinc-based ointment (i.e. Desitin) thickly after cleansing the bottom. This keeps the diarrhea stool away from your child’s skin.
  • Washing hands and diapering surfaces well after each diaper change.

Even if you do everything right at home, your child still may become dehydrated. You should call your child’s doctor if:

  • You are unable to get fluids into the child and diarrhea lasts longer than 24 hours.
  • You are able to get fluids into the child but diarrhea lasts more than 7-10 days.
  • Your child shows any of the following signs:
    • No urine output in 8-12 hours
    • No tears when crying
    • Unusually drowsy or fussy
    • Inside of the mouth and/or lips are dry
    • Eyes appear sunken
    • Child is extremely thirsty
    • Blood is present in the diarrhea or vomit
    • Bile (dark green) is present in the vomit
    • Baby’s soft spot is sunken

Your doctor may ask to see your child or have your child seen in the emergency department. Your child will be examined and watched for signs of dehydration. The nurse or assistant will measure how much fluid goes in and comes out of your child. Your child will be weighed. You may be asked to help care for your child by giving him/her an Oral Re-hydration Solution. This may keep your child from needing an IV. If the diarrhea and vomiting continue and your child refuses fluids by mouth, he/she may need an IV. An IV will let special fluids go into your child through a vein.