Medac Health Services, P.A.

Of Special Interest

Vomiting and Diarrhea in Children

Our children are our greatest treasures. That is why when they become ill it can be so disturbing. Recently our community, children and adults alike, has been host to an intestinal virus.

A parent can be at a loss for what to do when confronted with a child vomiting and simultaneously having frequent watery stools. Most parents quickly become concerned about possible dehydration. Often times the child just isn’t their usual run-all-over-the-place, perky self. Then, as luck may have it, there is the fever to boot.

Try not to be overwhelmed. Before you run out of the house in search of professional help, consider these points.

Let it run its course. Most of these intestinal bugs are self-limiting diseases. In other words, they simply run their course and get better in due time. Indeed if both the vomiting and diarrhea continue, there is a true risk of dehydration. The key is to focus mainly on the vomiting. If the vomiting can be controlled and the child can start to take liquids, then many of the concerns and problems are already solved.

What about fever? Often an accompanying fever serves to only worsen the vomiting. I suggest rectal acetaminophen (Tylenol). This is available without a prescription, but is often kept behind the counter because of refrigeration requirements. Ask the pharmacist for it.

Rehydration fluids. I recommend a balanced glucose electrolyte solution, such as Pedialyte or a like product. Unfortunately, some children find these solutions unpalatable. The goal is to get them drinking, so find something that fits the bill, such as Gatorade, jello, popsicles, broth, or flat clear carbonated drinks (ginger ale, 7-Up, Sierra Mist, etc.) Give this in small 2 to 4 ounce increments every 45 minutes to one hour. Two ounces held down is better than 8 ounces back in your lap. For infants you may want to try getting back to the formula or breast milk after several hours. Toddlers and older children can be maintained on clear fluids for about 24 hours to help reduce the work and irritation on the stomach.

When do you start solids? There is some disagreement about when to get back on solid food. I feel like it is better to rest the bowels for a day and allow the infection to move into the lower intestinal track. Too often I see children trying to turn the corner but get started back on solids too soon, only to see the whole process start over again. Put your worries aside and your urge to add nutrition back with the diet. A period of bowel rest can go a long way.

If you are one of the lucky parents whose child has only diarrhea, then I still recommend only fluids for a day. Too often the vomiting will follow and your advantage is lost. These children can also take oral acetaminophen (Tylenol). I prefer this over other preparations such as ibuprofen (Motrin or Advil) because it is known to be less irritating to the stomach.

Children get sick quickly but most often bounce back just as fast. Be patient. Try some of these simple measures at home first. If all fails, your local primary care provider or urgent care staff is ready to lend a hand.

--Joseph R. Arena, M.D.

Dr. Arena received an AA in Nursing, a BS in Biology from the College of Santa Fe, and his MD degree from the University of New Mexico, Albuquerque, New Mexico. He completed his residency at Texas Technical in El Paso, Texas. Dr. Arena is board certified in Emergency Medicine and has been a practicing physician with Eastern Carolina Emergency Physicians since 1999. His practice time is divided between Cape Fear Hospital in Wilmington, and Pender Memorial Hospital in Burgaw, NC. Additionally, Dr. Arena is the Medical Director for the Pender Memorial Hospital Emergency Department.