As we hit hour 40, heading into day 2 of vomitorium here at our house (O has been sick), I will suggest a couple of things I know as a mom and pediatrician about gastroenteritis or the “stomach flu”:

  1.  Hand-washing and keeping things clean is your best defense from getting ill with a stomach bug. Not surprisingly, this is particularly true after touching or supporting your child and when preparing food and/or eating. Some viruses will survive on surfaces for days. And some viruses can even survive hand-sanitizer. But even with ridiculous meticulous detail to hygiene, every parent knows that when the vomit if flying it’s hard to lasso every single errant particle. So simply commit to do you best. Change the sheets and clean up areas of vomit immediately after supporting your child. Soapy warm water is your friend. Wash surfaces immediately, use hot water for the wash, and use high heat in the dryer.
  2. 24 Hours (or so) In general most pediatricians will tell you that vomiting doesn’t exceed 24 hours with typical gastroenteritis. But really, it can. Many kids don’t follow the rules. Once a virus that causes gastroenteritis takes hold of a child, vomiting starts. Children tend to vomit more than adults but I’ve never read or learned why this is. With most viruses that cause the “stomach flu,” as the infection moves through the stomach and intestines, vomiting stops after about 24 hours. But not always. If you advance liquids too quickly, or a child eats more solids than they are ready for, even after the first meal 1-2 days into eating again, they may have a vomit encore. If you have one of those, start back where you started (sips of clear liquids) and go very very slow advancing their diet. If vomiting is accelerating at 24 hours, it is time to check in with your child’s doctor.
  3. Disgusting & Terrifying It’s creepy-eepy to take care of a child with vomiting. Not only is it entirely gnarly and disgusting to remove and clean chunks from vomit-laden carpet, sheets, and clothing, it’s also terrifying to provide support to a vomiting child because you can get equally uneasy about catching the virus. You’re not alone in this. It’s absolutely nauseating to see your own child ill, unwell, and retching. And it’s awful to imagine having to provide care while getting miserably sick. Do your best to keep your hands washed and keep the love going. As all of us know that when you find yourself picking out vomit bits from the carpet at 3am, it really can only get better from there.
  4. Medication Children rarely need medication when recovering from gastroenteritis. Although some anti-nausea drugs are available for use in children, most children don’t need prescription medications. Talk with your child’s pediatrician if you feel you child is vomiting longer than 24 hours and/or becoming dehydrated. Remember that vomiting is a protection reaction of your child’s body to clear infection.
  5. Soap, Water, And Bleach I was reminded today that William Osler said, “Soap and water and common sense are the best disinfectants.” Cleaning your home to avoid spreading infection is a must. You don’t need expensive products just vigilence. With some highly infectious viruses that cause vomiting, even 10 viral particles can cause illness. So in addition to soap and water, consider using a dilute bleach solution to hard surfaces.
  6. Detective Work Sometimes you’ll simply never know where it all came from. But it won’t stop you from playing the role of infectious detective. I wrote previously about that moment when you try to figure out if illness is food poisoning or infection. But this time around I’ve lost many a moment trying to figure out the vector for this infection. Literally, I have caught myself day-dreaming about the moment that the viral particles entered my little boy’s body. How I’d love to return to that moment and intervene against the germs, those little gremlins. The only issue, this is simply wasted time…
  7. Yummy, Clingy, Love There is an occasional perk to a terrible stomach bug. And we have to find one to maintain a sense of optimism. My friend Dr Claire wrote about vomit and magic recently. Mentioning magic, she talks about the way our kids want us, over anything else on earth, when they are ill. Sometimes, she says, we’re magic. And I totally agree–there is an intimacy that rises in illness. I nicknamed O “Velcro” today. He simply wouldn’t leave my side…magic.

Then there is resiliency. And children do very well recovering from typical viral gastroenteritis although diarrhea can last for days. Even so, our children’s resiliency will long astonish us.

Tips For Feeding Your Child When Recovering From Gastroenteritis:

Children should go very slow drinking liquids after vomiting. Don’t trust your 3 year-old to know how to pace taking in liquids. Offer SIPS SLOWLY. Start with clear liquids, preferably something with electrolytes [AKA Pedialyte] due to lower sugar content and water, broth or very dilute juice. Start with sips every 10 minutes or so for just a few ounces of liquid an hour.
Once your child has tolerated sips for about 6 hours, consider a bland, boring food. Think of things without extra fats like salty crackers, bread, noodles, or rice. After your child has had a few hours of tolerating those foods, allow more volume and more complex foods. Remember, continue to go slow advancing back to their typical diet. There’s always a possibility for a barf encore, so be careful. You don’t necessarily need to avoid cow’s milk, but I wouldn’t start with it.
For infants, breast milk or formula are best for feeding. Infants don’t need juice or even electrolyte solution in most cases.

When To Call The Doctor:

If you’re at all concerned about dehydration due to a lack of tears with crying, minimal urine output in your child’s diaper or on the toilet, or you see very chapped, dry lips or dry mouth, call your child’s doctor for advice and/or a visit.

If your child has a persistent high fever, is complaining of abdominal pain, or hasn’t had any liquids for over 1 day, you may need an urgent visit for an evaluation. Trust your instincts and call the office when necessary.