Viral Gastroenteritis (Children)

Viral gastroenteritis is the inflammation of stomach and intestines caused by several different viruses. The main symptoms are vomiting and diarrhoea.

Vomiting is the forceful ejection of a large portion of the stomach's contents through the mouth. In contrast, regurgitation is the effortless spitting up of one or two mouthfuls of stomach contents that are commonly seen in babies less than one year of age.

The vomiting may be followed by diarrhoea (watery loose stools) and abdominal cramps. There may also be a fever. The vomiting usually stops in 6 to 24 hours. Dietary changes usually speed up recovery. If diarrhoea is present, it usually continues for several days.

The viral infection is usually mild and does not last longer than one week. Your child should get better with lots of rest, liquids and appropriate food. However, your child's illness may be serious if he or she becomes dehydrated. Dehydration can be very serious if your child is very young.

Viral gastroenteritis is commonly caused by viruses but can also be caused by bacteria (either directly or through their toxins) and as side effects of certain medicines.

There is often a history of contact with other children or adults with similar symptoms.

Some signs and symptoms of viral gastroenteritis include:

• Diarrhoea
• Nausea
• Vomiting
• Abdominal cramps
• Fever

Medications are usually not needed to stop vomiting or diarrhoea. However, they may be administered in a hospital care setting. Certain medications for adults are dangerous for children.

Your child does not need antibiotics for most illnesses that are caused by viruses. Antibiotics do not kill viruses. Most of the bacterial infections do not need antibiotics unless the child is very sick (invasive bacterial infections).

Oral rehydration therapy is a simple way to help your child when he or she vomits or has diarrhoea. This therapy has two simple steps:

Step 1: Give your child oral electrolyte solution

An oral electrolyte solution is a liquid that has exactly the right amount of water, sugar and salts. You can buy this solution in most pharmacies in different forms.

Warning: You must mix the powders exactly according to instructions. For the first 6 hours, make sure your child gets at least the amount of solution prescribed below for his or her age.

• Less than 6 months old
  Give 60mL to 90 mL (12 to 18 teaspoons) per hour
• 6 months to 2 years old
  Give 90mL to 125mL (18 to 25 teaspoons) per hour
• 2 years old or older
  Give 125mL to 250mL (4 to 8 ounces) every hour

Do not stop breastfeeding. Feed your child for a shorter time and more frequently. Breast milk is the best liquid for your child.

If your child is vomiting, give frequent sips of liquid. Give your child 5mL of liquid (1 teaspoon) every 1 to 5 minutes.

When your child starts to feel better, you can give larger volumes but less often. Make sure that your child drinks the amount of liquid he or she needs for his or her age.

After 24 hours, give your child the oral electrolyte solution only after each watery diarrhoea.

Step 2: Feed your child healthy food

Feeding your child a healthy diet will help your child's fight against infection. It will also help to heal his or her digestive system and prevent weight loss.

Stop giving your child solid food for 6 to 12 hours only if he or she is vomiting.

If your child has diarrhoea, do not stop feeding your child. Give your child small amounts of food that he or she likes every 3 to 4 hours.

Here is a list of appropriate and inappropriate food for your child:

• Appropriate foods
  • Breast milk, regular milk or formula milk (for infants who have not been weaned); do not further dilate the milk
  • Starchy food such as rice, potatoes, noodles, toast and crackers
  • Cereal such as rice or wheat cereal and oatmeal
  • Protein such as boiled or baked meat, fish, chicken, soy products and eggs
  • Vegetables with no added butter
  • Fruits not packed in syrup
  • Soup
• Inappropriate foods
  • Fruit juice or soft drinks
  • Ice cream
  • Fatty food such as french fries, hamburgers and butter
  • Spicy food

A common error in the treatment of vomiting is to give as much clear fluid as your child wants rather than gradually increasing the amount. This almost always leads to continued vomiting. Keep in mind that there is no effective drug or suppository for vomiting and that diet therapy is the answer.

Another tip is to help your child go to sleep. Sleep often empties the stomach and relieves the need to vomit. Your child doesn't have to drink anything if he feels nauseated.

You can help to lower chances of your child falling sick by:

• Washing your hands after touching raw meat or fish.
• Keeping raw meat and half-eaten food in the refrigerator.
• Not feeding your child uncooked food.
• Throwing away eggs with cracked shells. Do not feed your child raw eggs.
• Sterilising bottles before each use if you are using formula milk.

You can prevent your child's illness from spreading by:

• Keeping your child at home until the vomiting and diarrhoea stops.
• Washing your hands after changing diapers, using the toilet and before making and eating food.
• Not sharing toothbrushes, drinking cups and utensils such as forks, knives, spoons and chopsticks.
• If your child puts toys in his or her mouth, do not let him or her share toys.

You can protect your child's bottom by:

• Changing your child's diapers often.
• Washing your child's bottom with soap and water; pat it dry or let it dry in the air. Do not use baby wipes
• Using a barrier cream on your child's bottom.

Please bring your child to the Children's Emergency immediately if he or she has any of the warning signs listed below:

• Signs of dehydration:
  • No tears when crying
  • Sunken eyes
  • Less than five wet diapers in 1 day
  • Dry skin, mouth and tongue
  • Sunken fontanelle (the soft spot on your child's head if he or she is less than 18 months old)
• Not willing to drink
• Frequent vomiting for more than 4 to 6 hours
• More than six large volume, watery diarrhoea in 1 day
• Stomach pain that is severe and does not stop
• Fast breathing
• Very sleepy or very fussy
• Cool or grayish skin
• Green vomitus
• Blood in the vomit or diarrhoea
• Crying and bringing the knees up to stomach
• Fever of above 39°C for longer than 12 hours