When your child has diarrhea or vomiting – or worse, both at the same time – preventing dehydration is the top priority. Learn when to see a doctor for diarrhea and vomiting and how to safely manage your child’s symptoms.
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What causes diarrhea and vomiting?
Diarrhea and vomiting are common conditions that can both make your child miserable. (And parents, too – cleaning up after them is no fun!)
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Diarrhea is the frequent passing of loose, watery stools (three or more in one day), often accompanied by abdominal cramps or pain. Vomiting is the forceful expulsion of your child’s stomach contents through their mouth, usually after feeling nauseous.
Why do diarrhea and vomiting happen? For a number of reasons, including:
Viral infections
Most cases of diarrhea and vomiting are caused by viral infections, such as rotavirus and norovirus. These two highly contagious viruses are the main culprits behind gastroenteritis – commonly known as the stomach flu or children’s stomach bug.
Gastroenteritis is an acute inflammation of the stomach and intestines, resulting in (you guessed it) diarrhea, vomiting, abdominal cramps, and nausea.
Bacterial infections
Bacterial infections like Salmonella and E. coli can also cause diarrhea and vomiting, which is often referred to as bacterial gastroenteritis. Bacterial infections are spread through contaminated food, water, or contact with an infected person.
Food intolerances
Food intolerances happen when your child’s body cannot properly digest certain foods. Symptoms like diarrhea, vomiting, abdominal cramps, and bloating usually appear within a few hours of eating the foods in question. Examples of food intolerances include lactose (dairy), wheat gluten, and soy.
Certain medications
Can antibiotics cause diarrhea? Yes, along with NSAIDs (including ibuprofen and aspirin), antidepressants, and more. These medications can disrupt the balance of bacteria in your child’s digestive system and affect their ability to process food properly.
Stress and anxiety
Your child’s mental health plays a role in their physical health as well. Stress and anxiety that manifests physically may lead to digestive issues, including diarrhea and vomiting.
What does diarrhea look like in newborns?
If you’re the parent of a newborn, their first bout of baby diarrhea – or what you think is diarrhea – can be unsettling.
Remember, breastfed and formula-fed infants normally have seedy, slightly runny stools that are yellow or brown in color. It could be diarrhea if your baby’s stools become more frequent, more liquid, contain mucus, change color, or have an unusually foul smell.
What does green diarrhea mean? For newborns, the color green is also normal, especially as they transition from meconium (your baby’s first tar-like stools after birth, which are dark green or black) to regular bowel movements.
As your baby grows, green diarrhea is usually caused by food moving too quickly through their digestive system, which prevents bile from changing color from greenish-yellow to brown. Older children and adults may have green diarrhea for the same reason.
Vomiting vs. spitting up
Newborn care is messy. How do you know when your baby is vomiting or just spitting up? Both involve the flow of stomach contents out of their mouth, but that’s where the similarities end.
Vomiting is an involuntary reflex that happens when abdominal muscles contract and the lower esophageal sphincter relaxes, forcing your baby’s stomach contents up their esophagus and out.
Spitting up – also known as gastroesophageal reflux or GER – is the easy backward flow of stomach contents out of your baby’s mouth, frequently with a burp. Spitting up, which causes a smaller amount of regurgitation, is most commonly seen in infants under 1 year of age.
Watch closely for signs of dehydration
Can dehydration cause diarrhea? No, but diarrhea can cause dehydration – and that’s why parents must be vigilant. Dehydration is the greatest danger of both diarrhea and vomiting, especially for infants and young children.
Seek immediate medical care if your child has any of these dehydration warning signs:
Dry mouth or lips
Sunken eyes
Lack of tears when crying
Unusual sleepiness or irritability
Fewer wet diapers or trips to the bathroom
If your child is not yet potty-trained, frequent loose stools can make it difficult to monitor for wet diapers. Therefore, be sure to watch for these other signs of dehydration as well.
Mild to moderate dehydration
Less urine output
Drier, stickier mouth or tongue
Fewer tears when crying
Plays or engages less than usual
Your child’s stools will continue to be loose if their dehydration is caused by diarrhea. But if their dehydration is due to other fluid loss (such as vomiting or not enough fluid intake), they will have fewer bowel movements.
Severe dehydration
Little to no urine output
Parched, dry mouth
Sunken eyes
Wrinkled skin
Very fussy
Excessively sleepy
Discolored hands and feet (may be cool to the touch)
Sunken soft spot (fontanel) on infant’s head
Severe cases of dehydration can lead to life-threatening complications like seizures, brain damage, and organ failure. Therefore, getting immediate medical care is crucial.
How to keep your child hydrated
Follow these tips to ensure that your child gets enough fluids each day:
For infants – Offer small, frequent sips of oral rehydration solutions like Pedialyte, breast milk, or formula.
For older children – Offer clear fluids like water, diluted electrolyte sports drinks, or broth. Avoid sugary drinks like juice or soda, which can dehydrate your child even further. Clear fruit juice can be mixed half and half with water or Pedialyte.
When vomiting – If your child is vomiting, wait 30-60 minutes after the last episode, then offer small sips every 5-10 minutes.
Know when to seek care – If your child cannot keep any fluids (including clear fluids) down, contact your pediatrician immediately.
Continue feeding if possible
Continue to feed your child a regular diet as tolerated, including breast milk and/or formula for infants. It’s also fine to continue milk and dairy products for toddlers and older children, unless they have bloating or excessive gas (or your pediatrician advises against it).
Wondering what foods help with diarrhea? Some say that yogurt is good for diarrhea, since the live probiotics can help restore healthy gut bacteria. It’s best to choose a plain, low-fat yogurt with live and active cultures. Avoid high-sugar, high-fat yogurts, which can worsen your child’s symptoms.
Other bland, low-fiber foods that are good for diarrhea include the BRAT diet (bananas, rice, applesauce, and toast), saltine crackers, and clear broths. Restricted diets are not recommended at any age, as adequate amounts of protein, carbohydrates, and fats are necessary for your child’s recovery.
More diarrhea and vomiting care tips
Avoid anti-diarrheal and anti-nausea medication
Never give your child anti-diarrheal or anti-nausea medication without consulting your pediatrician first. These medications are often unsafe and unnecessary for children. Your pediatrician can provide more information about how to stop diarrhea.
Keep a symptom log
It’s always a good idea to track how often your child has diarrhea, vomits, or both. Take note of how much fluid they are keeping down and how often they urinate. Again, fewer wet diapers or trips to the bathroom is a warning sign of dehydration.
Practice good hygiene
Everyone in your household should wash their hands thoroughly and often – particularly after changing diapers, after using the bathroom, and before eating meals. Regularly disinfecting shared surfaces like doorknobs, tables, countertops, and toys also helps prevent the spread of infection.
Protect your baby’s delicate skin
Babies with diarrhea fill a lot of diapers. Always change diapers frequently and use a thick barrier cream to protect your child’s skin, preferably one that contains zinc oxide. Gently clean their genital area with water or fragrance-free wipes designed for sensitive skin. Try dabbing instead of wiping, especially if their skin is sore.
Prevent diarrhea and vomiting
In today’s germ-filled world, preventing diarrhea and vomiting may seem like an impossible task. But there are things you can do to help keep diarrhea and vomiting to a minimum:
Get vaccinated – Always keep your child’s vaccinations up to date, especially for illnesses like the flu and rotavirus that are known to cause diarrhea and vomiting. (Parents should get their flu vaccines, too!)
Make handwashing a habit – Teach your child to wash their hands thoroughly with soap and warm water before eating meals and after using the bathroom, especially if they are potty-training.
Stay away from sick people – Try to keep your child away from others who are sick with diarrhea or vomiting.
Eat safely – Never serve your child food that might be uncooked, raw, or contaminated, and always store and refrigerate foods properly.
Take note while traveling – Watch what your child eats and drinks, especially in developing countries. Avoid tap water, ice made from tap water, and unwashed fruits and vegetables in these destinations.
Limit sugary drinks – Limit juice and other sugary drinks, which can cause diarrhea and other health issues.
Breastfeed if possible – Breast milk contains antibodies that help protect infants from many infections.
When to call your pediatrician
Vomiting in newborns is a medical emergency that requires immediate attention. You should also seek care for the following:
Infants under 3 months of age with any diarrhea or vomiting
Vomiting that lasts more than 24 hours
Diarrhea that lasts more than 2-3 days
Your child cannot keep any fluids down, especially clear liquids
Your child shows signs of dehydration
Your child’s stool is black or tarry after meconium has ended
There is blood in your child’s stool or vomit
There is green or yellow-green bile in your child’s vomit
Your child’s vomit has the color or consistency of coffee grounds
Your child has diarrhea or vomiting accompanied by a fever, severe abdominal pain, bloating, lethargy, or drowsiness
When diarrhea or vomiting go from being an unpleasant symptom to a serious health concern, Pediatric Associates is here to help! Contact us today to schedule a same-day sick appointment or virtual telehealth visit, so your child can start feeling better soon.
