Stomach viruses are common in childhood. Usually, the virus comes on strong, then goes away over the next few days. But about 2 million children every year become very sick with stomach viruses and need medical care.

“Knowing what to do can help your child get better more quickly. It can also decrease the chances that your child might need emergency care,” says Dr. Christopher Saenz, a pediatrician in Steiner Ranch. “Many parents are still using old-fashioned remedies, which can delay a child’s recovery.”

The Best Drinks

Give oral rehydration solution (ORS). When a child has vomiting or diarrhea, he loses both fluid and important electrolytes. The CDC says all families should have a supply of commercial ORS on hand and start therapy as soon as diarrhea begins. ORS drinks are available over the counter. Some examples are Pedialyte, Infalyte and ReVital. These drinks contain glucose and electrolytes to replace what the child is losing.

What about sports drinks? Some experts advise against sports drinks, such as Gatorade, because they have too much sugar and inappropriate electrolyte levels. “On the other hand,” says Dr. Saenz, “if your child is older than 2 years and doesn’t like the taste of ORS, Gatorade is an acceptable alternative.”

“Before you give liquids, wait for about an hour after vomiting to allow your child’s stomach to rest,” advises Dr. Saenz. “Then give about a teaspoon every 5 minutes or so over the next hour or two. As your child improves, you can slowly advance the diet.”

The CDC says giving ORS early helps reduce visits to the doctor’s office, clinic or emergency department. ORS doesn’t “cure” vomiting and diarrhea; it helps prevent dehydration, which can be very serious in children. Watch for signs of dehydration (see sidebar) and contact your pediatrician if you are worried.

Avoid sugary drinks and Jell-o. The CDC says foods high in simple sugars can make diarrhea worse. They advise parents to avoid giving large amounts of:
Carbonated soft drinks
Fruit juice
Gelatin desserts
Other highly sugared liquids

Don’t Withhold Food

The most important thing in managing a stomach virus is to replace fluid losses and make sure your child has adequate nutrition for recovery. The practice of withholding food for longer than 24 hours is inappropriate, according to the CDC. Early feeding helps reduce the length of the illness and improves nutritional outcomes. Try to see that your child gets increased nutrition after an episode of diarrhea.

“Giving good bacteria, such as the probiotics in yogurt, will help shorten the illness,” adds Dr. Saenz.

For babies, offer more frequent breast or bottle feedings. Don’t withhold milk products or dilute formula.

Forget the BRAT diet. Many of us have been told the BRAT diet is best for a child with vomiting or diarrhea. The BRAT diet limits food choices to Bananas, Rice, Applesauce and Toast. But experts—including the American Academy of Pediatrics—now agree that these foods alone don’t provide enough nutrition. Offer a well-rounded diet of complex carbohydrates (rice, potatoes, bread), lean meats, yogurt, fruits and vegetables.

When to Get Medical Help

Children can become dehydrated quickly. Babies and young children are especially at risk. Watch for signs of dehydration (see sidebar) and contact a healthcare provider immediately if your child has any of these signs. The CDC recommends that a child with diarrhea be evaluated by a healthcare provider if the child:

Is younger than 6 months old or weighs less than about 18 pounds
Was born prematurely
Has a chronic medical condition or had another illness before the diarrhea started
Has fever
Has blood in the stool
Is having frequent and substantial amounts of diarrhea
Has vomiting that won’t stop
May be dehydrated (see sidebar)
Has a change in typical behavior, such as being unusually drowsy or lethargic.
Signs of Dehydration in Infants and Young Children
Dry mouth and tongue
No tears (or few tears) when crying
Less urine than usual; no wet diapers or trips to the bathroom in 6 hours
Unusually cranky
Unusually drowsy or lethargic
Sunken eyes or soft spot

Brenda Schoolfield is a freelance medical writer in Austin.

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