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Microsoft word - vomiting and diarrhea.doc

Southpointe Pediatrics
Vomiting and Diarrhea
Simple vomiting or spitting up in young infants generally means little, but if vomited material spurts out a distance of two to three feet, it could indicate a serious intestinal problem especially in infants under two months of age. There is no significance or concern if some emesis comes out the nose. Vomiting more than 2-3 times a day is a common symptom of illness in children. Diarrhea is defined as having 4 or more liquid stools per day. Kaopectate, Imodium and other antidiarrheal drugs are not recommended for children. Dietary management is usually sufficient for treatment of diarrhea. Vomiting and diarrhea can be dangerous. Vomiting and diarrhea can drain water and salts from your child. If these are not appropriately replaced your child can become dehydrated and may need to be hospitalized. To protect your child you should follow the following steps: 1.) **Breast fed: Wait at least 2 hours after the last vomiting episode to feed again. It is advisable to nurse more frequently with shorter feedings. Continue to breast feed since it is easily digested.
**Bottle fed: Wait 2-3 hours after the last vomiting episode to give an oral electrolyte solution (PEDIALYTE) in small
amounts, starting with 1-2 teaspoonfuls. If this volume stays down increase the volume to 2-3 teaspoonfuls in 15 minutes.
Continue to increase the amount given slowly attempting to give 4 ounces per hour by small feedings every 15-20 minutes. If
the infant vomits, wait 2 hours and start again. DO NOT GIVE JUICE, SODA OR SPORTS DRINK.
After 8 hours formula may be restarted. You may use your baby’s normal formula or use Isomil DF, which is specially
formulated to be used when an infant has diarrhea. (Do not use Isomil DF for more than 7 days before returning to the baby’s
normal formula.) Start with small amounts, ½ to 1 ounce, given more frequently to gradually work back up to your infant’s
normal feeding routine. If you infant is normally eating cereal, you can also start feeding this again in small amounts.
**Follow the guidelines for infants less than 6 months but you may also give small amounts of food that your infant is already
eating, like bananas, crackers, baby foods, etc. after your child has gone 8 hours without vomiting.
**Wait at least 2 hours after the last vomiting episode before trying any liquid. Then give 1 teaspoonful of an electrolyte
solution such as Pedialyte. If that is not available you can give Gatorade, ginger ale, or 7-Up. (Avoid fruit juices and Kool-
Aid). If this stays down 15 minutes give increasing amounts every 15-20 minutes aiming to give 4-8 ounces per hour. Three
to four hours after the last episode of emesis you may begin crackers, pretzels, dry toast, and unsweetened cereals in small
amounts. Provided there hasn’t been any vomiting for 8 hours, you may start advancing the diet to include all fruits,
vegetables, rice, potatoes, bread, lean meats and yogurt (especially those with live cultures). Don’t force your child to eat, but
don’t limit them to only fluids if it has been over 8 hours without vomiting and they are ready to eat. Avoid fatty foods, greasy
foods and spicy foods for 2 to 3 days. Do not continue a brat diet for more than a few days. The sooner your child returns to a
regular diet the faster the diarrhea will resolve. THE GOAL IS TO HAVE THE CHILD RETURN TO A NORMAL
Remember the following for any age: **Increase the diet slowly; the stomach needs time to rest. **Appetites normally decrease when children are ill. **Children will lose weight with this illness, but will make it up quickly after the illness subsides. 4. SIGNS OF DEHYDRATION: **Not urinating at least once every 8 hours during awakening hours **Sunken eyes **No tears when child cries **Dry tongue and mouth 5. CALL THE OFFICE IF: A. Infant less than six months old with vomiting longer than 8 hours. B. Infant 6-12 months old vomiting longer than 12 hours. C. Child greater than 1 years old vomiting over 24 hours. G. Diarrhea stools are greater than 4 per day for 1 week.



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