Diarrhea and vomiting are among the most common complaints in childhood. They are usually caused by viral gastroenteritis (stomach flu) and resolve on their own within a few days. However, the real danger — especially in young children — is dehydration, which can develop rapidly. This guide explains what you can do at home and when to seek emergency care.
Common Causes
- Viral infections (70-80%): Rotavirus, norovirus, adenovirus. Usually accompanied by fever and abdominal pain.
- Bacterial infections: Salmonella, Campylobacter, E. coli — suspect when diarrhea is bloody or mucous.
- Food poisoning: Sudden-onset vomiting and diarrhea 2-6 hours after eating.
- Parasites: Such as Giardia — prolonged watery diarrhea.
- Antibiotic use: Can cause diarrhea by disrupting gut flora.
Recognizing Dehydration
Mild Dehydration
- Dry mouth and lips
- Less urine than normal (fewer than 1 wet diaper in 6 hours)
- Mild fussiness
Moderate-Severe Dehydration (EMERGENCY)
- No tears when crying
- Sunken eyes; in infants, sunken fontanelle
- No urine for 8+ hours
- Excessive drowsiness or irritability
- Skin that stays pinched (loss of skin turgor)
- Cold, mottled hands and feet
Home Fluid Therapy
ORS (Oral Rehydration Solution)
Pharmacy ORS packets are the safest option. Use low-osmolality ORS as recommended by the WHO.
- If vomiting: Give 5 ml (one teaspoon) every 5 minutes. If no vomiting for 15-20 minutes, slowly increase.
- After each watery stool: Under 6 months: 50-100 ml; 6mo-2yr: 100-200 ml; over 2yr: 200-400 ml ORS.
Feeding
- Breastfed babies: Continue breastfeeding, give ORS in addition
- Formula-fed babies: Continue normal formula (do not dilute)
- Older children: Early return to normal diet is encouraged — avoid fatty, sugary, spicy foods
What NOT to Give
- Fruit juice, cola, carbonated drinks
- Homemade salt-sugar water (wrong ratios can be dangerous)
- Anti-diarrheal drugs without doctor's advice (loperamide is contraindicated in children)
Preventing Spread
- Frequent handwashing (at least 20 seconds with soap)
- Separate towels, cups, and utensils for the sick child
- Wash soiled laundry in hot water
- Keep child home 48 hours after symptoms stop
Rotavirus Vaccine
Rotavirus is the most common cause of severe gastroenteritis in children under 5. The oral rotavirus vaccine (given at 2-4-6 months) is 85-98% effective and nearly eliminates severe cases. Discuss with your doctor.
When to Go to the ER
- Baby under 3 months with diarrhea or vomiting
- No urine for 8+ hours
- No tears when crying, sunken eyes
- Bloody or green vomit
- Bloody or mucous diarrhea
- Severe abdominal pain
- High fever (above 39°C/102°F) not responding to treatment
- Excessive drowsiness, unresponsiveness
- Cannot tolerate ORS (vomits every time)
- Symptoms lasting more than 5 days
Most gastroenteritis cases can be successfully managed at home. The key is early and adequate fluid replacement. When in doubt, call our clinic — we'll evaluate together.
