Caring for a Child with Diarrhoea and Vomiting at Home

Most children with infectious diarrhoea, also called gastroenteritis, can be safely managed at home with appropriate advice and support.

Children at increased risk of dehydration include those

• Less than six months of age (particularly if they were born prematurely or weighed less than 2.5 kg at birth)
• Who have passed more than five large watery stools in the previous 24 hours
• Who have vomited more than twice in the previous 24 hours
• Who have persistently refused fluids
• With a pre-existing condition that causes poor weight gain.

The following symptoms may indicate dehydration

• Appearing to get more unwell
• Changing responsiveness (for example, irritability, tiredness)
• Decreased urine output
• Pale or mottled skin (red or purple spots on any part of the body)
• Cold arms and/or legs.

If your child develops any of the above signs you should contact your GP (or Kingfisher Ward if your child regularly attends Kingfisher ward or has recently been discharged from Kingfisher Ward).

For children who are not dehydrated and are not at increased risk of dehydration

• Continue usual feeds, including breast or other milk feeds
• Encourage the child to drink plenty of fluids
• Discourage the drinking of fruit juices and fizzy drinks (drinks with high amounts of sugar will make the diarrhoea worse).

For children who are not dehydrated but who are at increased risk of dehydration

• Continue usual feeds, including breast or other milk feeds
• Encourage the child to drink plenty of fluids
• Discourage the drinking of fruit juices and fizzy drinks (drinks with high amounts of sugar will make the diarrhoea worse)
• Offer ‘Oral Rehydration Solution’ (ORS), such as Dioralyte™ (available from your local pharmacy) as supplemental fluid. 5ml of solution for each kg your child weighs, or about __ ml after each loose watery stool.

For children with dehydration

Rehydration is usually possible with ‘Oral Rehydration Solution’ (ORS).

• Make up the ORS according to the instructions on the packaging
• Give your child ORS in small amounts and very frequently. For example, give 2ml of solution for each kg your child weighs (about __) every 10 minutes for the first four hours or so, and then reassess your child’s progress
• Seek advice if the child refuses to drink the ORS or vomits persistently
• Breastfeeding may continue.

After rehydration

• Encourage your child to drink plenty of their usual fluids, including milk feeds
• Avoid giving fruit juices and fizzy drinks until the diarrhoea has stopped (drinks with high amounts of sugar will make the diarrhoea worse).
• Reintroduce your child’s usual diet
• Give 5ml of ORS for each kg your child weighs after each large watery stool if you feel that your child is at increased risk of dehydration.

General advice

• Washing hands with soap (liquid soap if possible) under warm running water and careful drying are the most important factors in preventing the
  spread of diarrhoea. Please visit ‘Henry the Hand’ (www.henrythehand.com) for more information about hand hygiene
• Hands should always be washed after going to the toilet (children and parents) or after changing nappies (parents/carers) and before preparing,
  serving or eating food
• Towels used by infected children should not be shared
• Children should not attend school or childcare facilities while they have diarrhoea or vomiting to prevent the spread of gastroenteritis
• Children should not go back to their school or childcare facility until at least 48 hours after the last episode of diarrhoea or vomiting
• Children should not swim in swimming pools for two weeks after the last episode of diarrhoea.

How long can gastroenteritis last?

The usual duration of diarrhoea is five to seven days and in most children it stops within two weeks.

The usual duration of vomiting is one or two days and in most children it stops within three days.

Seek medical advice if your child’s symptoms do not resolve within these time frames.

For further information

For further information about diarrhoea, please visit the Wessex Healthier Together website at: www.what0-18.nhs.uk/parents-and-carers/worried-your-child-unwell/diarrhoea-and-vomiting/

About this leaflet

Author: Dr Julie Doherty, Paediatric Consultant & Deputy Medical Director
Written: November 2004, April 2007, October 2008, May 2009, June 2012,
November 2014, May 2017.
Approved: July 2018
Review date: July 2021
Edition: Version 8

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk