Diarrhoea and / or Vomiting
(Gastroenteritis) - Advice for parents and carers of children.
When should you worry?
RED
If your child has any of the following:
- Has dark green or blood stained vomit
- Breathing very fast, too breathless to talk, eat or drink
- Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
- Breathing that stops or pauses
- Is pale, blue, mottled or feels unusually cold to touch
- Difficult to wake up, very sleepy or confused
- Weak, high-pitched cry or can’t be settled
- Has a fit (seizure)
- Has a rash that does not disappear with pressure (the ‘Glass Test’)
- Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red or amber features
You need urgent help.
Please phone 999 or go to the nearest Hospital Emergency (A&E) Department.
AMBER
If your child has any of the following
- Has blood in their poo or wee
- Has tummy pain that doesn’t go away for more than 1 day even after paracetamol or ibuprofen
- Is vomiting and unable to keep down any fluids
- Is drinking or breastfeeding much less than normal
- Breathing a bit faster than normal or working a bit harder to breathe
- Dry skin, lips or tongue
- Not had a wee or wet nappy in last 8 hours
- Poor feeding in babies (less than half of their usual amount)
- Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
- Is 3-6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
- Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
- Temperature less than 36°C in those over 3 months
- Getting worse and I am still worried
You need to contact a doctor or nurse today.
Please ring your GP surgery or contact NHS 111 - dial 111 or for children aged 5 years and above visit 111.nhs.uk
Green
If none of the above features is present,
- Watch them closely for any change and look out for any red or amber symptoms
- Additional advice is also available for families for help cope with crying in otherwise well babies
- If your child has a long term condition or disability and you are worried please contact your regular team or follow any plans that they have given you.
Self care
Using the advice below you can provide the care your child needs at home.
Advice and Guidance
Self care and Prevention
How can I look after my child?
- Avoiding dehydration and low blood sugar is important – give your baby/child extra fluids and make sure that they contain sugar. In the hospital, diluted apple juice is often used. To make this, simply mix half apple juice and half water (50/50). Please give this between feeds or after each watery stool. Little and often works best – in hospital babies and young children are given 1 or 2 tablespoons (5-10ml) of apple juice to drink every 5-10 minutes. You can try using a syringe to give fluids to your child.
- Continue to offer your child their usual feeds, including breast and other milk feeds.
- Do not worry if your child is not interested in solid food. If they are hungry, offer them plain food such as biscuits, bread, pasta or rice. It is advisable not to give them fizzy drinks as this can make diarrhoea worse.
- Your child may have stomach cramps; if simple painkillers such as paracetamol and ibuprofen do not help please seek further advice.
- Most children with diarrhoea and / or vomiting get better very quickly, but some children can get worse. You need to regularly check your child and follow the advice given to you by your healthcare professional and / or as listed on this sheet
About Gastroenteritis
- Tummy bugs are extremely common in young children and are almost always caused by a virus.
- They are easily spread, resulting in outbreaks in nurseries and schools.
- Diarrhoea can often last between 5 – 7 days and stops within 2 weeks. Vomiting usually stops within 3 days. If your child continues to be ill for longer than these periods, seek advice.
- Severe diarrhoea and / or vomiting can lead to dehydration, which is when the body does not have enough water or the right balance of salts to carry out its normal functions. If the dehydration becomes severe it can be dangerous.
- Children at increased risk of dehydration include:
- young babies under 1 year old (and especially the under 6 months)
- babies born at a low birth weight and those who have stopped drinking or breastfeeding during the illness
- children with faltering growth
After Care
Once your child is rehydrated and no longer vomiting:
- continue breastfeeding, other milk feeds and fluid intake - give full strength milk straight away.
- reintroduce the child’s usual food.
- avoid giving fizzy drinks until the diarrhoea has stopped
- if dehydration recurs, start giving ORS again
- anti-diarrhoeal medicines (also called antimotility drugs) should not be given to children
- your child cannot return to nursery / school until 48 hours after the last episode of diarrhoea and / or vomiting
Preventing the spread of Gastroenteritis (diarrhoea and / or vomiting):
Your Child should:
You and/or your child should wash your hands with soap (liquid if possible) in warm running water and then dry them carefully:
- After going to the toilet
- After changing nappies
- Before touching food
Your child should not:
- Share his or her towels with anyone
- Go to school or any other childcare facility until 48 hours after the last episode of diarrhoea and / or vomiting
- Swim in swimming pools until 2 weeks after the diarrhoea has stopped
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