The most common cause of vomiting and diarrhea is a virus, although diarrhea may be seen almost any time a child is taking antibiotics. Vomiting and diarrhea may occur separately or together. Often vomiting will precede the diarrhea, and there may be fever during the initial stages of either vomiting or diarrhea.

The treatment of vomiting takes priority over the treatment of diarrhea. When your child has gone more than four hours without vomiting, then we can concentrate on the diarrhea.

Vomiting is the forceful ejection of a large portion of the stomach's contents through the mouth. The mechanism is strong stomach contractions against a closed stomach outlet. By contrast, regurgitation or reflux is the effortless spitting up of several mouthfuls of stomach contents in children under age 15 months.

Most vomiting is caused by viral infections of the stomach or eating something which disagrees with your child. Vomiting is often associated with or followed by diarrhea.

Vomiting or dry heaving will usually stop in 6-24 hours. Dietary changes usually speed recovery. Coughing spells, which lead to gagging, motion sickness and regurgitation often cause vomiting.

Call our office for vomiting IMMEDIATELY if

• Your child has not urinated in more than eight hours;
• Crying produces no tears;
• Any blood appears in the vomited material AND the blood is not from a recent nosebleed or cut in the mouth;
• Any abdominal pain has persisted for more than four hours;
• Your child has vomited clear fluids more than three times AND has passed three or more diarrhea stools
• Your child is lethargic;
• Your child's neck is stiff;
• The abdomen was recently injured;
• Poisoning from a plant, bad food, medicine or chemical is present;
• A foreign object was choked on; or
• Your child is acting very sick.

Home care for vomiting in babies and children

The most common mistake made by anxious parents in the treatment of vomiting is to give their child as much clear fluid as he wants, rather than giving him sips and slowly increasing the amount. Large volumes of fluid almost always lead to more vomiting.

If your child has a fever, consider Tylenol suppositories.

Home care for vomiting in babies ages 6-12 months

• Avoid ALL solids until 4 hours have passed without any vomiting.
• Give oral rehydration solutions - such as or Pedialyte - only for the first eight hours. Please be in touch with the office.
• The amount of clear liquids to give your child is one teaspoon to one tablespoon every 5-10 minutes. Any more than this, even if the child is thirsty and will drink more, will distend the stomach, which is already upset, and cause your child to vomit again.
• After 4 hours have passed without vomiting, start with foods like applesauce, strained bananas or rice cereal mixed with water. If your baby takes formula, give one or two ounces less than normal per feeding. On breast-fed babies, try to give shorter, more frequent breast feedings.
• Usually your child will be back on a normal diet within 24 hours if diarrhea is not present.

Home care for vomiting in children age 1 and older

• Avoid all solids for at least 4 hours.
• Give clear liquids, such as Pedialyte, flat soda, syrup from canned fruit. Stir carbonated soft drinks until no fizz remains and add a pinch of sugar. Avoid diet soft drinks.
• You may also use weak tea with sugar or Kool-Aid. Choose a flavor your child likes. Try to avoid red food coloring since it can pass into the stool & mimic blood.
• Start giving clear liquids by giving one teaspoon to one tablespoon every 5-10 minutes. Any more than this, even if the child is thirsty and will drink more, will distend the stomach, which is already upset, and cause the child to vomit again.
• If your child vomits using this small amount, rest the stomach for one hour then try again.
• After 4 hours without vomiting your child can gradually return to a normal diet. Start with foods like saltines, honey on white bread (do not feed honey to children under age 1), bland soups, like chicken with stars, rice, mashed potatoes, etc. Other bland foods include eggs, noodles, chicken, potatoes and pancakes. Usually, your child will be back on a normal diet within 24 hours if diarrhea is not present.

Diarrhea is the sudden increase in the frequency and looseness of bowel movements. The best indicator of the severity of diarrhea is its frequency. Mild diarrhea is the passage of a few loose or mushy stools. Moderate diarrhea gives many watery stools. A green stool points to the very rapid passage of a stool; it does not mean that a serious infection is present. Intestinal viruses are the usual cause of diarrhea. If your child passes only one or two loose stools, it may not be of concern. Since one loose stool may not be significant, don't start dietary changes until there have been at least two loose or mushy stools. Diarrhea lasts from several days to a week. The main goal of therapy is to prevent dehydration (excessive water loss). Give enough oral liquids to keep up with the fluids lost in the diarrhea. Don't expect a quick return to a solid stool. Unfortunately, there is no effective, safe drug that cures diarrhea. Dietary changes are the mainstay of home treatment for diarrhea. The best diet for your child depends on your child's age and the severity of diarrhea.

Call our office for diarrhea IMMEDIATELY if:

• Your child has not urinated in more than eight hours;
• Crying produces no tears;
• His mouth is dry rather than moist;
• Any blood appears in the diarrhea;
• Severe abdominal cramps are present;
• More than eight diarrhea stools have occurred in the last eight hours;
• Diarrhea is watery AND your child has vomited clear fluids more than three times; or
• Your child is acting very sick.

Call our office for diarrhea if:

• Mucus or pus is present in the stools;
• Diarrhea has caused loss of bowel control in a toilet-trained child;
• Your child was exposed to someone whom you know has a bacterial or protozoan diarrhea (dysentery, giardiasis, salmonella);
• Abdominal cramps come and go for more than 12 hours;
• A fever over 100° F has been present for more than 72 hours;
• Your child is on any medicines that could cause diarrhea, like antibiotics;
• Diarrhea has been present for more than one week; or
• Diarrhea is a recurrent problem for your child.

Home care for mild diarrhea in child ages 0-24 months

• Usually continue a normal diet.
• If your baby is on solids, offer bland foods such as rice, potatoes, applesauce, toast, chicken or pasta. Try to feed at longer intervals, since food will probably stimulate a bowel movement.
• Diarrhea is contagious, so wash your hands after changing a diaper or using the toilet. This is crucial for keeping everyone in the family from getting diarrhea.
• The diaper area can become irritated from diarrhea. To help prevent diaper rash, protect the skin with a thick layer of a barrier cream, such as A and D or Desitin. This protection is especially useful during naps or at night. Changing the diaper quickly also helps. Try to discontinue using disposable wipes and switch to a paper towel with warm water.

Home care for mild diarrhea in children age 2 and older

• For the child who is toilet trained, the approach to treating diarrhea is the same as in an adult; namely eat a bland diet-bananas, rice, applesauce, toast, chicken, pasta or pancakes.
• Avoid raw vegetables like beans and onions, bran products, spicy foods and any food that normally gives your child loose bowel movements.
• Increase the intake of clear liquids, such as flat soda, white grape juice, or Pedialyte.
• Reduce the intake of milk and milk products. You can use Lactaid products, soy milk, or rice milk.
• Your child may resume a normal diet once the diarrhea stops for one day. Again try to feed larger amounts frequently.

Home care for moderate diarrhea (many watery stools) in children ages 0-12 months

• We recommend using one of the special clear liquids or oral rehydration solutions available in your supermarket or drugstore, such as Pedialyte.
• Until you buy one of these solutions you may use Gatorade or JELL-O water. Mix Gatorade with an equal amount of water. Mix JELL-O with twice as much water as it says on the package so it doesn't jell. Don't use red JELL-O because it can be confused with blood if the red pigment passes into the stool.
• After being on clear liquids for 6-24 hours your baby will be hungry, so begin a soy formula like Isomil or Isomil DF (diarrhea formula), or return to the regular formula if the diarrhea has not been prolonged. There is much less diarrhea with soy formulas than with cow's milk formulas because they don't contain milk sugar (lactose). Plan on keeping your child on soy formula for 1-2 weeks. Isomil DF (diarrhea formula) is sometimes used initially for 7-10 days only. Again feeding larger amounts less frequently is helpful.

Home care for moderate diarrhea in children age 1 and older

• Use Pedialyte, Gatorade, cola or ginger ale (remove carbonation by stirring), decaffeinated tea with sugar, JELL-O, popsicles or water ice. DO NOT GIVE YOUR CHILD MILK PRODUCTS OR FRUIT JUICE.
• Babies over age 1 year may use Lactaid milk (100%).