Gastroenteritis in children

Key points to remember about gastroenteritis

If your baby is less than 6 months old and has vomiting or diarrhoea you should contact your doctor urgently. Babies can become dehydrated quickly.

1. Gastroenteritis is a bowel infection causing diarrhoea, and sometimes vomiting.
2. Diarrhoea means runny, watery poo.
3. Children need to drink plenty of fluids if they have gastro.
4. Give small amounts of fluid often.
5. Gastro can cause dehydration, especially in babies and young children.
6. Watch for signs of dehydration (such as dry lips, fewer wet nappies, sunken eyes, unusual sleepiness) and contact your doctor urgently if you suspect it.
7. If your baby is less than 6 months old and has vomiting and/or diarrhoea you should contact your doctor urgently - babies can become dehydrated and unwell quickly.

What is gastroenteritis?

Gastroenteritis is a bowel infection which causes diarrhoea (runny, watery poo, hamuti) and sometimes vomiting.

What causes gastroenteritis?

A virus usually causes gastro. Common viruses are rotavirus and adenovirus but there are many others. Because there are many viruses that cause it, your child can get gastro more than once.

Infants younger than 15 weeks of age can have rotavirus immunisation free of charge. This protects against one of the most common causes of gastro. Read about rotavirus immunisation.

Sometimes bacteria can cause gastro but this is much less common. This can cause blood in the poo.

How do children catch the gastroenteritis virus?

A child can catch the virus when they:

• touch something which has been in contact with the diarrhoea or vomit of a person with the infection, and
• they put their hand in their mouth.

The virus is easily spread in homes, day care, kindergartens and schools.

How long does gastroenteritis usually last?

The vomiting may settle quickly but the diarrhoea often lasts for up to 10 days. This doesn't matter as long as your child is drinking well and seems to be improving.

What puts my child at risk of getting gastroenteritis?

Gastro affects all age groups, but is more common, and can be worse, in babies and young children.

What are the signs and symptoms of gastroenteritis?

The most common symptoms are:

• feeling sick (nausea)
• diarrhoea (runny, watery poo)
• vomiting

Sometimes a child with gastro will also have:

• a fever
• tummy pains

Image credit: Canva

How can I care for my child with gastroenteritis at home?

If your child is over 6 months old and has mild gastro and is not dehydrated, you can care for them at home. The main treatment is to keep giving your child fluids. Whichever fluids your child is having, the important thing is to:

• Offer small amounts of fluid often rather than giving large amounts – aim for a quarter of a cup every 15 minutes or 1 teaspoon or 5 mLs in a syringe every minute.
• Keep offering your child fluids even if they are vomiting.

Types of fluids

• If you are breastfeeding, continue to feed on demand - you may need to feed more frequently and take extra fluid.
• If your child is on formula, continue to give them formula feeds.
• If your child is over 1 year, you may give them cow's milk.

You may also give your child the following drinks as long as they are not dehydrated. You need to dilute the drinks with water as they contain too much sugar (which can make the diarrhoea worse).

• Apple juice – mix 1 part juice to 1 part water.
• Cordial – make up to normal drinking strength then add 1 part of water to 1 part of made up cordial.
• Soup – add 1 part of water to 1 part of soup.
• Fizzy drinks such as lemonade – add 1 part of warm water to 1 part of drink (warm water removes the bubbles).

Your doctor or pharmacist may recommend electrolyte solutions such as Gastrolyte or Pedialyte if your child is dehydrated. You can buy these from your pharmacist – follow the instructions on the packet. Read about electrolyte solutions (also called oral rehydration solution).

What drinks should I avoid giving my child with gastroenteritis?

Do not give infants or children/tamariki with diarrhoea:

• undiluted soft drinks, fruit juices, Lucozade, Ribena, sports drinks (such as Powerade or Gatorade) – these contain too much sugar and can make your child's diarrhoea worse
• coffee and tea – these can make your child dehydrated.

Should I keep giving my child their normal food if they have gastroenteritis?

• You can offer your child food if they are hungry, even if diarrhoea continues.
• Continuing to feed your child can speed up recovery and can reduce the length of time your child has diarrhoea.
• Your child may refuse food at first - this is not a problem as long as they take fluids.
• If possible, do not stop giving food for more than 24 hours.
• Starchy simple foods are best - try and offer foods such as bread or toast, porridge, rice, potatoes, plain biscuits, yoghurt, milk pudding.

What foods should I avoid giving my child with gastroenteritis?

Do not give your child fatty or sugary foods such as:

• takeaways
• chippies, sweets, cakes, chocolate, ice cream, cream, coconut cream.

Will my child need any medicines for gastroenteritis?

Do not give your child medicines to reduce diarrhoea. They do not work and may be harmful.

Your doctor may occasionally prescribe a medicine for vomiting. Follow your doctor's instructions.

You can't treat viral gastro with antibiotics. The body will clear out the virus on its own without treatment.

What can I do for my baby's sore bottom from diarrhoea?

Diarrhoea can cause a rash. After each bowel motion, wash and dry your child's bottom well and then put on a protective cream or ointment (such as zinc and castor oil cream or Vaseline).

How can I tell if my child is dehydrated from vomiting and diarrhoea?

Watch for signs of dehydration – the younger the child, the easier it is for them to become dehydrated.

Dehydration is the loss of fluid, due to vomiting and diarrhoea. The younger the child, the easier it is for them to become dehydrated.

Watch for signs of dehydration:

• Dry mouth and tongue.
• Sunken eyes.
• Cold hands and feet.
• Unusual sleepiness or lack of energy.
• Fewer wet nappies or not passing as much urine as usual.

If your child has any of these signs, you need to contact a doctor urgently.

When should I seek help for my child with gastroenteritis?

You should contact your doctor or after hours medical centre urgently if:

• Your child has vomiting and/or diarrhoea and is less than 6 months old – babies can become dehydrated and unwell quickly.
• Your child is drowsy and difficult to rouse.
• Your child has a lot of diarrhoea (8 to 10 watery motions in 1 day).
• There is blood or mucus in your child's poo.
• Vomiting is increasing or your child cannot keep fluids down.
• Your child starts vomiting green fluid (bile).
• Your child develops severe stomach pains.
• Your child shows signs of dehydration.
• You are concerned for any other reason.

You should contact your doctor if your child's diarrhoea continues for more than 10 days.

Dial 111 within Aotearoa New Zealand for urgent medical help (use the appropriate emergency number in other countries) if you are very concerned about your child.

How can I help prevent the spread of gastroenteritis?

Gastro spreads very easily to others. There are ways to help prevent spreading the disease.

Thorough handwashing

Handwashing is especially important after going to the toilet, after nappy changing and before handling food. Encourage your child to wash and dry their hands after using the toilet.

Cleaning toilet and bathroom areas

It is a good idea to thoroughly clean your toilet and bathroom areas.

Washing dirty clothes

Wash your child's dirty clothing, in hot water preferably, and rinse separately from the rest of the family laundry.

Avoiding sharing food and drinks

Make sure your child doesn't share food or drinks with anyone else.

Keep them away from others

Keep your child away from friends and other children until vomiting and diarrhoea have stopped. Children with diarrhoea must stay away from day care, kindergarten and school until there has been no diarrhoea for 48 hours.

Learn more

Gastroenteritis Kidshealth, NZ
Rotavirus Immunisation Advisory Centre, NZ