The stomach flu in babies: What to do about vomiting and diarrhea

What do you do when your baby is vomiting and has diarrhea? Unfortunately, along with the many upper respiratory viruses that hit during the cold weather months, the stomach “flu” may also make an appearance. (A stomach virus is not actually the flu because it’s not caused by the influenza virus, but many people refer to it as the stomach flu anyway.) Of course, certain intestinal illnesses also appear during the summer as well. These viruses are not fussy about the weather!

If vomiting and diarrhea strike your infant, the most important action is to contact your doctor first. There are other diseases that can cause vomiting and diarrhea in a baby beside a stomach virus, so most likely your pediatrician will want you to bring him or her in for a visit. Babies can have vomiting, diarrhea, or both because of ear infections, colds, metabolic problems, meningitis, intestinal obstruction, urinary tract infection, and a myriad of other afflictions, so don’t assume the vomiting or diarrhea is from a stomach bug.

Your pediatrician will take a history to find out if others in the household are sick with a similar illness, whether fever is present, how long the symptoms have been going on, and what other symptoms the baby has, such as loss of appetite, nasal congestion, ear pulling, or fussiness. She will want to know how many times your baby has vomited, whether he or she has been able to keep any fluids down, when he or she last had a wet diaper, how many bowel movements your baby has had, whether there was any blood in the stool, and whether the baby has traveled anywhere recently.

The doctor will then examine your baby for signs of dehydration and other possible illnesses. She will check your baby from head to toe, looking for irritability, listlessness, a bulging soft spot, a rock hard stomach, a mass in the abdomen, chest congestion, dryness of the mouth, an inability to produce tears, and red, infected eardrums. The doctor will also evaluate your baby’s overall responsiveness.

If, in fact, your baby has a simple stomach virus, the goal is to keep him or her hydrated until the virus passes. This can be done by what we call oral rehydration therapy. This starts with small frequent sips of a drink such as Pedialyte. The trick is not to let the baby drink too much at one time since the stomach is still irritable. Every ten or fifteen minutes, the baby can have another sip or two until the vomiting seems to be stopping. Solids are not helpful. Once the baby is taking down several ounces of Pedialyte without vomiting, you may be able to resume formula or breast milk, but go slowly.

There is no good treatment for diarrhea in babies. The once popular BRAT diet treatment—consisting of banana, rice cereal, applesauce, and toast—is no longer thought to be necessary. Check with your doctor about when your baby is well enough to start on solids. Once your baby has gotten that OK, then you can introduce small amounts of the foods he or she normally eats. Diarrhea in infants can last a long time—sometimes as long as two weeks. It’s important to be sure he is urinating regularly even while he has diarrhea. This is a sign that he is not dehydrated.

Stomach bugs are high maintenance for families and usually require increased of use of the washer and dryer, not to mention rags and a mop. But, at least now you know what to do until the virus passes.

One other thing: Wash your hands often to keep from getting the bug yourself!

Has your household been plagued by a stomach bug? What did you do?

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

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