Diarrhoea and Vomiting (gastroenteritis)

Diarrhoea and vomiting (gastroenteritis) is usually caused by a virus infection. It generally gets better on its own after 3-5 days. There may be a fever in the beginning.

Is gastroenteritis dangerous?  

The danger of gastro is dehydration. If you can prevent this by making sure the baby or child drinks enough, the illness will get better on it’s own.

How do I treat gastroenteritis?

• Fluid replacement is the most important thing. If your baby is breastfeeding or formula feeding, try smaller feeds more frequently. If baby vomits milk, use rehydration solution (Rehidrat, Hydrol and many others) from the chemist, since this contains the water, salt and sugar the baby is losing in the stool. Again, small frequent amounts of fluid (use a syringe or medicine measure if you have to) are less likely to be vomited out.
• Probiotic drops help the diarrhoea to settle.
• Zinc suspension (Smart Zinc or Zinplex) also helps the diarrhoea.
• Paracetamol (Panado/Calpol syrup or Empaped suppositories) will help if there’s a fever. Bringing the temperature down may also reduce vomiting.
• Barrier cream (Fissan/Bepanthen and many others) frequently and generously applied will help to prevent nappy rash.

What about antibiotics?

Most gastro is viral and doesn’t need antibiotic treatment.

Anti-diarrhoeals?

Diarrhoea medicines like Imodium can have serious side effects in children under 2 years and should not be used. They may have a place in the treatment of older children.

Anti-nausea medicines?

These medicines, particularly cyclizine (Valoid) and prochlorperazine (Stemetil) also cause severe side effects in young children and shouldn’t be use under 2 years. Ondansetron (Zofer/Zofran) may be used carefully by doctors in hospital or the ER.

Flat Coke or Rooibos tea?

Not ideal, but better than nothing. Add a half teaspoon of salt to 1 litre of flat Coke, and both a half teaspoon of salt and 6 teaspoons of sugar to 1 litre of rooibos tea.

When should I worry?

• vomiting all fluids, even little sips, or refusing all fluid – this child will dehydrate and may need to be admitted on a drip.
• signs of dehydration – sunken eyes and fontanelle (soft spot), dry mouth, no wet nappies, skin stays up when gently pinched. Child needs to be seen by a doctor.
• signs of a severe illness – high fever, drowsiness, irritability, very bloated stomach, severe stomach pain.
• blood in the stool – may need antibiotics
• chronic diarrhoea – if the diarrhoea goes on for more than a week, the child may need tests and other treatment.

If you are not sure whether your child is taking in enough fluid, have the child checked by a doctor.