Wednesday, January 19, 2011

Vomiting and Diarrhea - the Dreaded Stomach Bug

“I need to spit up!”  declares my three-year old.  

Hearing these words (which are code for I’m about to vomit right now), I launch myself off the couch, leap across dangerous obstacles composed of toys and books  to get across the living room to scoop him up off our off-white carpet.  Then running like mad cupping my hand strategically below his mouth, I repeat over and over, “Wait wait wait!  Throw up in the potty, not on the floor!  You’re okay, you’re okay!”  

And then, a few inches from our target destination of the bathroom toilet, he throws up.  Oh well… at least it’s easier to clean here.

The holiday season this year brought my family many presents… including a stomach virus.  I got it and my kids got it (my husband kept thinking he was getting it –but managed to avoid it).  Many people have unfortunately fallen prey to stomach viruses this year.  You or your family members may have been through it, too.   If so, I’m so sorry – I know how horrible it can be.   Luckily, it tends to go away in a few days leaving most of us wiped out, but okay.

Children are smaller and have less ability to tolerate vomiting and diarrhea compared to adults.  Therefore, they get dehydrated much quicker than grownups do. 

If your child is vomiting or having diarrhea, it is of utmost importance that your child stays hydrated.  Food or solids are not important while your child is vomiting.

Sometimes vomiting or diarrhea can be a symptom of a more serious illness. 

If you see any of the following, you should call your doctor:
  1. Projectile or forceful vomiting
  2. Blood in the vomit or diarrhea
  3. Severe stomach pain
  4. Fevers>104 F
  5. No improvement in vomiting in 24 hrs
  6. Persistent diarrhea more than 10 days
  7. Prolonged diarrhea after finishing antibiotic use.
  8. Your baby is less than four months old and is having vomiting or diarrhea
  9. Pain with urination or more frequent urination
  10. Severe headaches
  11. Drinking frequently
  12. Symptoms other than just vomiting or diarrhea
To help your child get through it, try the following:

For vomiting, give your child small sips of clear fluids that have electrolytes (such as Pedialyte).  If your child refuses to drink or is unable to keep fluids down, use a medicine syringe and squirt small amounts into his/her mouth every five minutes.  Your child needs to urinate at least three times a day.  If your child has not urinated for more than eight hours or is lethargic or can’t keep anything down, call your doctor immediately. 

Do not give milk or heavy foods, such as dairy or fried foods.  These are likely to come back up.  If your child wants to eat, give small amounts of bland foods such as crackers, toast or plain cereal.  Foods with lots of liquid are also good – such as popsicles, soup, and jello.

If your child has not thrown up for at least 12 hours, it is reasonable to try slowly advancing his/her diet.  Again, avoid heavy foods for the best chance of success.

For diarrhea (and no vomiting), give your child the BRAT diet (bananas, rice, applesauce and toast) to help firm up stools.  Lactose can be difficult to digest with diarrhea, so using a lactose-free milk or soy milk/formula temporarily may help with symptoms.

Probiotics are also useful for combating diarrhea.   Probiotics are the healthy bacteria that help to keep our digestive system healthy.  If your child is not vomiting, then eating yogurt is one way to get probiotics.  Many pharmacies and grocery stores carry probiotics in various forms that kids can eat  – granules for infants and toddlers, chewable tablets for young children, and capsules for older children and adults.

To prevent spreading the virus to others, wash your hands frequently!  The viral particles are in the vomit and the stool.  Wash your hands frequently and use antibacterial soaps and surface cleaners.  Make sure that other children do not share utensils, cups and food with the sick child.

Oh wait,  I think I hear something. 

“Mommy!  I need to spit up!”  Uh oh, gotta run… here we go again! 

Stay healthy, and thanks for reading!

113 comments:

  1. The timing of this blog is perfect! My son and his entire daycare are dealing with this bug right now. I have found this very helpful and encouraging as I am trying to avoid dehydration in my little man. Thank you for sharing your experiences and knowledge!

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  2. Thank you for this post. It really feels good to hear it from a mom/pediatrician. My question is he has both of those symptoms, and does not have the serious symptoms you said, so is it safe not to go to the doctor? I can't afford the visit and prescriptions. I hate to ask, because any mother should take their child regardless, but honestly, my insurance has HIGH deductibles.

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    1. So, sorry to hear that your son is sick! Most of the time it is safe to treat vomiting and diarrhea at home as long as your child can keep fluids down. If he is lethargic, not peeing at least three times a day, or has any of those symptoms I listed above that might indicate a more serious illness, you should take him to a doctor. If he has been sick for more than two days and is still vomiting, you should take him to be seen. If he seems to be getting better, and is drinking fluids, you can probably treat him at home just fine. If your child is very young (under age 2), call your doctor to make sure it's okay to treat at home. Good luck and hope he gets better soon!

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    2. Yay! He's not showing any of those symptoms, so I think we're in the clear. One other question, the vomitting started Monday, diarrhea Tuesday, and neither one today (Wednesday). I plan to keep him home one extra day without symoptoms, and was wondering if it would be safe for him to go back to school on Friday?

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    3. Great to hear that he's doing better! He should be okay to go back to school if he has not had vomiting or diarrhea or fever for 24 hrs. Be sure to make sure that he is drinking plenty of fluids to stay hydrated as he recovers! Take it slow when re-introducing foods. Avoid fatty or greasy foods since those foods can sometimes trigger vomiting again. Take care!

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  3. Dr Sandy hope you get this I could really use the help like the previous mother insurance costs right now are to high for me. I took my daughter to the er last night and they were really no help. My daughter caught what I thought was a stomach bug 10 days ago. First night vomiting second night vomiting and diarrhea note severe diarrhea all day but vomiting is only happening at night. Urinalysis was fine and so was her stomach xray we are on day 10 she hardly eats I am getting fluid in her. But she complains of severe abdominal pain. Please help. Is there anything more I can do at home? I'm not sure I can find this page again please email me if you can jenniferotto92@gmail.com

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    1. It was suppose to say now she has had severe diarrhea for 10 days ask day even accidents in her pants thank you again

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    2. Hi, Jennifer,

      So sorry to hear that she is still so sick! Most viral stomach bugs get better after a few days. I would recommend that you take her to a pediatrician who can send stool studies and look for causes of prolonged diarrhea. Some viruses can cause diarrhea for up to 2 weeks. However, diarrhea can also be caused by bacterial infections. Her severe stomach pain makes me concerned that there may be more to it. If she is vomiting again, having worsening pain, fever, blood in her stool, or shows symptoms of dehydration, you need to take her back to an Emergency Room immediately.

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  4. The dreaded “stomach flu” that hits particularly hard in winter is not a flu at all. It is norovirus, green diarrhea causes

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  5. Hi Dr. Sandy,
    My daughter vomitted in the middle of the night of Monday or early Tuesday morning with diarrhea no fever, then when she woke up she was completely fine but I kept her from school and activities that day. Since she was fine I sent her back to school on Wednesday, and she was great until late Friday evening at 11:30 pm and vomitted and had diarrhea for about 3 hours no other symptoms. Then when she woke up she was fine all day Saturday and sunday until this early Monday morning at around 12am and was sick for almost 3 hours with vomitting and diarrhea. I've had stomach bug before but it 's never been as inconsistent as this. Does that still sound like a stomach bug or do you think it sounds like something else? Thanks!

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  6. Sorry to hear that she is still sick. Since it has been so long between each episode, you should take her in to be seen by her doctor. While it still may be viral, it would be important to rule out other causes of vomiting and diarrhea. Good luck and hope she feels better soon!

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  7. Dr. Sandy-

    My 2 year old son has had vomiting and diarrhea on and off for the last 3 weeks plus. No Fever. He drinks more then the average child but has been that way for the last 6 months! I keep not taking him to the doc because he will seem fine for 2-3 days, with just loose stool but then back to vomiting and diarrhea. I called my doc today and I am taking him in inthe morning. She has requested that we get an abdominal xray done today before he goes in, so we are going tonight. What is the reason for the xray? Do I need to be worried that this is something more than a simple "bug"?

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    1. I'm sorry to be late in replying to your message since I was traveling and did not have access to the Internet. Most likely your doctor was looking for signs of blockage or gut dysfunction.. There are rarer causes of recurrent vomiting which can sometimes be identified by Xray, or other tests such as a CT scan or an upper GI test. Your physician should decide if these types of test are needed based on your child's symptoms. I hope that everything turned out okay for your child. By the way, if your child drinks a lot and is vomiting, I would strongly recommend if it has not already been done that your doctor check your child's blood sugar level to rule out diabetes. I hope he gets better soon!

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  8. Hi Dr! My daughter started having diarrhea thursday night for a little bit, but I thought it was because of her eating two mozzarella cheese strings. Friday when I came home from work she was laying around. I woke her up, and she ran to the bathroom with diarrhea. She comes back sits up and vomits everywhere!! Do u think its a stomach bug, or something else? Also, how soon is to soon to reintroduce solid foods.. She told me shes starving,but I told her its still to soon. I've been giving her ginger ale.. To keep her hydrated, and to keep her tummy settled. Thxs!

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  9. Hi, Nikeshia,
    Sorry to hear that your daughter is sick! Please take a look at what I wrote in my blog post for what to do when your child has thrown up. Solid food is not very important right now. Keeping her hydrated is much more important, preferably with an electrolyte solution like Pedialyte for school aged children or younger. Unfortunately, I cannot tell you if your daughter has a stomach bug since I have not seen and examined her. If you see any of the warning signs I have listed in the blog, please call your doctor or take her in to a medical facility to be seen. Hope she gets better soon!

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  10. hi DR SANDY MY NIECE HAS BEEN VOMITING NONSTOP AT NIGHT BUT IN THE MORNING ITS FINE AND SHE JUST HAD diarrhea THIS PAST FEW DAYS NON STOP WHAT SHOULD WE DO ?

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    1. I'm sorry that your niece is not feeling well. If the vomiting has been going on for more than one night, please take her in to the doctor. She may be dehydrated and she may need more tests to see why she is still vomiting. I hope she feels better soon!

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  11. Hi Dr Sandy.
    My 8 year old son has been getting sick at night (vomiting every 2-3 days for about 10 days now). He had had a couple of episodes of diarrhea mixed in there during yhr day, but has also had a few formed bowel movements. He is absolutely fine during the day and has never had a fever. It seems like when we start going off the BRAT diet that is when he vomits at night/ early morning. I have called his padiatrician and she said it is most likely a virus that could take up 2 two weeks to pass. I guess I will take him in yo see her in the morning but am at my wits end with this since everytime we think he is over it he throws up at night! Andly advice would be appreciated.

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  12. Hi, Todd,

    Hopefully your son is nearing the end of this. Sometimes it can take several days for the body to recover enough to handle a normal diet. It's a good idea to go to see your child's doctor today to make sure there is no other cause. If he does not improve in the next few days with a bland diet and lots of clear fluids, then you may want to take him to the emergency room to get some other studies done. If he appears sicker or has any of the warning signs I've listed, call your doctor immediately. Good luck!

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  13. Thanks for the reply Dr. Sandy. His pediatrician put him on probiotics (florastor) and said to keep with the BRAT diet for 3-4 days straight even if he seems fine. If that still doesn't stop the symptoms then she wants to see him again to run some tests. But she thinks it us still the bug in him and said it sometimes takes 2 weeks to get tis of. Does that sound right?

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  14. While I have not has the benefit of examining your son, the plan recommended by your son's pediatrician seems reasonable as long as his exam was normal. It is true that some viruses can cause symptoms, especially diarrhea, up to 2 weeks. However, prolonged vomiting is more unusual. If he doesn't improve when you restart the bland diet and clear fluids like Pedialyte or diluted Gatorade, then I would recommend going back to the doctor sooner to rule other causes of vomiting. Hope this helps!

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    1. Oh we will, the interesting thing is that the vomiting only happens after being asleep for several hours and has incurred every 2-3 days or so. Never on back to back nights and he acts absolutely normal and says he feels great during the day. Just really bizarre. His last bowel movement was no longer diarrhea but loose. Lets see how tonight goes. Fingers ate crossed. Thanks again for the replys.

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    2. well,you aren't alone. My daughter (9) is experiencing the same thing as Todds child. This has been going on off and on since spring break. We are going to the doctor today but I can't imagine he will know what is going on either. It is so strange and is starting to scare me

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    3. Hi, Christina,

      If your child has been vomiting off and on since Spring Break (which I assume was in March or April), then it is very unlikely to be a stomach virus at this point. It will be important for your daughter to see the doctor to see if any additional testing or imaging is needed. Sometimes gastroesophageal reflux will show up in older children this way and can be diagnoses with an upper GI study. Reflux does not usually come with diarrhea though. So if she is having diarrhea like Todd's child, then there may be another cause. Best of luck and hope she feels better soon!

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    4. After 2.5 weeks being symptom free...the throwing up came back early yesterday morning and again this morning. Going to his Pediatrician today to hopefully start the process of getting answers and testing done. I have no idea what is causing this but its not normal...

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  15. My son was diagnosed with acid reflux. He is now on Zantac. Lets hope this works

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  16. Hopefully that will help! If it does not help, it may be worth seeing a pediatric gastroenterologist or getting a test done to confirm the diagnosis of reflux such as an upper GI test. Best of luck!

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  17. Hi. My 3 yr old daughter has had diarrhea for a week and has thrown up about 4 times during the week. She will say her tummy hurts when she has to go potty or throw up, but other wise says she is fine. She plays but has slightly less of an appetite. She hasn't had a fever. Is this just a bug?

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  18. Hi, Molly,

    I'm sorry to hear that your daughter is ill. If she does not have a fever, is no longer vomiting, does not have blood in her stool, is drinking well, and is peeing at least 3-4 times a day, then it is reasonable to give her plenty of fluids with electrolytes (like Pedialyte) and a bland diet (the BRAT diet - bananas, rice, applesauce, toast can help diarrhea). If she is still vomiting or if the diarrhea does not get better in a few days, she should see the doctor. If she has blood in her stool, is acting sick, or is not peeing, she needs to see the doctor immediately. You may want to give her probiotics (like Culturelle for Kids) since that can help the diarrhea to improve. Hope she gets better soon!

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  19. Hi doctor,
    My 5 1/2yr old brought stomach bug from school last Monday and me,my 2year and 10mnth old daughters also got it..boy had vomiting only 2-3 times,but diarrhea is still there(3-4 times/day esp aftr food)even after taking diosmectite 3g,and loperamide after every loose stool for almost a week now.my 2 year old is had very heavy vomiting and reduced after taking 4stemetil 5mg suppositories..its 5th day now and after 10 suppositories,she still vomits if I stop medication.i give her Loperamide and diosmectite also.but sickness is still there,reduced a bit ..that's all....i am giving Pro-biotics to them too.my baby is really tired and she is not peeing.but her motion is watery,hardest part is she drins only milk..please help

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  20. Hi,
    In the U.S, we do not recommend using these medications for children. It may be different in your country. However, your baby needs to go to the hospital for I.V. fluids immediately. Your other children should also see the doctor to see if anything else needs to be done. Good luck and I hope everyone feels better soon!

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  21. Hi my son started vomiting nearly 4weeks ago for an entire week. The following week he had diarrhea. He was ok last week but has tonight vomited and had diarrhea all day. His stool sample was taken but came back as nothin growing in it. When he vomited tonight the was an unusual red round thing in it. (reminded me of a tonsil or a gland) I'm not sure what else to do. Help please

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  22. I would recommend that you take your child for immediate medical care. Bring the object or at least a photo of it so that they can try to determine what it is and if it is related to his illness. Good luck!

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  23. Very glad to read your blog.Thank you for sharing this article.It is great! I will keep your article in my idea. Very happy reading. TOSHIBA PVM-375AT

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  24. So my 6 month old vomited (projectile) 2 times Sunday and ran a mini fever of 99. On Monday she didn't really vomit. On tuesday she Vomited before even making it through the first bottle. I took her to the Dr and she was given a probiotic and some Zofran for nausea and I was told to only give pedialyte until wednesday morning. I did and she seemed better. Wednesday no vomit but diarrhea started that night and then again thursday morning (like complete blow outs)! Thursday she held down all bottles until about 8pm then she Vomited again! Help...please this is driving me crazy. She seems fine and is extremely happy after she vomits. The Dr said if she vomits through the night to bring her in the morning to possibly do an ultrasound.

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    1. So sorry your baby is sick. While it is likely she has a stomach virus (fever, vomiting and diarrhea), there are some more unusual possible reasons why infants vomit repeatedly. Typically we will look for these conditions (like pyloric stenosis) if the baby vomits every feeding, especially if projectile. You should follow your doctor's recommendations. If there isn't a sign of something more (repeated vomiting, fever again, blood in stool or vomit, pain, decreased wet diapers, lethargy or unconsoloable fussiness, and so on), then it is likely that she just needs Pedialyte for another day so her stomach can rest and recover. Hope she feels better soon!

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  25. My 5 y/o went to visit her grandparents over Thanksgivng break. That Sunday when she was supposed to come back, she woke up with a 101 fever and was vomiting. She got to a point where she refused to drink and wasn't peeing, so my in-laws took her to urgent care who sent her to the ER for fluids. She came home the next morning feeling absolutely fine and was able to return to school in Tuesday. 8 days later, this past Wednesday, she was completely fine until after dinner. 30 min after dinner She had just finished eating dessert (orange sherbet) and immediately complained of a stomach ache. She doesn't seem to be all that regular so my husband and I thought maybe she had to poop. While getting her situated, she vomited instead. She continued vomiting once every hour or so from about 7pm to 1:30am. She woke up acting and feeling fine yesterday morning, ate her toast and soup throughout the day. Around dinner she said she had a stomach ache again but ate dinner fine. She slept all night and woke up the next morning ready for school. She acted fine when she got off the bus, but right before dinner she said her tummy wasn't feeling right. Is this par for the course for a stomach bug? Dinner the night this started was tacos with a seasoning we have never used before and it definitely had more bite than we were used to. I had been thinking maybe that didn't agree with her, but would she still be feeling it two days later?

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    1. She has not had a fever this go round.

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    2. Sorry your daughter is not feeling well. Since she had so many days between her two episodes, it is possible that these are two different illnesses. If she continues to not feel well, I would recommend seeing her doctor to see of this is more than just viral. Hope she feels better soon!

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  26. My 17 month old has had a cold for about a week, then last night when we got home from spending some family time, he had diarrhea but was fine, still had an appetite and was his happy normal self, but at 2 am woke up screaming and he had a ton of vomit in his crib, he only vomited once, I gave him half a zofran tablet and it's been well out of his system, but he is still having diarrhea, no other episodes of vomiting and still no fever. To top it off I am 38 and a half weeks pregnant and have a 3 year old also, and suffer from sever emetaphobia. Does this seem like a virus even though he's only vomited once and can eat and drink without vomiting again, or does it sound cold related? Thanks!

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    1. Goodness! You certainly have your hands full. I remember when I was pregnant and had 3 kids under the age of 5 years. It was not much fun when viruses hit our household! It is very likely that your 17 month old has diarrhea related to a virus. It may or may not be the same one causing the cold symptoms. However if there is fever at this point, recurrent vomiting, severe pain, blood in the stool, or worsening sx, I would recommend seeing his doctor. In general, viral diarrhea can last several days, so make sure that he is drinking plenty of fluids and is still making a minimum of 3 wet diapers a day. Wash your hands and the children's hands well since viruses are contagious. If the diarrhea does not improve, it may not be viral and needs to be evaluated by a doctor. Good luck!

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    2. Can it still be a virus even though he only vomited once and has had no fever at all? He also has been biting on his hands a lot as if he is teething but I always hear different opinions on what teething symptoms cause exactly. It is exhausting being this pregnant with two little ones but an absolute blessing as well!

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  27. Yes. It can still be viral since he has diarrhea. Often children will only have the diarrhea part of the stomach bug and not have the vomiting portion at all. Everyone can have different symptoms and different severity with the same virus. Teething can cause loose stools, but not usually vomiting. Again, if he develops a fever or is not improving, you should take him in to make sure he does not have another cause. Take care!

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  28. Hi Dr Sandy.

    I'm going to sound extremely
    Sad but I am a big emetophobe and hypochondriac and was hoping you could help me. I visited my mum/niece Tuesday evening and left around 2pm Wednesday afternoon. That evening around 1130 my niece was up vomiting. They took her to hospital and they said it was more than likely a bug. She stopped being sick Thursday morning and now has diarrhoea. My question is because we were in contact with my niece before symptoms occurred, ive heard you can still be contagious before any symptoms show, do you think it's likely we will get the virus? We are away from that household now and I don't plan to go there till its gone but I'm such a worrier the worrying is making me ill in watching my daughter like a hawk incase she vomits. I know you can't predict if we will get sick but is that the way the virus works? Thanks, Gemma

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    1. It is very understandable to be worried when you know that your child may have been exposed to an illness. For some viruses, it is true that a person can shed virus and be contagious before showing symptoms. Most viruses that cause stomach illness are much more contagious once the person has started showing symptoms. However, it is possible to shed some virus before any symptoms appear. The virus is in the stool and the vomit. The virus can also live on surfaces such as counters and can be transmitted through contaminated food and water. The incubation period is 1-3 days. So if you all are healthy after 3 days, you made it! Good luck!

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  29. Thank you so much. My daughter seems fine is eating normally and playing normally. I'm just the worrier and panicker! You've put my mind a bit more at ease, whilst we are not clear yet at least we are almost through a day with no symptoms. Fingers crossed!

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  30. This comment has been removed by the author.

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  31. So sorry to hear that you are getting sick. If I read your post correctly, this is only happening on Mondays? If you are truly fine on all of the other days of the week, then it may be something that you are being exposed to only on Sundays (which leads you being sick on Mondays), or something that is triggering your symptoms on Mondays (such as a stressor happening at school). If you are not well on the other days, you should see your doctor. If it is only on Mondays and doesn't get better, then you should also see your doctor to help figure out what is wrong. If you have severe stomach pain, fevers, blood in your diarrhea or vomit, then you need to see someone immediately. Hope you feel better soon!

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  32. My son is 4 years old and I gavehim 4 milligrams of ondansetron but he spit it up on The floor. Is it ok to give him another one when I see that the dry heaving and vomiting has slowed down?

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  33. My son is 4 years old and I gavehim 4 milligrams of ondansetron but he spit it up on The floor. Is it ok to give him another one when I see that the dry heaving and vomiting has slowed down?

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  34. Children will often throw up or spit out medications especially if they don't like the taste. In general you should not repeat a dose unless your child vomited the entire dose immediately. If it was not immediate or if part of the dose stayed down, it is better to wait until it is time for the next dose since you don't know how much stayed down.

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  35. Hi sandy my 4 year old I t thought had s bug as she couldn't keep anything down on thurs. had Low key day fri ate a little. Back to herself on Sat but vomited Sat night , then again Sunday night . Bright and full of beans during the day. No other symptoms . Is this a normal pattern of a tummy bug?

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  36. There can be many ways that the stomach virus can show up. Often, the vomiting can persist if a child starts to eat a normal diet too soon. If this is her case, go back to giving her clear fluids (Pedialyte, water, soups, popsicles) and only bland foods (crackers, toast, etc). If she has not vomited again in 12-24 hours, then you can start advancing her diet. If she still starts vomiting again, then she needs to see her doctor. Hope this helps!

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  37. Hi Sandy, I've read through all the responses, but am just beside myself about my 18 month
    Old baby girl. I was out of the country 2 weeks ago (Tuesday) and she got sick. Throwing up and diarrhea. Wednesday she was still a bit sick but no throw up, still a bit of diarrhea. No more throw up until Sunday night in her car seat picking me up at the airport. No diarrhea. The next day, the tiniest bit of upchuck, but only in the car seat. She got a cold/cough with fever on Thursday, of the 2nd week. Started getting better then here we are 2 Sunday's later and she lost her whole stomach in the car seat again on the 45 min car ride home from my dads house. What do you think? She seems fine now, under the weather from her cough/cold, and I'm sure throwing up, but she has a regular 18 month checkup on Wednesday (it's Sunday).

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    1. So sorry to hear that she is still sick! I would strongly recommend that you take her to the doctor sooner instead of waiting for your well visit. With her fever last week, it sounds like something more than just a stomach virus. It may just be another virus, but with her having ongoing symptoms and being young, she should be checked by a doctor. Hope she gets better soon!

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  38. Hi, just read thru everyones comments. Just wanted advice. My 3 year old boy was sick last night during sleeping. After an 8 hour sleep he was fine then sick again this morning. (Which was green but stomach was obviously empty from the previous vomiting episode). He slept on and off all day and ate some crisps and a yogurt and sipped heavily diluted juice throughout the day. After 12 hours of no sickness he has now been sick again. He says he has a sore tummy but does not seem in severe pain as he only mentions it if I ask how it is. He has no dihorreah. (No bowel movement since wed). His face was red earlier and he felt warm so loosened his covers. He is now back to trying to sleep it off. Does this sound like a normal bug type illness that will pass itself? I was just concerned about the long gaps between the few sickness episodes. Thanks in advance for any advice. Laura.

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  39. Sorry your son is not feeling well. It would be reasonable to expect that he is still in the first phase of the stomach bug (usually 24 hours of vomiting). The frequency of the vomiting can vary considerably. As long as he can keep hydrated and does not have any of the warning signs described in my original blog post, then it should be fine. If he continues to have off and on vomiting for more than 48 hours, I would recommend taking him in to be checking by a doctor. Hope he feels better quickly!

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    1. Hi Sandy, thank u so much for ur reply. He was sick again this morning then again tonight. I called our out of hours doctor tonight but they sed as he is not in severe pain or dehydrayed etc just to monitor it.Seems to be only morning and night he is sick.. he is very lethargic and napping during the day but no actual sickness then as of yet. I jst wondered can a viral type thing really work this way with the vomiting at only certain times of the day? Is there a specific reason for that? Thank u so much in advance. I am one tired exhausted mum! (Also mum to a 6 week old daughter!) Laura

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    2. Vomiting can happen any time of the day. It can be triggered by eating or drinking, but it can occur in an empty stomach as well. Keep him hydrated with clear fluids and if he continues to vomit despite doing that, he should be checked out by a doctor. Good luck!

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  40. Advice please! My son has been waking up in the early morning hours (it is 3am now) and vomiting like monthly. This has been happening for several months now. It is not a nightly, or even weekly thing. Sometimes he will go for a month and only do it once, other times it may happen 2 times in a week. He has no other symptoms, and is always fine the next morning. I am very worried about what could be causing this, especially at such a varied time frame. I am going to take him to his pediatrician, but would love any advice in the mean time, or ideas as to what may be going on. Barbara

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    1. Hi, Barbara,

      Since he is vomiting only sporadically, it may be harder to identify the cause. If you haven't already, keep a log of what he ate and drank from dinnertime onwards on the nights he vomits. Also his activities those evenings. Sometimes food allergies or sensitivities can show up this way. Or if he has mild gastroesophageal reflux, it can be made worse with high acid foods (like tomato sauce, citrus, chocolate), or by overeating. Hope that helps!

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  41. My daughter has been fine through out the day, not wanting to eat as much due to teething but still drinking lots of fluids. Then out of nowhere sits up in bed and throws up ? It was 5 am when this happened and was almost 6:30am when it stopped, a quarter to 7am she was able to fall asleep.what would cause this ? She is 2 yrs old she has never thrown up before this.

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  42. Children vomit for different reasons. She may be coming down with a stomach virus, or had eaten something the night before that is causing her vomit, or may be getting sick. Some examples include vomiting if they have a fever, or the flu, or an ear infection. If your child continues to have vomiting or gets other symptoms, you may want to take her into her doctor to be evaluated.

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  43. My 3 year old has been vomiting every night in between 12 am an 5 am, he has had diarhha for about 2 weeks now.. It all started April 1 and he had a fever of 104 for 3 days not throwing up or diarhia at that point. He was fine for 3 days after that then on the 6 he started only throwing up between the hours of 12 am an 5 am, he hasn't been eating anything really since the 1 of April.. I've been to the hostipal and doctor and they keep telling me it is just a virus but I don't think it is I'm not sure what to do anymore it's now April 28 and no one has answered for me or wil refer me to a ped doctor .. Do you have any idea what could be causeing this ? He has also had extrem diarhia for the past 2 weeks

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  44. After two weeks, it is less likely to be a viral illness. It would be reasonable to send the stool for testing to look for bacterial causes of infection such as salmonella, Clostridium difficile, or others. For some infections, no additional treatment is needed, but at least you would know the cause. For some infections, there are medications that are given. If there is blood in his stool or vomit, he needs to be checked more urgently. If there is no blood, he should be seen by someone who can send off the appropriate testing. You should be able to search online for a pediatrician if you do not know of one. Even if you live in an area where there are no pediatricians, a family physician, urgent care, or ER could send stools for these tests. They will need a relatively fresh sample, so if he is using diapers/pull ups still, then save a recent one and bring it to your appointment. Hope that helps!

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  45. Is it normal for vomiting to last a week or more after a stomach virus or food poisoning? My two year old got violently ill a day after returning from Disneyland (vomiting every 45 minutes). We've been to the ER three times and to his regular pediatrician and all seem to think he's clinically okay, just recovering from either food poisoning or a virus. My husband also got extremely sick about 24 hours after my son, but so far myself and my 5 month old have not been sick (fingers crossed)... I'm just worried that my son is still vomiting once or twice per day, and now has diarrhea, and is just sill very weak and low energy. Is this typical for food poisoning or a virus? I've had stomach viruses before but none have last more than 2 or 3 days, so I'm starting to suspect food poisoning instead of something viral. Thanks so much in advance for any input!

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  46. If the vomiting is lasting more than 48 hours, then either the body has an ongoing infection or your child may be trying to eat or drink normal foods too soon. If after 24 hours of clear fluids and bland diet (crackers, toast, cereal, etC), he still has vomiting, then he should probably be tested for bacteria in his stool that include ones from food poisoning (such as salmonella). Hope he feels better soon!

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  47. 2.5 year old has been vomiting sporadically for a few days with no other symptoms for almost a week normally one time each day. She acts fine before and after vomiting and continues to eat normally. There is undigested food in her vomit and it's not projectile. She has now developed a cold with congestion and is now having vomiting episodes of mucus.

    Went to Peditrican today and she thinks it could be a stomach virus. Prescribed anti-vomit medication and told me to monitor it.

    What's your advice

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  48. Sorry to hear that your child is sick. Since she has other symptoms now, is able to drink and eat, and does not have a fever, it is reasonable to wait and see if this is viral. If she does not improve in a week or has more symptoms, like fever, worsening vomiting, severe pain, or signs of dehydration, she should be see her doctor again. Hope she gets better soon!

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  49. Thanks for much for the advice. I really appreciated it.

    Update: For the past week and half she's been really congested. She has continued to have some sporadic vomiting. However, it has been mainly mucus or mucus and food. Today, she vomited again after eating too much food.

    Note: Her appetite has been great and behavior before and after and during the day is amazing. She seems to have gotten a lot better from the congestion.

    Do you think this could still be a part of the viral infection or something else? Should I be concerned at this point or give it more time?

    Thanks again your advice is greatly appreciated.

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  50. I forgot mention the vomit today seemed from not chewing properly. When the food came back up it was whole not chewed. Almost as if she was just swallowing it whole.

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    1. It could be part of a viral illness if she is congested, however if she is not getting better soon, you should take her to the doctor to be checked. Vomiting of mucous after coughing is a common symptom for children. However most viral illnesses last 7-14 days. If she is not improving, she should be evaluated. Hope she gets better soon!

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    2. I really appreciate the advice you've provided to me so far. Another update: I've taken my daughter for follow up a couple of weeks ago to Pediatrician and she referred us to a GI. She still believes that is should be of no concern since she's acting fine, eats well and not exhibiting any other symptoms.

      She still vomits randomly. She actually went one week without vomiting and I thought it was done but it started again. She's now vomiting 1-2 times a week only one episode each time.

      I went to GI last week and he said since she's appears so healthy otherwise to give it more time and he didn't feel it was necessary to run any tests as he wasn't too concerned with random vomiting episodes. He said even if it happens for another month as long as there aren't any other symptoms don't be too concerned.

      What are your thoughts? Should I continue to worry? I hate that she has to go through this.

      Thanks again for your invaluable advice!!!

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    3. It sounds like you have several physicians involved in her care. There are some children who vomit easily and I would agree that for now if she seems otherwise fine, is gaining weight well, and has no other symptoms, that it is reasonable to wait to see if she stops doing it soon. If she continues to vomit sporadically, it is worth tracking her diet to see if there are any specific triggers (foods, spices, etc) that may be causing her to vomit. Best of luck!

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    4. If you have a family history of migraines, it could be abdominal migraines. Typically, the vomiting occurs late night to early morning hours. My son did this for years. He'd vomit once or twice screaming in pain but after he was done acted perfectly fine.

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  51. Hi sandy my daughter has gi bug 10 days ago but on and off ever since complains that her tummy is hot what could this be?

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  52. Sorry that your child is not completely better. If she does not have fever, vomiting, constipation or diarrhea, is eating and drinking and acting normally otherwise, then it is unlikely that her complaint is anything to be concerned about. If she is not eating or drinking or acting normally otherwise, then you may want to take her into her doctor to have her checked. Hope she gets better soon!

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  53. Hi ma'am, 10 days ago my son woke up in the morning with diarrhea. Was like that for 2 days, threw up one night, in between, but was improving. He was better for 2 days then the diarrhea started again. But what worries me is that in the middle of the night he wakes up to throw up what he ate during the day. In the past 7 days this has been happening we're he did not threw up only for days. He has been eating properly and drinking lots of water. Know The diarrhea happens in in the middle of the night and 2 times a day. What do you think. Can it still be a bug?

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  54. So sorry that your child is ill. You may want to try giving him clear fluids (Pedialyte, soup, jello, water) and only a bland diet (starchy foods, like crackers, toast, plain rice) and see if he can make it through the night without vomiting. If so, then it may just be that his body is not quite ready for a normal diet just yet. After he has not vomited for 24 hours, then try to resume a more normal diet very gradually. As long as he is not dehydrated, vomiting blood or having bloody diarrhea, running fevers, having severe pain, or acting lethargic or very sick, then it is reasonable to try this. However if any of the warning symptoms (see blog post) occur, he needs to see a doctor. Best of luck!

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  55. Hi doc
    My daughter is going to be 3 in june... she has been having diarrhoea since tuesday night only at night! She is perfectly fine during the day and eats normally as well...SHe did vomit once during friday night.... it is now saturday night and the pooh at night continues to be foul smelling yellow and watery. This happens twice during night with no fever! Should I be concerned and contact my doctor?

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  56. Sorry to hear that your child is not feeling well. If she continues to have vomiting, or the diarrhea is not improving in the next 24-48 hrs, or if there is blood in the stool, or fever, then you should seek the help of a doctor. You may want to change her diet to be a bland diet (simple starchy foods like crackers, toast) and clear fluids (with electrolytes) until she is no longer vomiting. Keep her hydrated and if she doesn't improve in 24-48 hrs, she should be seen by a doctor.

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  57. Hello, my 7 yo son threw up once tonight right after eating a slice of watermelon and having a large drink, he said he ate too much and his stomach hurt and went to have a bowel movement (which was normal, not diarrhea), and then threw up right after. He said he felt much better afterwards and seemed to be acting normal, said he feels fine. It's been about an hour and a half and he's been asleep with no more episodes - is it likely just due to too much fluid? He is not a kid who typically throws up easily, in fact he's only done it a few times in his life, once from stomach flu, and other times from strong coughing. I don't think this is stomach flu but could there be some other causes to be concerned about? Thank you

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  58. Since your son has been vomiting recently, I would recommend that when he is ready to drink and eat again, that you give him clear fluids. No need to have him eat solid food until he has not thrown up for several hours. Even then, stick to bland starchy foods (crackers, toast,etc). It is unlikely that he vomited due to too much fluid. Sometimes children who have gastroesophageal reflux can vomit easily if they have eaten too much, but your son does not have that history based on your post. It is possible that he has a stomach bug or ate something that may have caused this to happen. If he continues to vomit, has blood in the vomit or stool, high fevers, severe abdominal pain, or is unable to keep anything down, he should see a physician. Hope he gets better soon!

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  59. My 5 year old son has been displaying unusual symptoms. He randomly has vomited over the past 4 days, averaging about once a day. Today he had diarrhea about 5 or 6 times. For the most part, he acts completely fine, playing with his big brother. He has had a loss of appetite but has held most of his food down. He has no fever. He DOES have an easy gag reflux. He has gone to the bathroom several times but the feeling of vomiting goes away and he goes right back to playing. Could this be a virus or something else?

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  60. Since he has both vomiting and diarrhea, it is possible that it is a viral infection. You may want to try giving him clear fluids and a bland diet (starchy foods, avoid greasy or heavy foods) for 24 hours, then gradually advance his diet to regular foods once he is no longer vomiting. If there are any of the warning signs (lethargy, blood in stool or vomit, decreased urine production, severe pain, new fevers), he should be seen by a doctor. Hope he gets better soon.

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  61. Dr. Sandy,

    Thank you for being such a caring Dr.who is also a mother and sharing your wisdom with the rest of us. My son is 10 yo and is on day 7 of waking up at his normal time (6am) and going straight to the bathroom because he has diarrhea, stomach pains and nausea. He is vomiting what looks to be stomach bile with no foods in it.
    He has no other symptoms and no fever. He is spending anywhere from an hour to 2 hours in the bathroom upon waking as the diarrhea nausea and vomiting hit him in waves. When it finally dies down, he will be a bit shaky and tired and need to rest. Then, by about 11am, he starts to perk up and says he is hungry and even wants to play legos or watch TV. On day 3, we saw his pediatrician who said it is probably a bug. She gave us probiotic tablets which he has been taking once per day since. The symptoms continued with no improvements.
    Yesterday, day 6, his morning symptoms were much worse so I took him to the ER. His blood work , urine test, and stomach x-ray all came back in the clear. They even said his electrolytes looked good and chose not to run a bag of fluids through him. They sent us home with zofran and said they believe he is getting over a bug.After we left the hospital he was good the rest of the day.

    Yesterday they told me to give him Gatorade so he sipped on it all day. He ate 1 piece of bread with pb on it and a small handful of chips at lunch and for dinner.

    It is Day 7 and he has been in the bathroom with the exact same issues. I gave him a zofran as soon as he woke up but it has not curbed the nausea or vomiting. His stomach hurts and he has diarrhea.

    I am worried there is something else going on since it only happens every morning. Is it possible for it to connected to his heart? Any thoughts or suggestions on where to go from here would be appreciated.

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  62. I am so sorry that he has been sick for so long. It is somewhat reassuring that his lab work and Xray were normal. At this point it may make sense to do some stool tests to see if he has something other than just a virus. If he has fever or blood in his stool or vomit, he should be seen immediately. If he does not, then you should take him back to see his doctor to have stool tests done. Most bacterial infections than can cause prolonged diarrhea will go away on their own, but it would be good to know why he is still sick. Also it can be a public health issue if he got it from eating something that was contaminated. Hope this helps!

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    1. Thank you. I am going to ask them for a stool sample kit. He only vomits every morning when he has the diarrhea. It's not very much and mostly stomach bile but he is wretching and gagging and feeling nauseous. This all happens at 6am on the dot each day and lasts until roughly 8 or 8:30am. Then he is fine. He is so miserable and I am just tired of seeing him this way.

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  63. Hi Dr. Sandy,

    My son vomited on 3 occasions on Thursday, and had one bout of diarrhea. He was sick once Friday morning, fine all day and then sick again Friday night. He has no fever, but has been hungry, so I’ve been feeding him the BRAT diet. Yesterday he had a mostly solid Bowel movement, and Sunday early morning while he was in bed, he got sick again (after no vomit for 32 hours).

    Is this normal for a stomach virus? We saw a Dr. on Friday and they cleared us to fly out of the country this week. But now I’m starting to worry again. What advice do you have for me?

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  64. So sorry to hear he is still sick. As long as there is no fever, severe pain, blood in the stool, or other signs of severe illness, you may want to go back to giving him clear fluids and bland diet for another 12-24 hours. If he vomits again, or develops more symptoms, he should be seen again by his physician. Good luck!

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  65. Hi Dr. Sandy,

    I am hoping you can help me. I have a 5 month old son who has been throwing up and having diarrhea for almost two weeks now. I have taken him to his doctor and to the emergency room twice since it started.

    It started a week after my 5 year old son had gotten sick with diarrhea. He had those symptoms for approximately 2 weeks.

    A week after the five year old started with diarrhea, my 5 month old began having diarrhea and vomiting. He seemed to throw up after every feeding, so I began to give him small amounts of milk at a time to allow it time to settle. I also went out and purchased a soy formula variety hoping it would help him. He still continued to throw up at least 1-2 times daily, especially at night; his diarrhea comes and goes.

    I have been making him an electrolyte drink so he does not get dehydrated. It contains coconut water, lime juice, pink salt, and maple syrup. He seems to be able to drink this and not vomit. I place baby probiotics into one of his bottles daily since he has been sick. I also purchased another formula "Nutramigen" hoping it would alleviate symptoms, but it has not.

    Our first trip to the ER was on Thanksgiving day 11-23-17. He had woken up fine and I believe this was the evening he did not throw up overnight. He has always been happy go lucky throughout this entire ordeal, but he seemed to be a little off that day. I took his temperature using a forehead scanner and it read 99.7F. I took him into the ER because he has not ran a fever before then. At the hospital, they seemed to feel he was ok. They did xrays as a precautionary but those seemed fine as well. They said he may have teething symptoms, then sent us home. His fever got to 100.7 that evening. His vomiting resumed, at least 1-2 times throughout the day and night.

    His second trip to the ER happened on Saturday morning at 1:00am. Friday evening at 10:00pm, he woke up and started vomiting every 10 minutes until we got to the children's hospital about 1:00am. They gave him 1mg of zofran to help, which it did, and they also did a catheter to get a urine sample. They said everything looked fine with his urine, and the medicine helped with his vomiting. He did not seem to be in pain or be dehydrated so they feel it is just a virus.

    We took him back to his pediatrician on Monday, she also said because he is not in pain or dehydrated that he seems fine. She recommended I give him rice water to help alleviate his symptoms.

    I apologize for the long question, I am just nervous that a 5 month old having these symptoms for almost 2 weeks now is weird. I am hoping you may be able to provide an explanation of what may be happening and does this seem normal?

    Thank you for your time,

    Tanya

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    1. Hi, Tanya,
      I'm so sorry to hear that your baby is still vomiting and having diarrhea. If he is still having diarrhea, it may be worth doing some stool tests. If he is only vomiting, he may have some underlying gastroesophageal reflux. However, with his sibling recently being ill and with the baby recently having had a fever, it is a bit more likely to be infectious. While it could be viral, it is starting to get to be a bit long. It would make sense to go back to your pediatrician if he does not improve this week. If you can give an electrolyte solution (such as Pedialyte) as your hydration solution, that would be better than the coconut water solution you described. Rice water does not have all the electrolytes needed. Consider seeing a pediatric gastroenterologist if your pediatrician is unable to find the the reason for your baby's vomiting/diarrhea. Monitor for blood in the vomit or stool, severe pain, or return of the fever. If these occur, he should be seen immediately.

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  66. Hi Dr. Sandy. My daughter, who will turn 3 in February, has been having bouts of diarrhea and vomiting for three weeks. She will wake up vomiting, throw up a few times and then be fine for 3-4 days, before doing the same thing again. Along with this, she has had diarrhea on and off as well. Some days are worse than others, with all her stools being diarrhea. Other days, her stool will be normal and maybe have one episode of diarrhea. Yesterday, for instance, she had no diarrhea, but woke up last night vomiting. Through all of this, she has not had a fever at all, and has acted like a normal kid - playing and trying to eat normally. On days when she is having diarrhea, we keep her on the BRAT diet. At first, we and our doctor thought it was a lingering virus. Now I'm wondering if something else is going on?

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  67. Hi, I am sorry that your daughter has been sick for so long. Three weeks is getting to be rather long for a virus. It would be reasonable to start looking for other causes. Keeping a dietary record would be useful to see if the same types of food, ingredient, or drink are resulting in the vomiting or the diarrhea. Stool studies may also be useful to determine the source. If she has a fever, severe abdominal pain, or blood in her stool or vomit, she should be seen immediately. Good luck!

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  68. Hello Dr. Sandy.

    My son began throwing up around two weeks ago, on the third day he was so lethargic we took him to the ED. They performed blood tests, culture tests, cranial ct's, chest xray, abdominal xray, echocardiogram, just about everything you can think of and found nothing wrong with him. Once he had some fluids in him over the two day period we were there, they sent him home with us. He was still throwing up and he became incredibly boney due to no food for a week and a half. Starting yesterday I began dosing him with Nauzene because I need to at least get some food into him. Within a day of taking the doses he was eating, drinking and energetic again. Should I stop dosing him to let him heal naturally? I'm just worried for him.

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    1. also, they believe it's simply viral gastroenteretisi after they performed a stool and urinalysis test.

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  69. So sorry to hear your son has been ill. He certainly has had a lot of tests that would rule out many significant causes of vomiting. While I am not familiar with the medication you mentioned, as long as it is meant for a child his age, it may be safe to use for a day or two. However I would not recommend using it longer than that without being seen by a physician. Hydration is of utmost importance, and if he is able to drink and is urinating at least three times a day, then that is a good sign. If he is able to eat normally already, you probably do not need to be giving him the medicine anymore. Hope he is better soon!

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  70. Hello! I love your website! Our 11 year old son woke up yesterday morning feeling sick. He didn't vomit until last night. We kept him home from school today and he seemed fine all day. He just started throwing up again...24 hours later. Does that seem normal for a stomach virus?

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  71. Sorry to hear that he is sick. It is possible still to vomit again in the timeframe you described especially if he tried to eat or drink more than his body was ready for. Go back to giving smaller amounts of clear fluid to keep him hydrated and wait 12-24 hours before getting him to try anything more than that. If he vomits the next day despite clear fluids and giving his stomach time to rest, he should be seen. Also if he has any of the more severe symptoms like severe pain, blood in the vomit, high fevers or not urinating at least 3 times a day, he should be seen. Good luck and hope he feels better soon!

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  72. Dr sandy, you are a godsend. I stumbled on this post tonight by accident and I didn’t think you would still be responding to questions but you are! So I’ll ask. My son has been waking at 2am nearly on the dot, for the past three nights, vomiting. He then will go back to sleep and wake up fine, no fever, no more vomiting all day. He has been having a diaper blow out or two the next day but then that’s it...until 2am the next night. We took him to the dr a few days ago and she said his ears and chest were clear...though he has been having a wet sounding cough. Is this vomiting just a biproduct of the cough? Or is it viral because of the diarrhea? Should I take him back to the dr or can we ride this out with fluids and BRAT food? I’d hate to pay the large copay again for them to tell me it’s just a cold virus again. Thanks.

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  76. I'm sorry to hear that your child is ill. I'm not sure how old your child is based on your post, but assuming he is an older infant/toddler, then here is some general advice. Yes, when young babies or young children cough a lot, it can trigger vomiting. Especially when they are lying down, the mucous can pool in the throat which results in more coughing with lying down. Coughing with a lot of mucous in the throat can trigger a gag reflex which results in vomiting of the mucous. So, if your child does not have other symptoms during the day, and definitely has mucous and cough, then it is very possibly that it vomiting related to the mucous in the vomiting and can be normal. If he has more symptoms, such as high fever, signs of dehydration, recurrent vomiting, or blood in the vomit, then he should be seen. Clear fluids can help reduce the amount of mucous if you find that milk products are making it worse. If your baby is very young (under 6 months old), you should have him checked. I hope that helps!

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    1. He turned two in November. The only other symptoms, as I said before, are the diarrhea early in the day...no fever, no lethargy, no rashes, etc. his cough isn’t even that bad, but it sounds very mucousy so I think you’re right on the vomit stemming from that. It’s just weird that it’s almost exactly the same time every night. Would it help to elevate his head (putting a pillow under his mattress) at night?I’ll continue giving him fluids and BRAT foods during the day and hope it passes soon. Thank you for your quick answer.

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    2. Yes, try elevating his head. Also using a humidifier can help. Good luck!

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  80. Dr Sandy, my daughter is 28 months. She seemed to be feeling slightly off on Wed, ate less than usual, was very picky, and didn't drink at all. She puked 4 times between 12 am and 4 am. Thursday-Friday she seemed fine other than a bit of diarrhea on Fri. Fri night she puked around 4 am, then had diarrhea all day Sat, at least 5-6 times. Otherwise, she seemed fine and was her usual self. Sat night she puked around 3:30 am and 4:30 am. All day today (Sun), she acted normally, just had diarrhea all day again. I've tried to keep her to foods that aren't likely to upset her stomach and she drinks a cup of pedialyte and at least 2 cups of water each day. She's had so much diarrhea that I can't tell how often or if she's urinating at all. She hasn't had any fever or other symptoms. There's a stomach bug going around right now, could that be it? Should she go to the Dr? Thank you for any advice you may have!!

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  81. I am sorry to hear that she is still sick. While it is still possible that it is a viral stomach illness, I would recommend taking her in to be checked by a doctor since it has been several days and it is hard for you to tell how often she is urinating. A doctor should be able to check for other signs of dehydration and rule out other causes for her vomiting. Hope she gets better soon!

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  82. Hi Dr.Sandy,
    My son is 9 and has been throwing up, having a bad stomach ache and diarrhea for about 7 days now, he seemed to feel batter for a few days and then woke up sick again is this normal or should I take him to see the doctor?

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