Kids' Health Managing Vomiting and Diarrhea in Kids By Vincent Iannelli, MD facebook Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years. Learn about our editorial process Vincent Iannelli, MD Medically reviewed by Medically reviewed by Jonathan B. Jassey, DO on November 22, 2019 facebook Jonathan B. Jassey, DO, is board-certified in pediatrics. He has been in private practice at Bellmore Merrick Medical in New York since 2007 and is the co-author of "The Newborn Sleep Book." Learn about our Medical Review Board Jonathan B. Jassey, DO Updated on November 28, 2019 Print Parents often get confused about what to do when their kids start having vomiting and diarrhea. Do they give more to drink since they just vomited and are thirsty, even though they will probably just throw that up too? Or do they not let them drink, even though continued vomiting and diarrhea can quickly lead to kids getting dehydrated? Paul Bradbury / Getty Images Treatments for Vomiting and Diarrhea In general, when your child is vomiting a lot or has diarrhea from something like a stomach virus (gastroenteritis), you should: Give them fluids to avoid dehydration or help them get rehydratedOnce the child is able to keep fluids down, resume feeding to provide nutritional supportAvoid routine antibiotics as a treatment, as gastroenteritis is commonly caused by virusesAvoid antidiarrheal medications in young children Recommended Fluids for Vomiting and Diarrhea Parents often give water or juice to their kids when they have diarrhea or vomiting, but it is best to use an oral rehydration solution (ORS) instead. Oral rehydration solutions have the right mix of sugar and electrolytes to best help your child, while the high amount of sugar and lack of sodium in other fluids, like apple juice, might actually make your child worse. Similarly Gatorade's high sugar content makes it controversial when used for diarrhea or vomiting. Although the World Health Organization Oral Rehydration Solution (WHO-ORS) is the gold standard for managing acute gastroenteritis, many parents and pediatricians use commercially available solutions such as Enfalyte or Pedialyte. They are available in most supermarkets and drug stores without a prescription and come in good-tasting flavors, although some brands do taste better than others. Medications and Dietary Treatments for Young Kids With Diarrhea How Much Fluids to Give a Vomiting Child The biggest mistake that parents make when their kids have diarrhea and vomiting, next to giving the wrong fluids, is being too aggressive and giving their children too much to drink at one time. If your child is vomiting frequently, limit fluids to a teaspoon at a time, using a syringe, medicine dropper, or actual teaspoon to measure the dose. Gradually increase the amount you give at each time as your child begins to keep it down. A good starting point is a teaspoon (5ml) or tablespoon (15ml) of fluid every five or ten minutes for the first hour or two, increasing to a few tablespoons at a time once the vomiting decreases and your child is keeping the fluids down well. If your child can't or won't drink anything else, a Pedialyte popsicle can be a good alternative to prevent dehydration. The total amount of fluids you should aim to give depends on how dehydrated your child is. Children with: Minimal or no dehydration should get about 2-4 ounces of ORS for each episode of vomiting or diarrhea if they are less than 22 pounds and 4-8 ounces if they are over 22 pounds. Keep in mind that one ounce is the same as 30ml, so even if you are just giving your child one tablespoon (15ml) every five or ten minutes, you can very quickly get up to 4 ounces (120ml).Mild to moderate dehydration, with decreased urine output, dry mouth, decreased tears, and a 3-9 percent loss of body weight, should get about 25 to 50ml (a little less than 1 to 2 ounces) of ORS per pound of body weight over 2-4 hours. In addition, they will also need 2-4 ounces of ORS for each episode of vomiting or diarrhea if they are less than 22 pounds and 4-8 ounces if they are over 22 pounds to replace ongoing losses.Severe dehydration, with greater than a 9 percent loss of body weight, fast heart rate, deep breathing, parched mouth, deeply sunken eyes, absent tears, minimal urine output, and cold mottled extremities, will need immediate medical attention and IV fluids. They can then be changed to ORS once they start improving. When to Seek Medical Attention Gastroenteritis can typically be treated at home, however, you should call the pediatrician if your child:is less than 6 months oldrefuses to drink Pedialyte or other oral rehydration solutioncontinues to vomit frequentlyhas severe dehydration or feverexperiences a change in mental status (like being lethargic or irritable)has bloody diarrheacontinues to worsenis unable to be cared for at home Thirsty? The Ins and Outs of Dehydration Feeding Through a Stomach Virus It is often recommended that parents not feed their child, offer a BRAT diet (bananas, rice, applesauce, and toast), or otherwise limit their child's diet when they are sick. Unless your child is vomiting a lot or simply doesn't want to eat, you do not need to limit their diet. Especially if your child just has diarrhea and/or occasional vomiting, you should: Continue to breastfeedContinue to formula feed your infant, using full-strength formula, once they are rehydratedGet back to an age-appropriate unrestricted diet as soon as possibleAvoid restricting milk (lactose) in your older child or making changes to your infant's formulaAvoid foods with a lot of added sugars, like fruit drinks, fruit juice, and carbonated soft drinks What about probiotics? Although often used, they are likely often overused when kids have vomiting and diarrhea. Zofran, an anti-vomiting medicine is an option for some kids who are vomiting to help avoid dehydration. Stomach Flu Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Anigilaje EA. Management of Diarrhoeal Dehydration in Childhood: A Review for Clinicians in Developing Countries. Front Pediatr. 2018;6:28. doi:10.3389/fped.2018.00028 Dehydration and diarrhea. Paediatr Child Health. 2003;8(7):459-68. doi:10.1093/pch/8.7.459 Iro MA, Sell T, Brown N, Maitland K. Rapid intravenous rehydration of children with acute gastroenteritis and dehydration: a systematic review and meta-analysis. BMC Pediatr. 2018;18(1):44. doi:10.1186/s12887-018-1006-1 Hatchette TF, Farina D. Infectious diarrhea: when to test and when to treat. CMAJ. 2011;183(3):339-44. doi:10.1503/cmaj.091495 Additional Reading American Academy of Pediatrics. Clinical Report—Probiotics and Prebiotics in Pediatrics. PEDIATRICS Volume 126, Number 6, December 2010. CDC. Managing Acute Gastroenteritis Among Children. Oral Rehydration, Maintenance, and Nutritional Therapy. MMWR. November 21, 2003 / 52(RR16);1-16