Diarrhoea and vomiting

Feeling sick and then vomiting is usually the first sign that your child has a ‘tummy bug’. Diarrhoea tends to occur after your child has started vomiting and means passing frequent watery poos that are offensive in nature.

  • Tummy bugs are extremely common in young children and are almost always caused by a virus. They are easily spread, resulting in outbreaks in nurseries and schools.
  • Babies under 1 year of age (and especially under 6 months of age) are at more risk of becoming dehydrated when they have a tummy bug than older children, which is why it is important to make sure that they are drinking enough.

When should you worry?

If your child has any of the following:

  • Becomes pale, mottled and feels abnormally cold to touch
  • Going blue around the lips or too breathless to talk / eat or drink
  • Becomes extremely agitated, confused or very lethargic (difficult to wake)
  • Develops a rash that does not disappear with pressure (the ‘Glass Test’)
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features)

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Seems dehydrated: ie. sunken eyes, drowsy, sunken fontanelle (soft spot on baby’s head) or not passed urine for 12 hours
  • Has blood in the stool (poo)
  • Tummy pain that doesn't go away
  • Has completely stopped drinking or breastfeeding
  • Is unable to keep down any fluids during this illness
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
  • Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
  • Continues to have a fever of 38.0°C or more for more than 5 days.
  • If your child has diabetes, monitor their blood sugars closely and follow the sick day rules as specified by their individual plan  

You need to contact a doctor or nurse today.

Please ring your GP surgery or out of hours contact NHS 111 for advice – dial 111 or for children aged 5 years and above visit 111.nhs.uk  

If none of the above features is present, most children with diarrhoea and / or vomiting can be safely managed at home.

(Please note that children younger than 1 year may become dehydrated more quickly. If your child appears otherwise well but you still have concerns, please contact your GP surgery or call NHS 111).

Additional advice is also available to young families for coping with crying of well babies – click here.

Self care

Continue providing your child’s care at home. If you are still concerned about your child, please call your GP surgery (or call NHS 111 if your GP surgery is closed)

 

What should you do?

  • Avoiding dehydration is important – give your baby/child extra fluids. Give your baby Oral Rehydration Solution (ORS) in between feeds or after each watery stool. Little and often tends to work best – in hospital, babies are given 1 or 2 tablespoons (5-10 mls) of fluid to drink every 5-10 minutes. You can try using a syringe to give fluids to your child. Mixing the contents of the ORS sachet in dilute squash (not “sugar-free” squash) instead of water may improve the taste. Apple juice can also be used instead of ORS
  • Do not stop giving your baby milk. If you are breastfeeding, continue doing so.
  • Do not worry if your child is not interested in solid food. If they are hungry, offer them plain food such as biscuits, bread, pasta or rice. It is advisable not to give them fizzy drinks as this can make diarrhoea worse.
  • To avoid spreading the virus, wash your hands with soap and water after changing nappies. Keep toilets clean and don’t share towels.
  • They should not return to school or any other childcare facility until 48 hours after the last episode of diarrhoea and / or vomiting
  • You can get ORS from your local pharmacy

 

How long will your child’s symptoms last?

  • Vomiting tends to last for 1-2 days, and diarrhoea tends to last for about 5 days.
  • The charts below show how long diarrhoea and vomiting lasts in children when they have a tummy bug. The faces represent 10 children who have seen their GP with a tummy bug. Green faces are those children who have recovered within that time period.

The diagrams above are taken from www.whenshouldiworry.com

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Where should you seek help?

  • If it is non-urgent, speak to your local pharmacist or health visitor.
  • If your child has any of the above amber features, urgently see your GP. If your GP surgery is closed, please call NHS 111.
  • You should only call 999 or go to your nearest A&E department in critical or life threatening situations or red features above. 

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contact the school nurse 

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
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