Article at a Glance

• Norovirus causes vomiting and diarrhea
• Dehydration is the most serious complication, so be vigilant about keeping your child hydrated
• The stomach flu is highly contagious, so be extra careful about hand washing and disinfecting

While we can’t promise to make the whole ordeal fun, we can help give you the peace of mind of knowing how to best care for your child.

What is Norovirus or the Stomach flu?

The stomach flu is a viral infection in the stomach or intestines (technically gastroenteritis, typically caused by norovirus or rotavirus) and is characterized by symptoms of upset stomach, vomiting, and diarrhea.

Norovirus is most commonly transmitted through fecal matter or vomit, so you can get norovirus by doing things like eating contaminated food, putting your fingers in your mouth after touching a contaminated surface, or by sharing utensils or food.

The best way to decrease the spread of the virus is good hand washing and cleaning contaminated surfaces.

Is Stomach Flu and Influenza the Same Thing?

The “stomach flu” often gets confused with influenza (commonly called the flu) but these are two different viruses.

The “stomach flu” is a viral infection in your stomach or intestines. But Influenza, or the flu, is a viral infection in your nose throat and lungs, and includes symptoms like a fever, sore throat, cough, body aches, and stuffy nose. Some people also vomit when they have influenza.

Note: It is recommended for most people to get an annual flu shot to protect from influenza, but that won’t protect you from the stomach flu.

Is the Stomach Flu Dangerous?

Typically the common symptoms of vomiting and diarrhea aren’t serious by themselves and can be treated at home. The main danger with the stomach flu is the risk of dehydration due to losing fluids and not being able to replenish them.

Dehydration can be serious, and it is very important to monitor the warning signs of dehydration while the stomach flu runs its course.

Recognizing Dehydration

Children of Any Age:

• Look for a decrease in urination. Children should urinate at least 3-4 times per day.
• Check inside the mouth for dry tissues or a dry tongue. This is more accurate than checking lips.
• Does your child seem weak or fatigued? Severe dehydration can leave a child too weak or dizzy to stand.

Infants:

• Is your child not urinating?
• Are your child’s eyes dry? Is there a lack of tears when crying?
• Is your child pale, limp, or generally unwell?

If your child has a headache, is excessively thirsty, hasn’t urinated in over 10-12 hours, doesn’t produce tears when crying, or complains of a dry mouth, please call your pediatrician right away. Dehydration is a serious condition that can escalate quickly.

Dehydration is especially dangerous in very young children and infants. Check frequently for signs of dehydration and seek help immediately if you cannot keep your child hydrated or if you are in any doubt or have concerns about their condition.

How do I keep my child hydrated?

Dehydration is the most serious complication from diarrhea and vomiting. During those first few hours, your main goal will be to help your child keep down small amounts of fluid to prevent dehydration.

Even if children continue to vomit or have diarrhea, they are still absorbing and retaining some of the fluid you give them. Next to staying hydrated, the most important thing you can do for your child is to allow for plenty of rest and sleep. Sleeping can help empty and settle the stomach.

Children over one-year-old:

• Offer small amounts of clear fluid—about 3 teaspoons—every five minutes.
• Try chilled Pedialyte
• Other options are Gatorade, popsicles, clear broth, or lemon-lime soda and ginger ale.
• If your child has been vomiting for more than 12 hours, you will want to use an oral rehydration solution to help restore some of the salts and sugars that have been lost.

Don’t let your child drink anything too quickly as this can trigger vomiting again. For the next few hours, you are going to want to take it slow. If your child continues to vomit, wait about 30 minutes and try again. Once your child hasn’t vomited for 3 to 4 hours, gradually increase the amount of fluids.

Breastfed babies:

Breastmilk is the perfect food for sick babies. It is easy for them to digest, is comforting, and contains lots of antibodies.

Babies who only vomit once can continue breastfeeding as usual. If your baby vomits again, you will want to reduce the amount of breastmilk your baby is getting each time by nursing for about 5 minutes, every 30 to 60 minutes.

If your baby hasn’t thrown up in 4 hours, you can return to normal nursing. If your baby continues to vomit breast milk, then use an oral rehydration solution (Pedialyte) but do not use water.

Bottle-fed babies:

If your baby is formula-fed and throws up more than once, you will want to use an oral rehydration solution, not water.

For the first 4 hours, offer 1 to 2 teaspoons every 5 minutes. You can double the amount after your baby hasn’t thrown up after 4 hours. After 8 hours, you can return to regular formula.

How do I reintroduce solids?

When your child stops vomiting, you may resume a normal diet. If your child has diarrhea you may want to use lactose-free milk and low lactose foods.  Some parents use probiotics like Culturelle to help recovery, though more recent studies have concluded that they are no more effective than a placebo.

What if my child needs to take medication?

If your child has a high fever and is vomiting you can ask the pharmacist about using an acetaminophen suppository. If your child throws up a prescription medication, contact your pediatrician to find out what to do.

Sometimes a prescription for Zofran can help decrease nausea and vomiting—which can also be a great way to give the child (and parents) a much-need rest from vomiting.

How can I prevent the stomach flu?

One of the worst parts about the stomach flu is waiting to see who will get it next. It isn’t uncommon for one family member to get sick and then have somebody else get sick five days later.

The viruses that cause stomach flu are spread through ingestion, so keeping hands and surfaces clean and disinfected are key.

People are usually contagious when they start to feel sick and for a few days after they recover. The norovirus can also survive for days on surfaces. You will want to be careful even after the storm has passed. The norovirus can also survive for days on surfaces. You will want to be careful even after the storm has passed.

Keeping Things Clean

When disinfecting, focus on the kitchen, commonly touched surfaces, and the laundry. Noroviruses are hardy and can withstand hot and cold temperatures as well as many disinfectants.

Try to keep sick kids out of the kitchen and other common areas. Clean up immediately after your child throws up and wash your hands immediately after cleaning up diarrhea.

Wash soiled sheets and towels in hot water and dry in high heat.

Wash Your Hands

Wash your hands and your family’s hands frequently, particularly before eating or preparing food. Hand sanitizer isn’t going to cut it—you will need to wash with soap and water.

Stay Vigilant

As tempting as it is to assume that your kid won’t throw up when they are complaining of an upset stomach, it is better to be safe than sorry.

Vomiting can come on quickly and once it starts, it is already too late. Prepare for the worst by streamlining clean up to make it easier to keep things disinfected and clean.

For example, keep a bucket, large bowl, or pitcher at the ready in case your child needs to vomit. Kids are notorious for not making it to the toilet in time and it will make your life a lot easier if you aren’t having to clean the mess up off the carpet, bed, or couch.

Little kids still might miss, but most kids don’t want to be covered in vomit any more than you do, so they will learn quickly.

Other tips:

• Cover the area by the bed with towels or sheets to protect the carpet.
• Have some clean sheets handy for changing the bed when you need to.
• Use large towels instead of blankets because they are more absorbent.
• A towel over the pillow is also helpful.
• Pulling long hair back into a bun or braid is also a great idea and could save you from the unpleasant task of picking vomit out of hair.

A little foresight will not only make life a lot easier for you but will make it less likely that the virus will spread to other members of the family.

Most often, vomiting lasts less than 24 hours and your child will be back to her old self quickly. Occasionally, children will vomit off and on for up to a week. This is ok if they are eating and drinking well most of the day and not dehydrated.

Give your pediatrician a call if vomiting lasts more than 24 hours, if vomiting is a frequent problem, or if your child has been vomiting clear fluids for more than 8 hours.

More Information
Vomiting and Spitting Up
Preventing dehydration in children