Vomiting (throwing up) and diarrhea (watery stool) are common symptoms in children that can happen at any time of year. They often happen together, but some children just have vomiting or diarrhea.
The most common causes of vomiting and diarrhea are viruses that easily spread from person to person. These viruses cause an infection called gastroenteritis.
The best way to prevent spreading the infection is to:
- wash your hands often
- wash your hands carefully after you use the bathroom, change diapers, and before you handle food
- use soap and water to clean your hands (or an alcohol-based hand sanitizer if there isn’t any soap and water)
How to manage
Diarrhea and vomiting are managed by preventing dehydration (loss of too much fluid).
Drinking
To prevent dehydration, make sure your child drinks lots of fluids. They need to drink enough fluids to meet what they need each day and replace the ones they lose with vomiting or diarrhea.
If your child has diarrhea without vomiting, they can drink as much as they want.
If your child is throwing up, they should drink small amounts of fluids often. Offer your child 5 mL of fluids every few minutes. If they can keep that down, give them up to 30 mL of fluids every 5 minutes. If your child does not appear to be dehydrated, give them clear fluids, such as apple juice mixed with water, or sport electrolyte drinks. If your child has signs of dehydration, give them an electrolyte maintenance solution such as Pedialyte.
Eating
If your child has diarrhea but isn’t throwing up or is no longer throwing up, let them eat healthy foods that aren’t too high in fat or sugar. Eating will help them get better faster.
Once they haven’t thrown up for a few hours, slowly give them small amounts of foods to eat. It’s best not to give your child fatty or greasy foods if they have diarrhea or have been throwing up.
Don’t give your child over-the-counter medicines that claim to prevent vomiting, such as dimenhydrinate (Gravol), or drugs that try to stop diarrhea, such as loperamide (Imodium). These drugs don’t work well in children and may have serious side effects.
If your child isn’t dehydrated
If your child isn’t dehydrated, they have a low risk of developing other health problems. The most important thing to do is make sure they get enough fluids. When your child is getting enough fluids (is well hydrated), they:
- have a normal skin colour (but may be a bit red or “flushed” if they have a fever)
- act normally and have a normal activity level for most of the day
- may sleep more but are easy to wake up
- may have dry lips or a dry tongue but the inside of the mouth is wet (moist)
- have tears if they cry
You’ll know that your child is getting enough fluids to drink (that they’re hydrated) if they are peeing as often as usual:
- have a wet diaper usually every 3 hours (if they are 3 to 5 months old)
- have a wet diaper usually every 6 hours (if they are 6 to 23 months old)
- pee (pass urine) usually every 8 hours (if they are 2 years and older)
What you can do
Wash your hands often, especially after you use the bathroom, change diapers, and before you handle food.
As long as your child is well hydrated, you can let them drink and eat when they want.
- Offer your child fluids and small amounts of healthy foods they like to eat.
- Slowly give your child more fluids to drink.
- Slowly add back foods but start with ones that are easy to digest. This includes rice, cereal, pasta, mashed potatoes, cooked carrots, and bananas.
- You can let your child drink fluids that are right for their age. Don’t give your child unhealthy fluids like pop.
If your child throws up, wait 15 minutes before you offer them fluids again. If your child keeps throwing up, offer them small amounts of fluid (5 mL or 1 tsp.) every few minutes.
Watch your child for signs of dehydration.
When to get help
Call your child’s family doctor, pediatrician, or Health Link at 811 if your child has:
- vomiting or diarrhea for more than 2 days
- a fever (a temperature over 38°C) for more than 48 hours. For babies less than 3 months old, call if their temperature is over 37.5°C.
- a bloated tummy (abdomen) or stomach pains that don’t go away, get worse or are not centered around the belly button
Go to the emergency department if your child has:
- blood in their diarrhea
- dark green vomit
If your child has some dehydration
If your child has some dehydration, they have a risk of developing other health problems. It’s important to watch your child closely. Make sure they get enough fluids and call your child’s healthcare provider or Health Link at 811 to find out if they should see a doctor.
When your child has some dehydration, they:
- are very tired, can’t relax, and get upset easily
- have a lower activity level (for example, you can’t get them to play)
- have eyes that may sink a bit in the eye sockets
- have a dry tongue without much saliva in their mouth
- have some tears when they cry but less than usual
- have a sunken soft spot on top of head (babies and young children)
- have fingers and toes that feel cool
Checking how often your child passes urine (pee) can help you know if they’re dehydrated. Your child may be dehydrated if they are peeing less often than usual:
- a dry diaper for more than 4 hours (if they are 3 to 5 months old)
- a dry diaper for more than 8 hours (if they are 6 to 23 months old)
- they haven’t passed urine for more than 10 hours (if they are 2 years and older)
What you can do
- Wash your hands often, especially after you use the bathroom, change diapers, and before you handle food.
- Keep offering fluids even if your child is throwing up. Once vomiting slows down or stops, you can offer your child small amounts of food that are easy to digest. This includes rice, cereal, pasta, mashed potatoes, cooked carrots, and bananas.
- Slowly give your child more fluid to drink.
- Give your child an electrolyte maintenance solution like Pedialyte. If they do not like the taste, offer them a sports electrolyte drink like Gatorade. Do not give your child sugar-free sports electrolyte drinks.
If your child throws up, wait 15 minutes before you offer them fluids again. If your child keeps throwing up, offer them small amounts of fluid (5 mL or 1 tsp.) every few minutes.
When to get help
Call your family doctor, pediatrician, or Health Link at 811 if your child:
- vomiting or diarrhea for more than 2 days
- a fever (a temperature over 38°C) for more than 48 hours. For babies less than 3 months old, call if their temperature is over 37.5°C.
- a bloated tummy (abdomen) or stomach pains that don’t go away, get worse, or are not centered around the belly button
- is dehydrated
Go to the emergency department if your child has:
- blood in their diarrhea
- dark green vomit
If your child is very dehydrated
If your child is very dehydrated (has severe dehydration), they have lost a lot of fluids and have a high risk of developing other health problems.
When your child has severe dehydration, they:
- have eyes sunken into the eye sockets
- are very weak, hard to wake up, or won’t wake up
- don’t act or respond normally (they may not know who you are, be very upset, or won’t calm down)
- have dry lips and the inside of the mouth and tongue are dry
- don’t have tears when they cry
- have deep, heavy breathing
- have fingers and toes that are cold and blue
Checking how often your child passes urine (pee) can also help you know if they’re dehydrated. Your child may be very dehydrated if they are peeing much less often than usual:
- a dry diaper for more than 6 hours (if they are 3 to 5 months old)
- a dry diaper for more than 10 hours (if they are 6 to 23 months old)
- they haven’t passed urine for more than 12 hours (if they are 2 years and older)
If your child has severe dehydration,
go to an emergency department or call 911 right away.
For 24/7 nurse advice and general health information, call Health Link at 811.
