While hopefully your child never experiences gastroenteritis, it is unlikely that he or she will get through infancy without some sort of tummy upset.  It is important to know what to do in this circumstance as there are many old wives tales, and misinformation abounds.  To a worried mum with a sick child sorting through this information is confusing and frustrating, and potentially dangerous.  It is helpful to know what to do in advance. 

During gastro –

Babies have little reserves to protect themselves when things aren’t going right.  Unlike adults, who can cope with a few days of less than ideal nutrition, babies can become dehydrated very quickly.  Continue to feel them with their usual feed, either breast milk or formula.  If your baby has not kept any fluid down for twenty four hours, take them to emergency department.  If your baby has had less than four wet nappies in 24 hours take them to the hospital also.  Here they will be rehydrated. 

For toddlers and older children offer oral rehydration solutions.  These are fluids designed to help the child retain the fluid they are drinking, while also replacing important electrolytes that are lost during vomiting and diarrhoea.  Encourage the child to sip on the drinks every few minutes. If they gulp the drink they are likely to vomit it up.  Following are some examples of clear fluids that can be used.  In ‘the olden days’ flat lemonade was sometimes recommended.  This is not recommended anymore, particularly if the child has a fever, as it can exacerbate dehydration, as it is too concentrated.  An example of fluids to help with rehydration includes ‘Gastrolyte’. Make this up according to the directions on the packet, do not adjust the dilution.  If this is not available, the following dilute drinks can be used. 

1 teaspoon of table sugar in 1 cup of water OR ¼ cup of cordial in 4 cups of water OR 1 cup of lemonade in 4 cups of water OR 2 cups of commercial sports drink in 2 cups of water. 

For infants under 12 months, use cooled boiled water. 

After the vomiting and diarrhoea has slowed, continue to encourage them to drink fluids, as it will take a while to rehydrate properly.  

For infants – continue to give breast milk or formula, the babies usual feed, made up to the normal strength.  NO other fluids are required, however cooled boiled water can be offered. 

For toddlers and older children, water, milk and weak cordial can be given.  Children can experience a period of lactose intolerance after a bout of gastro.  This is almost always temporary, and while it is ok to avoid lactose for a few days until the diarrhoea or vomiting subsides, there is no reason to continue avoiding it.  Reintroduction of these foods is important to prevent long term lactose intolerance.

Start to offer food once your child has been rehydrated, that is, they are urinating at least as often as what was normal for them prior to being sick.  Start with plan foods such as dry biscuits, dry toast, plain pasta, mashed potato or pumpkin.  As these are tolerated reintroduce meats and other fruits and vegetables.  Avoid spicy and oily, fatty foods until your child is back to being 100%.