Tummy Bug 101

As you can imagine, when the tummy buy is going around the nurses here find ourselves giving the same tips and information to one call after another,

I have tried to write down some of the more important pointers.
I hope you find it useful
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If you or your child has fever, chills, bloody diarrhea and vomiting, this could be food poisoning. You likely need to be seen

If you or your child are just back from travel or camping and have awful gassy, incredibly stinky stools, we should make sure that you don’t have giardia or some other parasite


However, by far most of the tummy bugs that we see are caused by a virus. Time will fix this.
The typical symptoms are vomiting, loose stools and sometimes fever.

Your main job is to keep your child hydrated. It is okay and even expected for them to not have a normal appetite for a few days. Unless they are extremely slender, we are not too worried if they lose a bit of weight. They will fatten right back up when this passes. Don’t stress about the food intake. We just need to make sure that they are getting adequate fluids.

A dehydrated child has very low energy, the urine is dark and way less frequent, They don’t have lots of wet tears and drool. Their mouth feels dry. These are the kids that get carried into our office draped over their parent’s shoulder. If your child is running around I am not too concerned and they probably don’t need to be seen.

If you are not able to win the hydration battle then a trip to the emergency room is appropriate. Once there your child may get some IV fluids which often perk them right up.

Right before they are going to vomit, it is normal for them to look quite miserable. Some kids actually look greenish. Once they throw up, most of the time they feel a bit better.


This month most of the afflicted folks started with some vomiting. This particular illness swept through the entire families. Mommies, Daddies and Nannies all came down with it.
Luckily it only lasted for a few days.

There are no hard and fast rules here.
I typically wait at least ten minutes after they have thrown up before I offer anything to eat or drink.
Ideally you will be giving them clear fluids ( breast milk is also perfect if you have it)

Because we lose lots of electrolytes when we vomit or have diarrhea, it is best to replace the fluids with something that replaces the electrolytes as well. Water is not your best choice.
There are products on the market that are specially formulated for this purpose.
Pedialyte has been around for quite a while. There are pedialyte popsicles that are terrific for older kids, Unfortunately regular pedialyte tastes a bit like soap.
If you can get your child to take it, consider yourself lucky.
There is a new product out there now called Drip Drop that promises to taste a little better.
Coconut water is another fine choice.

Once your child has started keeping down some fluids, it is okay to advance the diet.
More often than not, we expect the stools to be looser than normal.
This month the vomiting has rarely lasted for more than 24 hours.

Bland starchy foods are your best bet.

Bananas, rice, applesauce, crackers, toast, potato, pasta, boiled chicken and watermelon are all okay.
I find that folks have a quicker time getting over this if they avoid dairy.
(some folks can stay on yogurt and tolerate that fine)

In my experience, getting started with probiotics right away is very useful.

There are plenty of good brands out there. One of my favorites is Florajen for kids which you can get from the Noe Valley or Diamond Heights Walgreen’s. It is kept in the back in the refrigerator, but there is no prescription needed
Baby Jarrodophilus ( whole foods or health food stores) is another brand that we have had success with.

If your child has a fever, a tepid bath can help get it down. If the bath hasn’t done the trick, the fever is over 101 and your child is miserable it is worth giving some fever reducing medicine.
Ibuprofen tends to be a bit harder on the stomach so I would chose acetaminophen
( Tylenol) when I have an illness that includes tummy symptoms.
Another advantage to the Tylenol is that it comes in suppository form, so it is more easily tolerated by a vomiting kid.


Many folks call me because their child seemed like they were improving and have had a bit of a relapse.
Most of the time this is caused by advancing the diet a little too quickly. ( especially dairy)

If your child is retaining fluids but has loose stools, I love the Similac DF ( diarrhea Formula) The Walgreen’s in Noe Valley and Diamond Heights try to keep this in stock for me. You may need to ask the pharmacist if you don’t see it on the shelves.
For older kids you can still use this soy based formula as the base for a smoothie.
Similac DF
Banana
Frozen yogurt
Mix the ingredients in a blender,
This smoothie is usually easily accepted, well tolerated and helps form up the stool.


If your baby is under 2 months old and you suspect that they have a tummy bug, we will want to monitor them closely. Young babies can get dehydrated much more easily than a larger child.

Many babies spit up on a regular basis daily and normal baby poop is very liquidy. If they are nursing well, and peeing fine that is very reassuring.

What we would be watching out for would be stool that looks watery/ clear, increased amounts of vomiting and any concern about their energy level.

With a dehydrated infant, the fontanel ( soft spot) may appear more sunken, and they will be way sleepier or fussier than usual.


Regardless of their age, If you have a vomiting child for more than a day, with perfectly normal stools it is worth checking in with your doctor’s office, especially if they have a fever!



Good Hand washing is your best defense.

Nurse Judy