Isn’t it always the case school is back and the children get a tummy bug – and the thing about tummy bugs (gastroenteritis) is that they are highly contagious – so ideally your child needs to be well for at least 3 days before you send them back to school. That means that it has been 72 hours since they last vomited or had diarrhea and if they are not eating normally and don’t have normal poop, they are still sick and are still considered to be contagious.
So a few answers to questions about Gastroenteritis.
What are tummy bugs?
Tummy bugs are usually spread by a virus but can be spread by bacteria and result in diarrhoea (watery poo) and vomiting. For most children it is not serious and passes within a few days, although as the parent it feels like forever when your child is unwell. The most important factor during an episode of childhood gastroenteritis is to ensure that your child does not become dehydrated.
How common are they?
Tummy bugs are very common in young children with most children having several episodes during childhood. It is almost impossible to avoid contact with it, especially when your child is at nursery or school, where it tends to occur in outbreaks.
What do they look like?
The symptoms are diarrhoea and/or vomiting, and sometimes this occurs with a high temperature and tummy pains. Diarrhoea usually lasts for 5–7 days and in most children it will stop within 2 weeks. Vomiting often lasts for 1–2 days and in most children it will stop within 3 days.
Most children with gastroenteritis get better quickly without treatment and can be looked after at home safely. However, severe diarrhoea and vomiting can lead to dehydration, which is when the body doesn’t have enough water or the right balance of salts to carry out its normal functions. Children with dehydration often feel and look unwell, and if the dehydration becomes severe it can be dangerous.
Some of the symptoms of dehydration are:
- seeming unwell
- sunken eyes
- dry mouth and dry eyes
- being unusually irritable or lethargic
- passing less urine than normal.
Dehydration in children with gastroenteritis is more likely to occur in:
- children younger than 1 year, especially those younger than 6 months. (This is because babies don’t need to lose much fluid to lose a significant proportion of their total body fluid).
- infants who were of low birth weight and have not “caught up” their weight.
- children who have passed six or more diarrhoea stools in the past 24 hours
- children who have vomited three times or more in the past 24 hours
- children who have not been offered or have not been able to tolerate supplementary fluids
- breast-fed infants who have stopped breastfeeding during the illness
- children with signs of malnutrition.
What should I do?
In mild cases, you probably will not need to visit your family doctor (GP). You will not usually need medicines to treat tummy bugs. The most important thing to do is to replace the fluid your child’s body is losing through the diarrhoea and vomiting. In most cases, it is better that the germ is ‘flushed out’ of your child’s system.
If your child has gastroenteritis but is not dehydrated, keep feeding them as normal and offer regular drinks. Fruit juice and fizzy drinks should be discouraged because they can make the diarrhoea worse. Encourage your child to drink clear fluids or try rehydrating sachets, such as diarolyte, which are available from chemists without prescription and you can make up the drink by dissolving them in water, following the instructions on the sachet. It is a good idea to have a stock of these in your secure medicine cabinet. This solution helps to replace the water and salts lost from the body because of diarrhoea and vomiting – this is called rehydration. If your child does not like the taste of the sachets, a trick in the A and E departments is to sometimes flavour the rehydration drink with a very little amount of orange squash.
Your child is less likely to be sick if you encourage him or her to drink small amounts frequently rather than a large drink, for example a spoonful every 2-3 minutes. You can spoon the fluid or use a syringe or put it in a bottle or cup – use whatever the child will allow. If your child vomits after drinking, wait 5-10 minutes before giving them some more.
If you are breastfeeding, you should try to maintain a normal feeding pattern.
Your child may not want to eat during the bout of diarrhoea and vomiting and although it is very hard as a parent to see your child not eating, the most important thing is to keep them well hydrated. Once your child is rehydrated, it’s important that they eat well to help with their recovery. They can start to eat solid food straight away, and they should be encouraged to drink plenty of their usual fluids. When they are feeling better they will catch up on their food again.
Symptoms of pain and fever can normally be relieved using liquid paracetamol. You should not give aspirin to children under 16 years of age. The use of anti-diarrhoea medicine is also not recommended for children under 12 years of age. Antibiotics are rarely needed and used when there is a history of foreign travel or of possible food poisoning, after a stool sample is taken to be tested.
When should I call the doctor/ambulance?
In the majority of cases, the bout will be mild, it will get better in a few days and you probably will not need to visit your family doctor (GP). Your child is unlikely to suffer any lasting effects from a tummy bug, if any dehydration is treated in time. The important thing is to ensure that they have plenty to drink.
If you contact a healthcare professional by phone, they should ask you questions about your child’s symptoms. This will help them to decide if your child needs to see someone face to face. Your healthcare professional should explain how to tell if your child’s illness is getting worse, and arrange for you to speak to or see them again if you need to. If you see a healthcare professional face to face they should examine your child to check if they have become dehydrated and to rule out serious illness.
Circumstances in which you would need to ring your GP for advice and/or a visit include
- If your child is under the age of six months.
- If your child has an underlying medical condition (for example, heart or kidney problems, diabetes, history of premature birth).
- If your child has a high temperature.
- If you suspect dehydration is developing .
- If your child is vomiting and unable to keep fluids down.
- If there is blood in their diarrhoea or vomit or any green vomit.
- If your child has severe abdominal pain.
- If there are any other symptoms you are worried about
- Infections caught abroad.
- If you think it was caused by a particular food.
- If your child has severe symptoms or if you feel their condition is worsening.
- If your child’s symptoms are not settling (for example, vomiting for more than 24 hours, or diarrhoea that does not start to settle after 3-4 days, or overall symptoms not improving within 48 hours ).
If at any time your child becomes listless, floppy and groggy, you should call your GP immediately, or go to your local Accident and Emergency (A&E) department as these are signs of dehydration.
Anything else I need to know?
How are tummy bugs spread and how can you prevent them?
Tummy bugs caused by a virus and are spread by droplets expelled during vomiting or by coming into contact with vomit or poo.
Tummy bugs can also be caused by bacteria and can be spread by eating and drinking contaminated water or undercooked food, or by poor hygiene, like not washing your hands after going to the toilet or before eating.
It can also be passed by direct contact from person to person or through poor hygiene. You should contact your GP as the bug may be caused by food poisoning, and they will know if other people have fallen ill after eating the same food. If this is the case, then the Environmental Health Department for your area will need to be told and you may be contacted for more information.
Tummy bugs are highly contagious among children. It is important to take steps to prevent the condition from spreading from your child to other children.
Recommended steps include:
- Ensuring you and your child washes their hands and dries them thoroughly after going to toilet, or touching the potty, or after changing nappies and also before touching food. It is recommended to use liquid soap and warm running water.
- Thoroughly cleaning the potty, or toilet, using disinfectant after each bout of diarrhoea and vomiting.
- Not sharing your child’s towels, flannels, cutlery, or eating utensils with other household members.
- Not taking your child to nursery, or school, or another childcare provider at least 3 days have passed since their last bout of diarrhoea and vomiting.
- Not taking your child swimming for 2 weeks after diarrhoea has stopped.