Slow rehydration key to preventing dehydration with the stomach flu

It’s that time of year again when parents are strolling around the house with buckets and towels and up half the night doing vomit soaked laundry. Most of the time children who get the stomach flu throw up a bunch of times over the first 8-12 hours of the illness and then the vomiting slows down. Usually diarrhea also kicks in and the kids are wiped out. Preventing dehydration is the most important thing and can be challenging in young infants.

During the active vomiting phase when children are throwing up every 30-90 minutes attempting to give any liquids is pretty futile. With the stomach churning anything you offer will come right back up. The body is trying hard to rid itself of the infection by literally throwing up the bacteria or virus causing it. The more vomiting the child experiences in these first few hours, the shorter the illness will be overall because the virus or bacteria is expelled and less able to multiply lower in the intestinal tract causing prolonged symptoms. Although uncomfortable and messy to clean up, vomiting won’t result in dehydration in the first few hours of illness because you aren’t losing that much fluid each time you throw up (after the first couple of times) and if you think about it, children go 12 hours or more without eating or drinking between dinner and breakfast without getting dehydrated.

Children are exhausted from the vomiting and spent from the fever and aches the bug may cause as well so they seem very sick but if you look closely you will usually find moist mouths and tears when they cry. It is during the recovery phase after the frequent vomiting ends that care is needed to rehydrate slowly so as to not overfill the stomach and cause more vomiting.

Here’s the best plan:

Wait 2 hours or so from the last episode of vomiting and start taking sips of liquid, no more than a teaspoon or two at a time, every 10-15 minutes for the first couple of hours.

Offer liquids with some sugar in them like watered down juice or flat, non-caffeinated pop. Pedialyte is an awesome choice if your child likes it. You can add some jello powder to it to flavor it if needed.

Breastfed infants can have breast milk as rehydration fluid and don’t need other liquids since it’s so easy to digest.

Popsicles are another option, letting your child have a bite or so every 10 minutes or suck on the popsicle more continuously without biting it which will provide the trickle of fluid constantly to allow for rehydration.

Giving too much too fast will overfill the irritable stomach and cause another episode of vomiting. Go slow and even if your child throws up a few more times over the next few days, more will have stayed down than come back up (even if the amount thrown up looks like a lot). Once your child has gone 6-8 hours without vomiting, you can start some bland foods too like crackers or soup but again, go slowly!

If vomiting persists frequently for more than 8-12 hours start looking for signs of dehydration. Signs of dehydration include:

Dry mouth and dry, cracked lips

Not making tears when crying

No urination in 8 hours or more for infants, 12 hours or more for toddlers and older children.

If your vomiting child has signs of dehydration and you he is still vomiting frequently, it’s time to head to the doctor.

Don’t be alarmed, though, if your child (especially an infant) vomits once or twice a day in the days following the intense vomiting phase. Because young children’s stomachs are seated just under the diaphragm with no esophagus portion below, it’s really easy for them to throw up. As long as the vomiting doesn’t become frequent again and most of the time they are able to keep fluids down, recovery is on track.