Four Seasons Pediatrics

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Gastroenteritis (Stomach Flu)

Four Seasons Pediatrics is experiencing a high volume of phone calls related to gastroenteritis (what many in the public call a stomach flu).  It is not truly related to the flu or influenza, but retains this name.  Gastroenteritis is a viral infection that causes vomiting, diarrhea or both.   As a result of being very contagious, there are many households with multiple family members being affected.

What to look for:

Many experience vomiting or stomach cramps as the first symptom, though some may start with diarrhea.   In some cases fever, sweats, dizziness and cold symptoms may be part of the illness.   A decrease in appetite is to be expected (many of us will not want to eat when we have these symptoms).

What do I have to be concerned with:

Unfortunately, there are not a lot of effective treatments for this.  The main focus is preventing spread of the infection and preventing dehydration.  There is no substitute for good hand washing in prevention.  Be sure to properly clean surfaces that may become contaminated with body fluids.  A dilute bleach solution is very effective in cleaning surfaces in the bathroom.

What can I do:

As stated dehydration is the main cause for concern.  As long as your child is alert, the tongue is moist and urination is occurring (every 8 hours for a child over 6 months; and every 6 hours for a child under 6 months), you may feel confident that you are keeping up with the fluids, even if your child is vomiting frequently.  We do not recommend products that slow down the diarrhea, as this may prolong the illness.  In the mean time, we do recommend giving fluids slowly as follows:

When vomiting, give 1/2 of an ounce (even as little as 1 tablespoon) of pedialyte.  This can be given every 15 minutes.  After 1 hour, you may increase this amount by 1/2 ounce.  Give this amount every 15″ for 1 hour.  Each hour you may increase the amount by 1/2 ounce until either 1) thirst is no longer present (assuming urination is occurring as noted above) or if vomiting starts up again.  If vomiting occurs, decrease the amount to the volume that was previously tolerated.  Water is not a good hydrating fluid.    For severe vomiting, rest the stomach completely for 1 hour, then start over with smaller amount.   It most cases the diet noted below can be started in 24-48 hours

If diarrhea is the main symptom, or becomes more of a concern once the vomiting is better, you may continue to eat, though appetite may be down.  You do not need to give pedialyte for diarrhea.  We recommend bland foods.  Avoid dairy if it seems to worsen the diarrhea.   There is a diet called the BRAT diet, which is noted to slow down diarrhea.  Each letter in the BRAT stands for constipating food.  If your child is old enough to eat these foods, they include Bananas, Rice, Apple Sauce and Toast.  Please remember, cooked apples slow diarrhea down.  Raw apples (whether juice or the apples themselves) will speed diarrhea up, so avoid these.    Lastly, we often recommend a probiotic called Culturelle.  Culturelle contains the healthy bacteria affected from stomach bugs (and antibiotics).  There are studies that show it reduces diarrhea by 40-50%.   You may use the capsule form – just swallow, or give 1/2 capsule in applesauce once a day for children under 1 year, and 1 full capsule daily for children over 1.   Continue until the diarrhea has resolved.  The choice of solids is a key factor in diarrhea.  Starchy foods are absorbed best.  Give rice cereals, oatmeal, bread, crackers, rice, noodles, mashed potatoes, carrots, applesauce, strained bananas, pretzels or saltine crackers (which give salt).

When to call:

Signs of dehydration – no urine production in 8 hours, very dry mouth, no tears

Diarrhea lasts more than 2 weeks

Your child is sluggish and not alert

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