Ask The Professional: The Pediatrician Part 2


A couple weeks ago I posted Part One of my pediatrician’s guide to Cold & Flu Season:  here is part two! I hope everyone is staying healthy you guys! It’s going to be a cold winter!




When your child gets the stomach flu, or viral gastroenteritis, they usually will have vomiting for the first 12-24 hours, followed by diarrhea that can last anywhere from 3-10 days.  During this illness, it is most important to keep your child hydrated.  The best way to do this is to give them clear liquids, and give small amounts frequently, like 15-30 mL every 10-15 minutes.  This will allow the child to keep the liquids down and hopefully prevent the need for IV fluids.  Pedialyte, watered down apple juice and water are all good choices.  Many kids won’t take pedialyte because it tastes bad, but you can try to mix it with some Gatorade or juice to see if that will make it more palatable.  If your child is only drinking water, you can give some him/her saltines or Goldfish crackers to nibble on as well.  Popsicles or ice works well as slow liquid intake as well.

When your child is dehydrated, if they will keep vomiting everything they take in, even small amounts of liquid, and they also are lethargic, the child should be seen or evaluated by their doctor or in the urgent care or ER for possible IV fluids.  No medications should be given at home for vomiting or diarrhea.  We would not recommend giving Immodium or Pepto Bismol for children.  The virus needs to literally work itself out of the system.  Definitely, there is no need for antibiotics as that can cause more stomach upset.

With the diarrhea only, which can be up to 3-8 plus times per day, you can feed them through this illness and start to drink liquids as much as they would like.  I do recommend limiting dairy intake if the diarrhea is voluminous, i.e. more than 5 times daily and quite watery.  Typically we also go heavier on the carbohydrates to help with the stools to be firmer and less diarrhea.  Bananas are good to give as well.  Babies that are taking breast milk or formula only, feed through the illness. If after 1 week the child has not improved, call your pediatrician.  Also, if there is blood in the diarrhea, the child needs to be seen.

You need to see your doctor if you are worried about dehydration, if there is a concern for appendicitis or if the diarrhea is continuing to be more than 5 times daily and quite watery and voluminous after 1 week.  Signs of appendicitis include severe and constant abdominal pain, more localized in the right lower quadrant of the abdomen.  In addition, the child will keep on vomiting and not keep anything down, and this would be beyond the first 24 hours of the illness.


Many viruses are associated with rashes like Roseola, Hand Foot Mouth and Parvo Virus (slapped cheek).  In general, younger children tend to get a rash on their bodies after the fever breaks.  These viral rashes will go away on their own in about 3-4 days without any treatment.  They are not itchy or painful.  If the rash is very itchy or painful, you should bring the child in to be seen.  Otherwise, wait it out for a few days, apply a little extra lotion and most often, the rash will resolve on its own.


As parents, you are a very good judge as to when you feel your child is really sick and needs to be seen.  If you are really worried, bring them to your pediatrician to be evaluated because as I said in the beginning, a big part of my job is reassuring parents and making sure that there is nothing more serious going on.  Hopefully this short post helps you worry less this winter when your child gets a cold, because it likely will happen!  Remember that these viruses are not bad to catch because with each cold, the child builds up their immune system, making it stronger to fight colds in the future.




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