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Pharmamum’s Ultimate Guide: Gastro
Gastro, unfortunately is no fun. When you see your child suffer with gastro, you feel helpless, however being informed about gastro, how quickly it spreads, how to treat the symptoms, what to do and not do, as well as what signs to look out for is very important as a parent and hopefully the information below, will arm you with confidence in how to handle a gastro outbreak in your family.
What is Gastro?
Gastro (gastroenteritis) is a term used to describe a bowel infection. Gastroenteritis is most commonly caused by a virus and less commonly caused by a bacteria or parasite.It can last for 3 to 4 days but can take up to a week to 10 days for the bowel motions to become normal again. The worst is usually over within the first 24 hours of symptoms presenting.
How contagious is it and how do you catch it?
Viral gastroenteritis is caused by person-to-person contact such as touching contaminated hands, faeces or vomit, or by drinking contaminated water or food.
Gastro is very catchy and is still contagious for 48 hours after the symptoms have stopped so it is important to keep your child away from other children until she/he has had no vomiting or diarrhoea for at least 48 hours. This is important from preventing an epidemic throughout the creche/kinder/school/work place.
- Stomach cramps
- Loss of appetite
- Runny nose and sore throat can be present
- The combination of these symptoms can all lead to dehydration.
How to reduce the risk of Gastro:
1) Wash hands thoroughly with soap and water after going to the toilet, changing nappies, after using a tissue and handling an animal
2) Wash hands thoroughly before preparing food
3) Dry hands with paper towel instead of cloth towel as bacteria can survive on towels for some time
4) Clean toilet seat regularly and baby change tables regularly.
5) When out and about, I carry anti-bacterial hand gel that you can quickly wash both yours and your children’s hands if you feel they need to be cleaned before touching food. This often limits the hassle of having to find a bathroom. Also whilst out, if placing your child in a highchair, always wipe down the tray table with a disposable wipe, because you just never know if an unwell child has sat in the high chair before placing your child in, and bacteria can live on surfaces for up to 24 hours.
If my child does get Gastro, how should I treat the symptoms?
Firstly if your child is 6 months or under, it’s straight to the doctor because they can go downhill very quickly and they need to be assessed for dehydration.They may need to return to their GP every 12 hours or so to be continually monitored.
The biggest problem whilst suffering with gastro is becoming dehydrated because of loss of fluid via vomiting or diarrhoea, so drinking fluid is very important. It’s important to be aware that not every drink your child requests will be good for them whilst suffering gastro and undiluted juices and soft drinks ie lemonade can exacerbate dehydration. Oral rehydration solution is the best way to stay hydrated and are available over the counter from any pharmacy. Examples of these are Hydralyte, Gastrolyte, Pedialyte. These come in a number of different forms ie powder sachets and effervescent tablets that you combine with water, ready pre-made solutions, icypoles and jelly solutions. The only way I can get them into my children is either an icypole or a jelly and even that is a struggle because the flavour is a combination of sweet and salty. Try and get your child to keep sipping water, however if juice or lemonade is requested, it must be diluted. 1 part lemonade or fruit juice to 4 parts water is the ratio recommended. So if you give 100ml of juice, add 400ml water to make up to a total of 500ml. Alternatively you can use 10ml of concentrated cordial and add 250ml water (equivalent to 1 cup of water).
a) Breastfed babies/toddlers:
If your baby is breastfed continue breastfeeding more frequently (on demand or at least every 2 hours) in order to increase the fluid intake. Also in between feeds, offer oral rehydration solution or water in a bottle. If your breastfed baby is on solids then do not give solids if your child is vomiting. When the vomiting has stopped or after 24 hours, continue breastfeeding every 2 to 3 hours or on demand and continue to offer water and oral rehydration fluid. You can start to reintroduce the solids if your baby is already on solids even if their stools are still loose. Offer simple foods to start that are easily digested ie rice cereal, potato or pumpkin.
b) Formula Fed babies/toddlers:
If your baby is formula fed, stop the formula for a maximum of 24 hours, offering oral rehydration solution and water and then return to the formula after 24 hours and continue to offer the oral rehydration solution and water in between feeds. When the vomiting has stopped or after 24 hours start usual formula or milk. The formula or milk do not need to be diluted. Continue to give feeds every 2 to 3 hours or more frequently if demanded. Occasionally children will develop lactose intolerance after suffering a bout of gastro and the loose stools may continue. Your child may need to go onto a lactose free formula (ie Nan L.I gold) for a short period of time (approximately 1 month) until the lactose intolerance settles, this would need to be done under appropriate advice from your child’s health care professional. If your child is older than one and is no longer on formula and drinks full cream milk, with appropriate advice he/she may need to switch to lactose free milk for one month and then be assessed thereafter. You can start to reintroduce the solids if your baby is already on solids even if their stools are still loose. Offer simple foods to start that are easily digested ie rice cereal, potato or pumpkin.
It can be very difficult to get your child to drink when they are feeling nauseous and really don’t want to put anything near their mouths. Be patient and keep encouraging your child. Children love icypoles, so what I do with my fussy eating 2 and 4 year old daughters, is always offer the oral rehydration solution in icypole form first, and if that doesn’t work, I make my own diluted (1 to 4 parts) lemonade icypoles or diluted fruit juice icypoles and that’s usually a winner. Another tip is using exciting looking twirly straws in water or oral rehydration solutions and children have fun watching the fluid go through the straw.
If your child is off their food, that is not a problem. If they do get hungry, start with bland food, ie toast, plain crackers, rice, boiled potatoes. Avoid dairy or hard to digest food as it can upset your child’s tummy. Children can also become lactose intolerant whilst suffering with gastro and for up to a month after. Once vomiting has stopped slowly re-introduce usual foods. Start with the above that were mentioned as they are easily digested.
How much fluid should my child be drinking?
The best advice is keep offering your child water and oral rehydration solution and reminding them to drink. Aim for at least 5mls of fluid per kg body weight each hour. ie if your baby is 10kg, you should aim for 50mls fluid each hour to replenish the fluid that is lost.
There is strong evidence to shows that Probiotics co-administered with standard rehydration therapy decrease the duration of infectious diarrhoea by approximately 30 hours with 2 particular strains of probiotics having the most evidence. ( Lactobacillus rhamnosus GG and Saccharomyces boulardii )
8) It’s very important NOT to give any medication to stop the nausea/vomiting and the diarrhoea. Let your baby/child’s body do what it needs to do, and that is, get the virus/bacteria out of their system! If you give medication to stop the nausea it will only keep the bug in their system for longer and delay the recovery.
9) Do not give sports drinks, Lucozade, or undiluted lemonade, cordials, or fruit juices as they can dehydrate your child even more by drawing fluid into their bowels.
10) Do not hesitate to take your child to a hospital for rehydration through an intravenous line if your child is refusing fluid. My nephew when ever he suffered with gastro, refused to drink and would not put any form of fluid close to his mouth, hence he would go downhill very quickly and had to be taken to the hospital for rehydration. My sister knew if her son ever got gastro, she wouldn’t wait too long before she took him to the hospital. Often children will want to drink because they do become thirsty but just be aware they are children, and children can refuse to do what is best for them.
11) See your doctor when:
- Your child can not keep any fluids down
- Your child looks dehydrated –ie Not passing urine ie dry nappies, dry mouth,lack of tears, is pale, has sunken eyes, cold hands and feet, drowsiness and very irritable
- If your baby/child is refusing to breastfeed or drink
- Rash that doesn’t fade when the skin is pressed
- Blood in your child’s stools or vomit
- Vomit is a green colour
- Severe abdominal pain
Please feel free to leave comments on this blog and if there are any questions I am more than happy to answer them. Also if you tried a remedy that worked well for your children that was or wasn’t mentioned above, let me know. I hope this information does help.