Diarrhoea and vomiting

Tummy bugs are extremely common in young children and are almost always caused by a virus. They are easily spread, resulting in outbreaks in nurseries and schools.

Diarrhoea can often last between 5 – 7 days and stops within 2 weeks. Vomiting usually stops within 3 days. If your child continues to be ill for longer than these periods, seek advice.

Severe diarrhoea and/or vomiting can lead to dehydration, which is when the body does not have enough water or the right balance of salts to carry out its normal functions. If the dehydration becomes severe it can be dangerous

  • Children at increased risk of dehydration include:
    • young babies under 1 year old (and especially the under 6 months)
    • babies born at a low birth weight and those who have stopped drinking or breastfeeding during the illness
    • children with faltering growth​​​​​​

Operation Ouch - Diarrhoea and vomiting

When should you worry?

If your child has any of the following:

  • Breathing very fast or breathing that stops or pauses
  • Working hard to breathe, drawing in of the muscles below the rib, unable to talk or noisy breathing (grunting)
  • Becomes pale, blue, mottled and/or unusually cold to touch
  • Difficult to wake up, very sleepy or confused
  • Weak, high-pitched, continuous cry or extremely agitated
  • Has a fit (seizure)
  • A temperature less than 36oC or temperature 38oC or more if baby is less than 3 months
  • Develops a rash that does not disappear with pressure and seems unwell (see the 'Glass Test')

You need urgent help

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Has blood in the stool (poo)
  • Has constant tummy pain
  • Is unable to keep down any fluids during this illness
  • Breathing a bit faster than normal or working a bit harder to breathe 
  • Dry skin, lips, tongue or looking pale
  • Not had a wee or wet nappy in last 12 hours
  • Sleepy or not responding normally
  • Crying and unsettled
  • Poor feeding (babies) or not drinking (children)
  • A temperature 39oC or above in babies 3-6 months
  • Temperature of 38oC or above for more than 5 days or shivering with fever(rigors)
  • Getting worse or you are worried about them
  • Has diabetes and their blood sugar levels are to high or to low

You need to contact a doctor or nurse today

Please ring your GP surgery or call NHS 111 - dial 111

We recognise that during the current COVID-19 crisis, at peak times, access to a health care professional may be delayed. If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest Emergency Department

If your child has none of the above

Watch them closely for any change and look out for any red or amber symptoms

Additional advice is also available for families for help cope with crying in otherwise well babies

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.

What should you do?

  • Encourage your child to drink plenty of fluids – little and often. Water is not enough and ideally oral rehydration solution (ORS) is best. ORS can be purchased over the counter at large supermarkets and pharmacies and can help prevent dehydration from occurring. This improves the taste and children are more likely to drink it whilst they are unwell
  • Mixing the contents of the ORS sachet in dilute squash (not “sugar-free” squash) instead of water may improve the taste
  • Continue to offer your child their usual feeds, including breast and other milk feeds
  • Do not worry if your child is not interested in solid food. If they are hungry, offer them plain food such as biscuits, bread, pasta or rice. It is advisable not to give them fizzy drinks as this can make diarrhoea worse
  • Your child may have stomach cramps; if simple painkillers such as paracetamol and ibuprofen do not help please seek further advice
  • Most children with diarrhoea and / or vomiting get better very quickly, but some children can get worse. You need to regularly check your child and follow the advice given to you by your healthcare professional and / or as listed on this page

Aftercare

Once your child is rehydrated and no longer vomiting:

  • continue breastfeeding, other milk feeds and fluid intake - give full strength milk straight away
  • reintroduce the child’s usual food
  • avoid giving fizzy drinks until the diarrhoea has stopped
  • if dehydration comes back, start giving ORS again
  • anti-diarrhoeal medicines (also called antimotility drugs) should not be given to children
  • your child cannot return to nursery / school until 48 hours after the last episode of diarrhoea and/or vomiting

Preventing the spread of Gastroenteritis (diarrhoea and/or vomiting)

You and/or your child should wash your hands with soap (liquid if possible) in warm running water and then dry them carefully:

  • After going to the toilet
  • After changing nappies
  • Before touching food

Your child should not:

  • Share his or her towels with anyone
  • Go to school or any other childcare facility until 48 hours after the last episode of diarrhoea and / or vomiting
  • Swim in swimming pools until 2 weeks after the diarrhoea has stopped

Where should you seek help?

  • If it is non-urgent, speak to your local pharmacist or health visitor.
  • Follow the advice in the red, amber and green boxes above

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

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County Durham

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Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

North Cumbria

Northumberland

North Tyneside

Newcastle

Gateshead

South Tyneside

Sunderland

County Durham

Darlington

Hartlepool

Stockton

Middlesbrough

Redcar and Cleveland

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
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