As a parent, you would have faced many anxious moments at every stage of your baby’s growth and development. Even mild tummy aches feel like nightmares and when symptoms like fever, vomiting and diahhroea occur rather suddenly and intensely, you are bound to experience anxiety, nervousness and panic. This happens because most parents do not know what is going wrong with their child and every effort to control the situation seems to be making it worse. Child throws up food, water and even medicine, making the parent feel even more anxious and helpless.
This is one the most common situations experienced by parents around the world and is often caused by a Virus affecting the gut, technically called viral gastroenteritis. It is the most common form of acute Gastroenteritis in the UAE, usually caused by viruses like Adenovirus, Rotavirus, Calcivirus, Corona virus and several other viruses. Sometimes bacteria like Salmonella could also be responsible, but such cases are not as common as the viral infections.
In UAE, majority of the cases are believed to be caused due to Rotavirus and more commonly among the expatriates, the severest form occurring in infants between the ages 3-24 months. Viral Gastro is a contagious infection and it spreads through close contact with the infected person. Playpens and toys usually help pass on the infection amongst the children.
Symptoms usually begin 1 or 2 days after the infection. May begin with fever or Vomiting and it can go from mild to severe. Vomiting and retching can be so severe that even a drop of water could be intolerant. Children may panic and cry after every bout of vomiting, feel lethargic and get clingy. Abdominal pain is common and they may have watery stools for 3 to 8 days. There could also be a fine allergic rash on the body in some children.
Symptoms of Dehydration like excessive thirst, dryness of skin, mouth and lips, scanty urination, weakness and dizziness are quite evident even in mild cases. At times, though not always, severe dehydration may set in requiring hospitalization and immediate medical attention.
What can parents do to help?
Preventing dehydration is the key line of treatment and this should begin at home itself. Most viral infections are self-limiting and they will go away on their own. Hence parents should first stop panicking and start focusing on managing dehydration.
For the 1st 24 hours, all types of solid foods and milk and milk products, except breast milk, should be stopped immediately. Breastfeeding mothers can continue nursing their babies, but all forms of solid food, as well as formula milk will have to be stopped if the vomiting is persistent. Parents on the contrary try to feed the child more often assuming the child is hungry and weak after every episode of vomiting. This only makes it worse. Milk products are rich in protein and the incapacitated digestive tract will not be in a position to breakdown the protein and lactose found in milk. Instead of food or water, Oral Rehydration solution (ORS) should be given immediately and at frequent intervals, but in small quantities, especially when the vomiting is severe. Commonly used ORS solutions for children are Babylite and Pedialyte. These solutions not only prevent dehydration but also control the nausea and vomiting indirectly by restoring the salt imbalance.
After 24 hours, if the vomiting ceases, liquids like water and clear soups can be offered. If the child is able to tolerate clear liquids, then you can progress to giving some bland and easy to digest foods like mashed banana, applesauce, plain toast, rice and probiotic rich drinks like laban. While breastfed babies can continue with breast milk, it is better to limit other dairy products like milk, butter and cheese at least for another week. Citrus fruits and juices like orange can be avoided for a while to prevent gastric irritation.
While most gastro infections can be managed at home, parents should always keep an eye for signs of severe dehydration. If the fever is very high, or if the child is cranky or drowsy, and despite the oral rehydration, if the vomiting persists, has dry mouth, passes little or no urine for a long time (about 6 hours), then the child may require immediate medical attention and fluid replacement. It is advisable to visit a doctor for immediate restoration of fluids in such situations.
Suggested reading: Are probiotic foods good for your health?
Written by Dr. Arpitha Reddy