Diarrhoea and vomiting

Feeling sick and then vomiting is usually the first sign that your child has a ‘tummy bug’. Diarrhoea tends to occur after your child has started vomiting and means passing frequent watery poos that are offensive in nature.

  • 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
  • Babies under 1 year of age (and especially under 6 months of age) are at more risk of becoming dehydrated when they have a tummy bug than older children. It is important to make sure that they are drinking enough

Operation Ouch - Diarrhoea and vomiting

When should you worry?

If your child has any of the following:

  • Becomes pale, mottled and feels abnormally cold to touch
  • Going blue around the lips or too breathless to talk / eat or drink
  • Becomes extremely agitated, confused or very lethargic (difficult to wake)
  • Develops a rash that does not disappear with pressure (the ‘Glass Test’)
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features) 

You need urgent help

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

If your child has any of the following:

  • Seems dehydrated: sunken eyes, drowsy, sunken fontanelle (soft spot on baby’s head) or not passed urine for 12 hours
  • Has blood in the stool (poo)
  • Tummy pain that doesn't go away
  • Has completely stopped drinking or breastfeeding
  • Is unable to keep down any fluids during this illness
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
  • Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
  • Continues to have a fever of 38.0°C / 100.4°F  or more for more than 5 days
  • If your child has diabetes, monitor their blood sugars closely

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 none of the above features is present, most children with diarrhoea and / or vomiting can be safely managed at home

(Please note that children younger than 1 year may become dehydrated more quickly. If your child appears otherwise well but you still have concerns, please contact your GP surgery or call NHS 111)

Additional advice is also available to young families for coping with crying of well babies – click here

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – (dial 111), or contact your local community pharmacist

What should you do?

  • Avoiding dehydration is important. Give your baby/child extra fluids.
  • Consider giving your baby oral rehydration solution (ORS) in between feeds or after each watery stool. Little and often tends to work best. In hospital, babies are given 1 or 2 tablespoons (5-10 mls) of fluid to drink every 5-10 minutes. You can try using a syringe to give fluids to your child. Mixing the contents of the ORS sachet in dilute squash (not “sugar-free” squash) instead of water may improve the taste.
  • Don't stop giving your baby milk. If you are breastfeeding, continue to do so.
  • Don't 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.
  • To avoid spreading the virus, wash your hands with soap and water after changing nappies. Keep toilets clean and don’t share towels.
  • They should not return to school or any other childcare facility until 48 hours after the last episode of diarrhoea and / or vomiting
  • You can get Oral Rehydration Solution (ORS) from the pharmacy. Please speak to your local community pharmacists for further advice on ORS.

How long will your child’s symptoms last?

  • Vomiting tends to last for 1-2 days. Diarrhoea tends to last for about 5 days.
  • The charts below show how long diarrhoea and vomiting lasts in children when they have a tummy bug. The faces represent 10 children who have seen their GP with a tummy bug. Green faces are those children who have recovered within that time period.

The diagrams above are taken from www.whenshouldiworry.com


Where should you seek help?

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

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

All community pharmacies across England are required to be Healthy Living Pharmacies. This means that they are able to offer advice about a range of healthy living matters which includes eating a healthy diet. They can provide information leaflets and give parents/carers and young people more information about other organisations that might be able to also help them with healthy eating.

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

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

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 the child and adolescent mental health services.

 

Contact your local Health Visiting Team:

Bradford Health Visitors or call - 01274 221223

Wakefield Health Visitors or call - 01924 310130

Craven Health Visitors or call - 01423 544265

Leeds Health Visitors or call - 0113 843 5683

Calderdale Health Visitors or call - 030 0304 5555 (local rate number)

Kirklees Health Visitors or call - 030 0304 5555 (local rate number)

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 about what Health Visitors do: 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.

Contact your local school nursing team:

Bradford School Nurses01274 221203

Wakefield School Nurses01924 310130

Leeds School Nurses - 0113 843 5683

Calderdale School Nurses030 3330 9974 (local rate number)

Kirklees School Nurses0300 304 5555 (local rate number)

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.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

All children should be registered with a GP. Anyone in England can register for free with a GP surgery. You do not need proof of address or immigration status, ID or an NHS number.

How to find your local GP.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

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

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.

Please note, the online version of NHS 111 is only recommended for children over the age of five. If your child is under five years old, please phone 111.

NHS 111 can also direct you to your nearest urgent treatment centre (minor injuries unit or walk-in centre).

Find your local urgent treatment centre.

When to visit an urgent treatment centre.

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
  • breathing difficulties
  • severe bleeding that cannot be stopped
  • major trauma such as road traffic collisions

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