Gastroenteritis means an in-flammation of the stomach and intestines.It is commonly known as the stomach flu, although it is not caused by theinfluenza virus.

The symptoms of the stomach flu can include: Headache, Vomiting, Stomachache, Diarrhea, Fever, Decreased Appetite.

In general, symptoms begin 1 to 2 days following exposure and maylast for 1 to 10 days. For most children, the stomach flu is not a serious illness. However, if a child is unable to drink enough fluids, they may become dehydrated. Occasionally, more severe illnesses can cause vomiting or diarrhea. Call your pediatrician when the symptoms in the box to the right are present.

Diarrhea is the passage of watery stools, usually 3 or more in a 24-hour period. It is the consistency of the stools, more than the number, that is important. Babies fed breast milk will pass loose, pasty stools. This is not diarrhea. Mild diarrhea, during which a child’s energy level and appetite remain normal, requires no special treatment except the avoidance of excessive fruit juice. More significant diarrhea can cause dehydration and should be treated.

ORT ORT comes in a variety of commercial brands, kid-pleasing flavors, and serving sizes. Different from other beverages, ORT contains the electrolytes kids need to re-hydrate quickly.

Dehydration is a loss of both water and salt from the body. The usual cause is a lot of vomiting and diarrhea. If fluid losses are not replaced, the body starts to dry out or become dehydrated. Those most susceptible to dehydration are babies under 1 year of age and anyone with a fever. There is no one way to assess dehydration. Early signs of dehydration include dryness of the mouth and thirst. As dehydration increases, symptoms can include irritability, lethargy, decreased urine output, few or no tears when crying vigorously, and dry sticky saliva.

The best treatment for dehydration is oral re-hydration therapy (ORT). When successful, it can prevent trips to the emergency room and the need for intravenous fluids.

ORT (Oral Re-hydration Therapy) does NOT stop vomiting or diarrhea, but helps prevent dehydration. Good Examples of Dehydration Therapies Over-the-counter Oral Re-hydration Therapy Pedialyte Rehydralyte Ricelyte Resol Gerber or Kaolectrolyte Powders Poor Examples of Dehydration Therapies Not adequate for Re-hydration Sodas (Fizzy or Flat) Sports Drinks Fruit Juices Fact: Re-hydration solutions contain just the right amount of salts and sugars to help avoid dehydration

Oral re-hydration therapy (ORT) is available commercially as Pedialyte, Rehydralyte, Ricelyte, Resol or Kaolectrolyte and Gerber powders. ORT does not stop vomiting and diarrhea; it prevents the body from dehydrating. Using ORT is not always easy. If a child is not yet dehydrated, they may refuse it due to its salty taste. If a child is actively vomiting or nauseated, they may also be reluctant to take the fluid. In this situation, treatment requires time and patience. To over-come a nauseated child’s refusal to drink, ORT can be given in small, frequent amounts, either through a dropper or by a teaspoon every 2 to 3 minutes. If a child vomits, it is appropriate to wait 10 to 15 minutes before giving more fluid.

• For a child under 20 pounds, aim for 2 ounces of ORT every hour over a 4 to 6 hour period.
• For a child over 20 pounds, try 3 ounces of fluid per hour over 4 to 6 hours.
• If your child is not vomiting and is improving consistently, you can gradually increase the fluids. You will need to go more slowly if this increase in fluids induces vomiting.
• As long as it is tolerated, breastfeeding can continue.
• If after 4 hours your child is not vomiting and is consistently thirsty, they can drink unlimited amounts of ORT.

Note: ORT is not effective if the solution is mixed with other beverages.

As soon as your child’s appetite returns, you should feed them. Good food choices include cooked meat, cooked cereal, toast, noodles, bananas, or yogurt.

Assessing Dehydration Determine your child's degree of dehydration and follow the treatment plans below SYMPTOMS NO DEHYDRATION SOME DEHYDRATION SEVER DEHYDRATION Check Diarrhea - number of loose stools per day Less than 4 hours From 4 to 10 hours More than 10 hours Vomiting Less than 4 hours Less than 8 hours Over 8 hours Thirst Normal Greater than Normal Unable to Drink Urine Output Normal Small Amount No Urine for 8 hours Tears Present Decreased Absent Mouth and Tongue Wet Slightly Dry - (Some Saliva) Very Dry - (No Saliva) General Condition Alert, Near Normal Activity Unwell, Fussy or Sleepy Very Sleepy, Very Fussy ASSESSMENT: 2 or More of the Above Symptoms 2 or More of the Above Symptoms 2 or More of the Above Symptoms DECISION: USE PLAN A USE PLAN B USE PLAN C If your child is younger than a year old, please call your pediatrician. Always check with your pediatrician with any questions or concerns as the need arises. Assessing and treating potential dehydration is not a simple process. This guide has been established solely as an additional resource for parents to utilize as they deal with the potential symptoms of gastroenteritis and dehydration at home. These guidelines do not constitute medical advice and do not replace the need to seek the independent medical judgment of your physician in each specific case. These guidelines are current as of the date that they are printed but are subject to change as new information regarding potential dehydration is developed. Treatment Plans for Dehydration PLAN A No Dehydration PLAN B Some Dehydration - If your child is younger than a year old, please call the Doctor - PLAN C Severe Dehydration Feed your child normally. If possible, try giving extra fluids for each bout of diarrhea. Use ORT* for infants. ORT* is also appropriate for older children, but they may not take it due to its salty taste. You may substitute water and salty foods such as pretzels or saltines. For a Child weighting Less than 20 lbs Give 1-2 oz of ORT each hour For a Child weighting More than 20 lbs Give 3 oz of ORT each hour IF VOMITING: Start slowly. For a child under 20 pounds, aim for 2 ounces of ORT every hour. For a child over 20 pounds, try 3 ounces of ORT every hour. If your child vomits, it is appropriate to wait 10 to 15 minutes before giving more fluid. If your child will not take ORT, try giving him/her less, 1 to 2 teaspoons every 2 to 3 minutes. After 4-6 hours, check how your child is doing and choose the suitable treatment plan. If your child’s vomiting is improving, increase the fluids to 1 to 2 ounces per feeding. You may need to go more slowly if the increased amount makes your child vomit. Breastfeeding can continue as tolerated. When your child’s appetite returns, you may feed them. If your child has failed to tolerate therapy after 4-6 hours, please call your pediatricia’s office. IF NOT VOMITING: You can give unlimited amounts of ORT. If your child resists ORT, try giving 1 to 2 teaspoons at a time by dropper or teaspoon every 2 to3 minutes. Breastfeeding can continue as tolerated. Feed your child once their appetite returns. Sever Dehydration Please call your pediatrician's office immediately. * ORT is not effective if mixed with other beverages.