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Diarrhoea and Vomiting
Tummy bugs are very common in young children and are almost always caused by a virus. They are easily spread around nurseries, schools and in families.
Diarrhoea often lasts between 5 to 7 days and stops within 2 weeks. Vomiting usually stops within 3 days. If your child continues to be ill for longer, seek advice.
Severe diarrhoea or vomiting can lead to dehydration, which is when the body does not have enough water or the right balance of salts. If this becomes severe it can be dangerous. Dehydration happens more in small babies. It is important to make sure your child is drinking enough.
Operation Ouch - Diarrhoea and vomiting
When should you worry?
If your child has any of the following:
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Has dark green or blood stained vomit
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Breathing very fast, too breathless to talk, eat or drink
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Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
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Breathing that stops or pauses
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Is pale, blue, mottled or feels unusually cold to touch
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Difficult to wake up, very sleepy or confused
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Weak, high-pitched cry or can’t be settled
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Has a fit (seizure)
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Has a rash that does not disappear with pressure (the ‘Glass Test’)
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Is under 3 months old with temperature more than 38°C or under 36°C (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:
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Has blood in their poo or wee
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Has tummy pain that doesn’t go away for more than 1 day even after paracetamol or ibuprofen
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Is vomiting and unable to keep down any fluids
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Is drinking or breastfeeding much less than normal
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Breathing a bit faster than normal or working a bit harder to breathe
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Dry skin, lips or tongue
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Not had a wee or wet nappy in last 8 hours
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Poor feeding in babies (less than half of their usual amount)
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Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
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Is 3-6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
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Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
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Temperature less than 36°C in those over 3 months
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Your child is jaundiced (whites of the eyes appear yellow)
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Getting worse or you are worried about them
You need to contact a doctor or nurse today
Please call your GP surgery or contact NHS 111 - Go to 111.nhs.uk or call 111.(111 online does not currently take questions about children aged under 5, so if your child is 4 or younger, please call 111).
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, recheck that your child has not developed any red features.
If none of the above features are present:
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Watch them closely for any change and look out for any red or amber symptoms
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Additional advice is also available for families for help cope with crying in otherwise well babies
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If your child has a long term condition or disability and you are worried please contact your regular team or follow any plans that they have given you
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
What should you do?
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Make sure your child is drinking plenty of fluid. Small amounts often are best
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Water is not enough and you need to make sure that your child is getting some sugar. This could be using diluted apple juice, squash containing sugar or Oral Rehydration Solution (ORS). ORS can be purchased over the counter at large supermarkets and pharmacies and can help prevent dehydration from occurring
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If using ORS, it is helpful add dilute squash (not “sugar-free” squash) to improve the taste
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Continue to offer your child their usual feeds, including breast and other milk feeds
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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. Do not give them fizzy drinks
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Your child may have tummy pain and you can use paracetamol. For more information please look at our tummy pain page.
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Please do not use anti diarrhoea medicines in children
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Your child cannot return to nursery or school until 48 hours after the last episode of diarrhoea and vomiting
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You and your child should wash your hands with soap and then dry them carefully:
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After going to the toilet
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After changing nappies
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Before touching food
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Your child should not share their towels with anyone
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Your child should not swim in a swimming pool until 2 weeks after the diarrhoea has stopped
How long will your child’s symptoms last?
- Vomiting tends to last for 1-2 days, and 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?
- If it is non-urgent, speak to your local pharmacist or health visitor.
- If your child has any of the above features, urgently see your GP. For an urgent out-of-hours GP appointment, call NHS 111.
- You should only call 999 or go your nearest A&E department in critical or life threatening situations.
For wear and tear, minor trips and everything in between
Self-care
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?
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
- Visit a pharmacy if your child is ill, but does not need to see a GP
- Remember that if your child's condition gets worse, you should seek further medical advice immediately
- 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 to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
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.
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.
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.
Sound advice
You have a choice of service:
- Doctors or GPs can treat many illnesses that do not warrant a visit to A&E
- 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, you can call 111 or use 111 online.
Please note that 111 online is for people aged 5 and over. Call 111 if you need help for a child under 5.
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.