Lou Romig, MD
Norovirus, like other viruses that cause vomiting and/or diarrhea, is very contagious to both children and adults. Very small children, the elderly and anyone with weakened immune systems have higher risks of getting very sick with these viruses and should be kept away from others with those symptoms.
If your child vomits, let his/her stomach rest for about half an hour before trying to give them clear fluids, such as Pedialyte or sports drinks; administer a teaspoon or a sip at a time. Give small amounts of fluids every 5-10 minutes, gradually giving more at a time as the child is able to keep fluids down. Fruit popsicles and gelatin count as clear liquids and should also be consumed just a little at a time. If the child continues to vomit, despite trying clear fluids for an hour or so, they should be seen by a medical provider. Children who are breastfeeding should continue to breastfeed, but more frequently than usual and for shorter periods of time. The child should not try any solid foods, including crackers, until they’ve had no vomiting and are tolerating liquids by mouth for at least 8-12 hours. Don’t keep your child on just clear liquids for more than 24 hours, as they need the calories and nutrition found in regular food. Children less than about 3 months of age should not go more than about 12 hours on clear liquids alone.
If your child is having diarrhea without vomiting, give them additional fluids to drink every time they stool. Lower-sugar clear liquids such as Pedialyte or Gatorade G2 are best, but if your child only wants to drink one thing, including milk, you may allow it. A starchy diet may help firm the stool a little faster. Viral diarrhea sometimes lasts for more than a week, but you should have your child seen if they have had diarrhea for more than 2-3 days, even if they seem okay otherwise.
Signs of dehydration include a dry mouth with sticky or no saliva; crying without tears/dry-looking eyes; or no urination for more than 6-8 hours for infants and young children, or more than 10-12 hours for older children. Well-hydrated children should have the urge to urinate at least every 2-4 hours. Dehydrated children are often far less active and sleepier than usual and may also be cranky.
When to Seek Medical Treatment
If your child isn’t taking in fluids, is vomiting or having frequent diarrhea, or is having periodic mild to moderate stomach pain, it’s ideal to take them to their pediatrician or an urgent care center, preferably one that specializes in caring for children. If your child is vomiting green or bloody stomach contents, having constant or severe stomach pain, having more than just streaks or small dots of blood in the stools or does not recognize and respond to you as usual, take him or her to a pediatric emergency department.
Whenever a family member has vomiting or diarrhea, it’s best to encourage frequent hand-washing by all family members. Don’t share bottles, nipples, drinking cups, silverware, pacifiers, etc. Unless informed otherwise by a medical provider, assume your child is contagious until they’ve had no vomiting or diarrhea and no fever for at least 24 hours. Don’t send them to school or daycare until the contagious time period has passed.
Call your primary care physician any time if you have questions or concerns about your child’s health.