Gastroenteritis: What to Feed Sick Kids
Gastroenteritis, or “gastro” as it is more commonly known, is a frequent visitor in most homes with children. Young children in particular, who may share toys with little friends and put objects and hands in their mouths without washing them, are notorious for spreading this disease. I should know: I have two little monsters spreading germs and, with my sensitive stomach, they never fail to share with me. Which is exactly what they have done yet again. Now that I’m down with this dreaded yet common disease, it prompted me to ask: When your kids come down with gastroenteritis, what should you give them to eat and drink?
What is Gastroenteritis, or “Gastro”?
Gastroenteritis is an infection of the gastrointestinal system, which is also known as the alimentary canal. The alimentary canal begins with your mouth and throat, then proceeds through your stomach, intestines, and bowels. Gastroenteritis can be caused by many different bacteria and viruses, so children can get gastro multiple times. It can last as little as 24 hours or as long as 10 days.
The most common symptom of gastroenteritis in children is diarrhea, or watery stool. Kids may also experience stomachache, cramping, or even vomiting. Fortunately, the vomiting phase usually lasts only a short time, even if the diarrhea persists for a few days.
Gastroenteritis can be dangerous for babies. If you have any concerns for your child’s health, please bring them to the doctor! Especially look out for symptoms of dehydration, including a lack of urination (wet nappies/diapers), has a dry mouth/tongue, has sunken eyes, has unusually cold hands/feet, or is exceptionally sleepy.
Children with Gastroenteritis Need to Drink!
This is essential no matter what the age of the child. Children who are vomiting should drink clear fluids even if they are going to vomit them up again. Vomiting on an empty stomach is awful and is not good for your kids (on an empty stomach, stomach acids or bile can still come up, which are not good for the lining of the throat). All children should be given a drink of water immediately after they vomit, to wash acids out of the throat, to rehydrate, and also to put something back in their stomachs. After that, kids should be offered a small drink (a sip or a mouthful) every 15 minutes or so to rehydrate and to see if they are able to keep fluids down.
What Should Kids with Gastroenteritis Drink?
When I was a kid, my mom always told me that ginger ale or another carbonated beverage would help settle my stomach. To tell you the truth, it still works for me to this day! But this is actually purely psychological – experts now tell us that carbonated beverages and soft drinks are actually not good for anyone (adults included) who has gastroenteritis!
So here is what to give your kids:
- Water. Water is the best prevention for dehydration. However, kids also need electrolyte replacement to avoid dehydration, so you should also give:
- Oral rehydration products, such as Pedialyte, that you can get from your local pharmacist/chemist – prepare them according to package instructions.
- Sucrose solution. Mix 1 teaspoon of maple syrup or honey in 1 cup of water.
- All natural fruit juice. Best if freshly juiced to retain all the enzymes! Mix 1 part fruit juice to 4 parts water.
- Cordial. I use a homemade rosehip cordial for this – I do not buy the processed, packaged stuff. My rosehip cordial is nothing but rosehip syrup with honey and a bit of agave nectar. Rosehip cordial is also good because rosehips help soothe stomach pains. Mix 1 part cordial to 16 parts water.
- Weak herbal infusion of ginger, as ginger reduces nausea; peppermint, which also reduces nausea; or chamomile, which soothes the bowels.
Here is what not to give your kids to drink when they have gastroenteritis:
- Soft drinks or carbonated beverages (sorry, Mom!).
- Sweetened fruit juices (even with concentrate) or fruit drinks.
- Sports drinks such as Gatorade.
- Caffeinated beverages (such as black tea).
- Alcoholic beverages (but you shouldn’t be giving your kids these anyway…).
- Broth, even clear broth.
Babies with Gastroenteritis
When babies get gastroenteritis it is very dangerous. Fortunately, there is now a rotavirus vaccine, which has dramatically reduced the number of cases. Vaccinations for rotavirus are administered (in Australia) begin administration at 2 months of age, so please get your baby vaccinated as soon as he/she is able, especially when there are so many irresponsible parents about failing to vaccinate their children. Remember, gastroenteritis can be fatal, especially for vulnerable babies. Gastroenteritis kills 1.4 million people every year*, half of which are children under the age of 5!** If your baby gets gastroenteritis monitor them very closely or take them to the doctor.
Babies who are breastfeeding should still be offered the breast as much as they desire. If you are exclusively breastfeeding and your sick baby will not take a bottle with some additional water to counteract fluid loss after vomiting, ensure your baby is latching on properly and actively sucking. Offer them the breast frequently and for as long as they want, especially following every vomit. Monitor them carefully and contact a doctor immediately in the event of any concern, as it is impossible to measure exactly how much milk they have consumed from the breast. A good way to tell if your baby is adequately hydrated is to check that they have wet their nappy/diaper as frequently as normal.
Babies who are bottle-fed should be given the clear fluids listed above for the first 12 hours, taking care to check that the baby drinks after every vomit and is offered small amounts of liquid frequently thereafter to prevent dehydration. (To administer small, mouthful sized amounts, I find a syringe very useful.) After 12 hours reintroduce their standard formula, but offer it at first in smaller amounts and more frequently.
Should Kids with Gastroenteritis Eat?
Conventional thinking was that kids with gastroenteritis should not eat, should eat very little, or should otherwise be restricted. But now experts have stopped this thinking. Today, experts advise that if your child wants to eat, they can eat.
This actually makes really good sense, if you think about it. Eating food starts up peristaltic contractions in the intestines, forcing digesting food through the bowels and “moving things along,” so to speak.
This does not mean you should force food upon your child! If your child refuses food, this is perfectly normal. But if your child does want to eat, you should allow them to eat. If you are concerned about vomiting, you can give them food more frequently in smaller amounts.
What Should Kids with Gastroenteritis Eat?
Just because kids with gastroenteritis can eat as they normally want to, does not mean all foods are created equal. If your child is vomiting, trust me when I say you don’t want to feed them dairy! If you have never had to smell milk vomit, just ask my mother and she will expound on how much you never, ever want to.
When I was a kid (and even today when I get sick as an adult), my mom invariably puts me on the BRAT diet (bananas, rice, applesauce, toast). Basically, the BRAT diet consists of bland foods, like plain rice or plain pasta. The idea behind the BRAT diet is that bland foods cannot irritate the digestive tract. However, today the BRAT diet is no longer recommended because it lacks the nutritional value to help the gastrointestinal system recover. Children who have gastroenteritis should be able to resume eating a healthy, balanced diet within 24 hours of coming down with gastro.
Nevertheless, there are still some foods to avoid. You want to make sure your child is getting fresh fruits, vegetables, and whole grains packed with nutrients.
Here are some foods to avoid if your child has gastroenteritis:
- High-salt canned or packaged soups (homemade low-sodium soups are fine)
- Fried or otherwise high-fat foods (e.g., potato chips, french fries, pastries, etc.)
- Ice cream, sherbet, popsicles, and jelly (Jello)
- Dried, dehydrated, or freeze-dried fruits and vegetables (these require extra water to digest and are not ideal when you are trying to prevent dehydration)
- Fruits canned in syrup (too high in sugar – but kids should not eat this anyway!)
- Spicy foods (spicy food can irritate the gut)
- High-sugar foods, such as sugary cereals, candy, and chocolate
Prevention is the Best!
The best strategy for dealing with gastroenteritis is simple avoidance of spreading it in the first place! Keep your children home from day care or creche and do not bring them to play dates so they do not spread it to other children. Everyone in the family should wash their hands regularly, especially after going to the toilet or before eating, including children. Remember to wash your hands well after changing nappies/diapers and before feeding babies.
The conventional thinking we grew up with is done! We now know that it is okay to let kids eat when they have gastroenteritis. Not only can they eat, but they can even eat a normal, healthy, balanced diet. Kids today do not need their food restricted, nor do they have to eat just a bland diet when they get sick. I hope you will find this guide helpful the next time a child you know gets gastroenteritis!
*Lozano, R (Dec 15, 2012). “Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010.”. Lancet 380 (9859): 2095–128. doi:10.1016/S0140-6736(12)61728-0. PMID 23245604.
**Walker, CL; Rudan, I; Liu, L; Nair, H; Theodoratou, E; Bhutta, ZA; O’Brien, KL; Campbell, H; Black, RE (Apr 20, 2013). “Global burden of childhood pneumonia and diarrhoea.”. Lancet 381(9875): 1405–16. doi:10.1016/S0140-6736(13)60222-6.PMID 23582727.