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There are many wonderful “firsts” we get to experience as parents – the first smile, first giggle, first words, and first steps to name just a few. But perhaps the least favorite “first” is the first stomach bug.

Surviving the stomach bug is one of the undesirable rites of parenthood we all have to go through. So whether this is your first time dealing with the stomach bug or you’re an unfortunate veteran, here are some answers to the most common questions we get in the office.

What are the symptoms of gastroenteritis?

The red-flag symptoms that a parent needs to be on the lookout for are a decreased frequency in peeing (< 3 times per day), bloody stools, or dark green vomit. Diarrhea may also occur. If your child experiences green stools or diarrhea, this is likely due to the rapid movement of contents through the intestines. A child who is difficult to wake up or limp like a rag-doll needs to immediately see a doctor. Vomiting without any diarrhea for more than 48 hours or vomiting after a recent head injury should be checked out by your pediatrician.

My toddler is throwing up and has diarrhea. I’m worried he is going to get dehydrated, what should I do?

After your toddler throws up, wait an hour and then offer a small amount (only 5 ml or one sip) of fluids. Let them continue to take small sips every 5 minutes. Resist the urge to give more volume as guzzling down a sippy cup can overfill an irritated belly and lead to more vomiting. If they can tolerate the small sips for about an hour, you can increase to a volume to 1-2 oz per attempt. After your toddler has made it 4 hours without vomiting, you can let them drink normally.

What is the best fluid for my toddler?

Pedialyte is a good choice because the sugar to salt ratio allows for maximum absorption of the fluid. However, maybe you don’t have pedialyte on hand or your child really hates the taste. You can make your own oral hydration solution with the following recipe: 4 c water, 1/2 tsp salt, 2 Tbsp sugar, 1/2 tsp instant jello powder for flavor. Additionally, for children who are only mildly dehydrated, a reasonable alternative is Gatorade or diluted apple juice. Do not fret too much about what your toddler is drinking – focus on the fluids going down and staying down!

Everyone is talking about probiotics – does my child need one?

A probiotic is a microorganism that has a beneficial effect on your health. You may hear probiotics referred to as “good” bacteria because they can help keep the digestive-tract healthy. There is good evidence that probiotics can decrease the duration of diarrhea by 1 day. As both a mom and pediatrician, one day less of diarrhea is a huge deal! Probiotics are sold under all different brand names (ie culturelle). The “active ingredient” you are looking for is Lactobacillus GG and S. boulardii, and the probiotic should be given 1-2 times per day.

How can I keep the rest of my family from getting the stomach bug?

Infectious diarrhea is spread through the fecal-oral route. The virus or bacteria are contained in stool and easily spread through diaper changes or helping a toddler potty. Stepping up hand washing frequency for the whole family is your best bet at stopping the spread of these germs.

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