Generally, what happens in the gastrointestional (GI) tract when it’s infected (either by a virus or bacteria) is that is get’s irritable. One strategy to help keep fluids down is to give very small amounts of fluid frequently. The stomach is more often able to handle these small amounts of fluid rather than just letting the child drink what they want. They’ll keep more down and you’ll be able to know exactly what they’ve taken in.
Pedialyte or equivalent is generally recommended for kids 2 and under. Sports drink preparations for kids 3 and up.
Sometimes, kids aren’t very fond of the commercially prepared flavors. One nursing trick for you to try at home is to get unflavored Pedialyte or an equivalent knock-off brand. Get a sugar-flavored drink mix and put just enough crystals in the fluid to give it a decent taste. It doesn’t take too much and mix only a small volume—a couple of ounces at a time. Then, if your child doesn’t like it, you haven’t wasted much of the Pedialyte which tends to be more expensive and you can try another flavor with the less expensive drink mix.
Once mixed, give small amounts every five minutes. For babies under 3 months—give 3ml. For 3mo-3yr—give 5ml. For 3+yrs—give 5-10ml to start. Once your child has tolerated this for 30-45 minutes, you can try to double the dose of the fluid.
What if they vomit? Give it 15 minutes and start over.
How long do I do this? It can be labor intensive as we’ll want to stay this route for several hours—like 4-8 hours of giving these small amounts of fluid frequently. Often times, parents will keep up the routine for an hour and if their child has done well, they’ll let them drink what they want. Sure enough, everything comes back up. Better to stick with the slow route.
When should see a doctor?
- Concern for dehydration. Some of the signs are as follows: Dry, cracked lips. No tears when your child cries. Pale color. Listless. Lack of a wet diaper in six-eight hours. Vomiting will lead to dehydration more quickly and the younger the child the more at risk they are. An infant 0-12 months who continues to vomit even with the small amount of fluids frequently needs to be seen. There are some concerning gut issues (like obstruction) that occur in this age group that is worthy of an MD exam.
- You notice blood or bile. Any time blood is noted in diarrhea or vomit, you should see your doctor. Bile looks either bright yellow or vivid green. Old blood can look like brown flecks. All of these should be evaluated.
- Your child fails ORT at home. You’ve given it your best shot but your child continues to vomit despite giving the small amount of fluid frequently.
- Abdominal Pain. This can be hard because stomach cramping is not unusual with gastroenteritis. This is at your discretion if the pain is worrisome considering your child’s normal baseline and how they handle pain.
- They flat out refuse oral fluids. Here, you’re backed into a corner. Of the utmost importance is for your child to be drinking. They must stay hydrated. So, if they won’t take anything at all, you’ll need to be seen by your doctor or in the ED.
Have you ever tried ORT at home?
Jordyn Redwood has served the pediatric population and their families for many years. She has five years of experience in the pediatric ICU and ten years of pediatric ER nursing which is the area she currently works. Jordyn also teaches CPR and advanced resuscitation courses.
Disclaimer: Remember, these posts are for education and discussion. If your child is sick and you think they require medical attention, take them to their pediatrician or local emergency department.