Stomach Bugs: A Step-By-Step Guide
We’re seeing a lot of cases of norovirus and gastrointestinal illnesses right now. I know how hard GI bugs can be on families - you’re caring for your little ones, thinking about spread, cleaning a lot, doing tons of laundry — it’s a lot! I want to make sure you know a few things that will help you feel confident caring for your kids and managing these illnesses at home. Let’s walk through it step-by-step.
what to know
Norovirus is a highly contagious virus and a leading cause of vomiting and diarrhea, particularly in young children. It belongs to the Caliciviridae family and is known for spreading quickly in close-contact settings like schools, daycare centers, and households. The virus is primarily spread through:
Direct contact with an infected person.
Consuming contaminated food or water.
Touching contaminated surfaces and then touching your mouth.
Norovirus is most contagious when symptoms are active and during the first few days after recovery. However, the virus can linger in stool for up to two weeks, making hygiene practices essential even after symptoms resolve.
what to do
caring for your child
The most important focus during a GI bug is hydration. Here’s how to keep your child hydrated and comfortable:
Oral Rehydration Solution (ORS):
Use solutions like Pedialyte (they have a dye free version I like) or prepare your own using the World Health Organization’s recipe: mix 1 liter of clean water with 6 teaspoons of sugar and 1/2 teaspoon of salt.
Offer small sips frequently.
Older children can sip water, diluted apple juice (1/2 juice and 1/2 water), or broth.
if your child is vomiting
Wait about 20 minutes from the time your child vomits before trying fluids.
Choose Fluids Carefully. When children are vomiting, they need replacement with fluids that have electrolytes.
Babies < 6 months old: chat with your care team.
Babies 6 months - 1 year old: Breastmilk, formula, or electrolyte solution (like Pedialyte or pedialyte popsicles).
Children 1 year old + older: Electrolyte solution (pedialyte, pedialyte popsicle), diluted juice (1/2 juice and 1/2 water), diluted sports drink (1/2 drink and 1/2 water), breastmilk.
Start Low and Go Slow. Try small amounts of fluids for the first 2-4 hours.
6-12 months: 10 ml (=2 teaspoons) every 5 minutes for a couple of hours.
1-2 years old: 15 ml (=3 teaspoons) every 5 minutes.
2+ years old: 30 ml (=2 tablespoons or 1 ounce) every 5 minutes.
Follow Their Lead. Once they’re tolerating fluids for a few hours, you can start to reintroduce small amounts of regular foods (for kids who have started solid foods). They may not feel like eating, and that’s okay - even for a week or so. Hydration with fluids is the most important thing in their initial recovery. Their appetites will come back slowly over time - keep offering gently, and follow your child’s lead.
if your child has diarrhea
When kids have diarrhea, it can be uncomfortable and also painful.
Use a zinc-based diaper ointment to help protect their skin barrier. This can help to protect their sensitive skin with repeated episodes of diarrhea.
You can use a Peri-bottle with warm water for diaper changes instead of wipes (that can aggravate the skin) if that’s more comfortable for your little one.
If the diarrhea is causing a bad diaper rash that’s painful or causing skin breakdown, try dabbing on a little Liquid Mylanta or Maalox to the affected area. Let it dry and then use a zinc-based diaper ointment. This can neutralize a lot of the painful rash and help with healing. Make sure to chat with your care team
Diet:
When vomiting subsides, you can start to introduce some of your child’s regular foods. Start slow and give them small amounts to see how much they tolerate. In the old days, we used to recommend bland diets like the BRAT diet, but those are no longer recommended (and can even worsen symptoms). It’s better for your child to have a rounded diet so that their gut can start to heal.
Rest:
Do your best to let your child rest to help their healing.
what to have at home
Here is a list of must-haves that I always keep at home in case of stomach bugs. A few essentials will make life much easier when you’re going through it!
tips for prevention
Here are some practical tips to help you prevent spread as best as you’re able.
Handwashing:
Wash hands thoroughly with soap and water for at least 20 seconds, especially after diaper changes, using the bathroom, or before eating.
Alcohol-based hand sanitizers are less effective against norovirus, so prioritize handwashing.
Cleaning High-Touch Surfaces:
Use a bleach-based cleaner or an EPA-approved disinfectant (I use Force of Nature, which is EPA-approved for norovirus and is a non-bleach option) effective against norovirus to clean surfaces like doorknobs, toys, and bathroom fixtures.
Wash contaminated laundry on a hot cycle.
Avoid Sharing:
Teach children not to share utensils, cups, or towels during an illness.
when to seek help
While most norovirus cases resolve on their own, there are times when medical attention is necessary:
Signs of Dehydration:
Dry mouth, sunken eyes, reduced urine output (fewer wet diapers or trips to the bathroom).
Lethargy or excessive fussiness.
Severe Symptoms:
Blood in stool or vomit.
High fever (above 102°F) that doesn’t improve.
Persistent or worsening vomiting or diarrhea
Underlying Health Concerns:
If your child has a weakened immune system or preexisting conditions, call your pediatrician sooner.
With any questions or concerns
Norovirus is unpleasant but can be manageable with proper care at home. By focusing on hydration, maintaining hygiene, and knowing when to seek help, you can help your child recover quickly and prevent the virus from spreading.
Remember, we’re here to support you. If you have any concerns or questions about your child’s health, don’t hesitate to reach out to your pediatrician.