Most babies will have loose poos at some stage. Diarrhoea is generally much more watery than normal breastfed poo and formula-fed poo, smells more acidic and can leave your baby with a sore, red bottom.
Diarrhoea and vomiting is a very common childhood illness. Very young babies can vomit a lot particularly because they mainly just have a milk diet. However, vomiting and diarrhoea can be severe enough to require hospitalisation.
What’s causing my baby’s vomiting and diarrhoea?
Prolonged bouts of vomiting are often caused by a tummy bug – for example rotavirus and this causes severe gastroenteritis, which is one of the main reasons for a baby being admitted to hospital in their first year. Breastfed babies get these tummy bugs less often than formula-fed babies.
A vaccine is available though you will probably need to pay for this as it is not given as part of the routine childhood immunisation schedule. It should ideally be given before a baby is 16 weeks old, and will not be effective if it is given after a baby is 24 weeks old.
When should I start worrying if my baby is vomiting or has diarrhoea?
Vomiting can be a symptom of other underlying problems so it is always important to look at all your baby’s symptoms together and think if they have been in contact with anyone else with similar symptoms.
It is particularly important if your baby has vomiting and a fever together that you seek medical advice quickly. This could suggest an underlying ear infection, chest infection, urinary infection or, in a severe case, meningitis, so it’s important to seek help quickly.
Could my baby dehydrate if she is vomiting or has diarrhoea?
If babies are vomiting or pooing out more fluid than they are taking in, they are at risk of dehydration, especially if this goes on for more than a day. Early signs of dehydration would be that your baby is not passing enough urine and the nappies are dry when you would expect them to be wet (although it may be difficult to tell how much urine they’re passing when they also have diarrhoea). It might be that your baby is not producing tears when she cries, her mouth or tongue might seem to be quite dry and she becomes quite listless and floppy.
A dehydrated baby may become lethargic or irritable, and have loose, pale or mottled skin. Their eyes and fontanelle (the soft spot on the top of their head) may become sunken (though do not wait until you see these symptoms as they are generally a late and extreme sign of dehydration). They may lose their appetite and have cold hands and feet.
If you see these signs of dehydration, it’s really important to see your doctor quickly to have your baby assessed and treated.
How can I keep my baby hydrated if she has vomiting and diarrhoea?
If your baby becomes dehydrated she will need extra fluids. Offer her frequent breastfeeds or bottle feeds. Diarrhoea in itself is easier to look after because you can continue to give the baby fluid through their mouth.
If your doctor recommends it, you can buy oral rehydration fluids or salts from your local pharmacy, or get a prescription from your GP. These help to replace all the electrolytes lost during vomiting and diarrhoea. Get medical advice to make sure this is the right treatment for your baby, and guidance on how to give these to your baby.
Contact your GP urgently for advice if your baby had six or more diarrhoea nappies in the past 24 hours, or if your baby has vomited three times or more in the past 24 hours. If your baby is unwell (is less responsive, feverish or is not passing much urine) and not ‘herself’, or if vomiting carries on the next day, get your doctor’s advice straightaway.
How can I protect my baby from vomiting and diarrhoea?
Vomiting and diarrhoea bugs are easily spread from one person to another, especially children. Make sure everyone washes their hands frequently using warm soapy water. Keep toilets clean and wash towels frequently on a wash of at least 60 degrees.
If you bottle feed your baby make sure that the bottle and all equipment is washed and sterilised properly. Sterilising bottles is really easy – just pop them in boiling water for 10 minutes – you don’t need any expensive equipment.
To avoid passing on your own baby’s tummy bug to other people, wash your own hands a lot, don’t share towels, keep your baby away from nursery and baby activities for 48 hours after recovery and don’t take your baby into a swimming pool for two weeks after the bout of diarrhoea.