Page 163 - 15Diarrhoeaandvomiting

Diarrhoea and vomiting caused by gastroenteritis in children under 5 years

Advise parents and carers of children:

• who are not clinically dehydrated and are not at increased risk of dehydration:
– to continue usual feeds, including breast or other milk feeds
– to encourage the child to drink plenty of fluids
– to discourage the drinking of fruit juices and carbonated drinks
• who are not clinically dehydrated but who are at increased risk of dehydration:
– to continue usual feeds, including breast or other milk feeds
– to encourage the child to drink plenty of fluids
– to discourage the drinking of fruit juices and carbonated drinks
– to offer ORS solution as supplemental fluid
• with clinical dehydration:
– that rehydration is usually possible with ORS solution
– to make up the ORS solution according to the instructions on the packaging
– to give 50 ml/kg ORS solution for rehydration plus maintenance volume over a 4 hour
period
– to give this amount of ORS solution in small amounts, frequently
– to seek advice if the child refuses to drink the ORS solution or vomits persistently
– to continue breastfeeding as well as giving the ORS solution
– not to give other oral fluids unless advised
– not to give solid foods.
Advise parents and carers that after rehydration:
• the child should be encouraged to drink plenty of their usual fluids, including milk feeds if
these were stopped
• they should avoid giving the child fruit juices and carbonated drinks until the diarrhoea
has stopped
• they should reintroduce the child’s usual diet
• they should give 5 ml/kg ORS solution after each large watery stool if you consider that
the child is at increased risk of dehydration.
Advise parents and carers that:

• the usual duration of diarrhoea is 5–7 days and in most children it stops within 2 weeks
• the usual duration of vomiting is 1 or 2 days and in most children it stops within 3 days
• they should seek advice from a specified healthcare professional if the child’s symptoms
do not resolve within these timeframes.

10.2 Preventing primary spread of diarrhoea and vomiting

Evidence overview
The UK Health Protection Agency and public health physicians are primarily responsible for
providing guidance on the control of infection in the home, in childcare, school and healthcare
environments.

The GDG was aware of two relevant guidance documents commissioned by the Department
of Health 203,204 addressing the prevention of primary spread in childcare facilities, schools, the
workplace and other settings.

GDG translation from evidence to recommendations
Although the intended audiences for these guidelines are healthcare, public health, childcare and
educational professionals, the GDG felt that some of the recommendations were also relevant
to prevention of primary spread of gastroenteritis in the household. The GDG was aware of the
crucial importance of consistent advice for parents and carers in the prevention of spread.

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