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Diarrhoea and/or Vomiting

Advice for professionals

About gastroenteritis

Feeling sick and then vomiting is usually the first sign that your child has a ‘tummy bug’. Diarrhoea tends to occur after your child has started vomiting and means passing frequent watery poos that are offensive in nature.

  • Tummy bugs are extremely common in young children and are almost always caused by a virus. They are easily spread, resulting in outbreaks in nurseries and schools.
  • Diarrhoea can often last between 5 – 7 days and stops within 2 weeks. Vomiting usually stops within 3 days. If your child continues to be ill for longer than these periods, seek advice.
  • Severe diarrhoea and / or vomiting can lead to dehydration, which is when the body does not have enough water or the right balance of salts to carry out its normal functions. If the dehydration becomes severe it can be dangerous.
  • Children at increased risk of dehydration include:
    • young babies under 1 year old (and especially the under 6 months)
    • babies born at a low birth weight and those who have stopped drinking or breastfeeding during the illness
    • children with faltering growth
Paediatric Pathway

Click here to view the diarrhoea and vomiting paediatric pathway.

When should you worry?

If your child has any of the following: 

  • Has dark green or blood stained vomit
  • Breathing very fast, too breathless to talk, eat or drink
  • Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
  • Breathing that stops or pauses
  • Is pale, blue, mottled or feels unusually cold to touch
  • Difficult to wake up, very sleepy or confused
  • Weak, high-pitched cry or can’t be settled
  • Has a fit (seizure)
  • Has a rash that does not disappear with pressure (the ‘Glass Test’)
  • Is under 3 months old with temperature more than 38°C or under 36°C (unless fever in the 48 hours following vaccinations and no other red or amber features

You need urgent help

Please phone 999 or go to the nearest Hospital Emergency (A&E) Department

If your child has any of the following:

  • Has blood in their poo or wee
  • Has tummy pain that doesn’t go away for more than 1 day even after paracetamol or ibuprofen
  • Is vomiting and unable to keep down any fluids
  • Is drinking or breastfeeding much less than normal
  • Breathing a bit faster than normal or working a bit harder to breathe
  • Dry skin, lips or tongue
  • Not had a wee or wet nappy in last 8 hours
  • Poor feeding in babies (less than half of their usual amount)
  • Irritable (Unable to settle them with toys, TV, food or hugs even after their fever has come down)
  • Is 3-6 months old with temperature 39°C or above (unless fever in the 48 hours following vaccinations and no other red or amber features)
  • Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
  • Temperature less than 36°C in those over 3 months
  • Getting worse and I am still worried
  • If your child has diabetes, monitor their blood sugars closely and follow sick day rules

You need to contact a doctor or nurse today

Please ring your GP surgery or contact NHS 111 - dial 111 or for children aged 5 years and above visit 111.nhs.uk

If none of the above features are present, most children with diarrhoea and / or vomiting can be safely managed at home

Note that children younger than 1 year may become dehydrated more quickly. If your child appears otherwise well but you still have concerns, please contact your GP surgery or contact NHS 111 - dial 111 or for children aged 5 years and above visit 111.nhs.uk

Self care

 

Continue providing your child’s care at home. If you are still concerned about your child, speak to your health visitor, local pharmacist or call NHS 111– dial 111

Children and young people who are unwell and have a high temperature should stay at home. They can go back to school, college or childcare when they no longer have a high temperature, and they are well enough to attend.

This guidance was last reviewed 27/06/2025.

  • Avoiding dehydration and low blood sugar is important – give your baby/child extra fluids and make sure that they contain sugar. In the hospital, diluted apple juice is often used. To make this, simply mix half apple juice and half water (50/50). Please give this between feeds or after each watery stool. Little and often works best – in hospital babies and young children are given 1 or 2 tablespoons (5-10ml) of apple juice to drink every 5-10 minutes. You can try using a syringe to give fluids to your child.
  • Continue to offer your child their usual feeds, including breast and other milk feeds.
  • Do not worry if your child is not interested in solid food. If they are hungry, offer them plain food such as biscuits, bread, pasta or rice. It is advisable not to give them fizzy drinks as this can make diarrhoea worse.
  • Your child may have stomach cramps; if simple painkillers such as paracetamol and ibuprofen do not help please seek further advice.
  • Most children with diarrhoea and / or vomiting get better very quickly, but some children can get worse. You need to regularly check your child and follow the advice given to you by your healthcare professional and / or as listed on this sheet.

Once your child is rehydrated and no longer vomiting:

  • continue breastfeeding, other milk feeds and fluid intake - give full strength milk straight away.
  • reintroduce the child’s usual food.
  • avoid giving fizzy drinks until the diarrhoea has stopped
  • if dehydration recurs, start giving ORS again
  • anti-diarrhoeal medicines (also called antimotility drugs) should not be given to children
  • your child cannot return to nursery / school until 48 hours after the last episode of diarrhoea and / or vomiting
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