Ah, the week of the stomach flu… I have just gone through one, so I am thinking about it. It’s my fourth time in five years, so that means almost each year it hits. I hate this week. I hate it every time it comes. But since it is largely the same, I thought I’d post about it just in case it helps someone.
Rotavirus is the most common cause of a week or two of family “stomach flu.” It is very common with babies and young children, and despite what the websites tell you, it usually passes on to the adults in the house! I don’t know why they say adults usually don’t get it, or as severely, because that’s not true. The bigger the adult, usually the more violent it is.
Anyway, rotavirus usually starts very suddenly with your child fine and eating, and then randomly after some meal, just vomiting everything up. Sometimes several times. If you try and give them Pedialyte, they will most likely vomit that up too. So despite what the websites say, save your money and don’t try that right away. Wait a day or two. The vomiting may last for awhile, it depends on the child. Usually the child will vomit until the stomach is all the way empty, and will stop once it is. If you give them cheerios or whatever the next mealtime, or liquids too soon, they probably will vomit that too. In my limited experience, it has usually taken 24 hours for my little children to hold anything in their stomachs. Sometimes closer to 48. And usually it is only a graham cracker or something very small. Once they can hold it down, they are usually crampy and don’t have much appetite anyway for awhile… cheerios or saltines are as ambitious as they get.
The other main symptom of rotavirus is diarrhea. And it is nasty–explosive, watery, smelly. I could always tell when my child’s diarrhea was stomach virus versus something else because it was so pungent. Sometimes my child got diarrhea right away with the first vomiting. Danger on both ends! A plastic high chair is a good place for a young child to be at these times because it is easy to clean up. Other times, the diarrhea follows after the vomiting stage is over, like 24-48 hrs later. The child might even be hungry and eating, but the diarrhea continues… usually directly after eating, and sometimes several bouts quickly before it stops. In my toddlers, they were usually fine when they weren’t eating, and I could put them down for a nap in between meals without worrying they’d mess the crib. But the sad thing is that the diarrhea can last a long time, even 7 days or more. In these cases, you really have a situation because the child might be back to “normal” but you have to watch them like a hawk for those bowel movements… they can really make a mess. Be prepared to have a lot of bleach, pairs of pants (jeans are the best), and a lot of laundry on hand for awhile. (And a face mask, for you!) As bad as it is, it is easier to deal with toddlers in diapers than preschoolers in underwear. You may want to consider putting a preschooler back in diapers or disposable swimmies, just for this situation. It’s embarrassing for them, but most preschoolers have trouble making it to the toilet in time, every time, when it comes quickly or often. You can have them wear plastic pants over their undies, but the elastic around the legs often makes it hard and messy to get off. Definitely avoid socks and sneakers if you can, since they will get messed. Stick with bare feet and plastic shoes like Crocs or sandals.
The main risk of Rotavirus is dehydration, and it is not totally uncommon for children or adults to have to go to the hospital for a rehydrating IV. Definitely if the patient cannot keep water down for more than a day, or passes out from the vomiting, you should take them to the ER so they can IV and monitor. But it is not uncommon to vomit seemingly forever, even turning pretty white, and just have to stick it out in your own bathroom until you can keep fluids down. If you have an infant, keep feeding and give Pedialyte in small doses (1 tsp) regularly after the vomiting stops. Some websites recommend soy formula rather than lactose-based for the recovery (because of the protein and easier digestion), although some infants can’t tolerate the soy even when they’re healthy!
The good news is, the worst of the rotavirus usually is over in 48 hrs–per person. But by then it has usually passed on to someone else! Then the 48 hrs begins for them. Usually the major vomiting stops within that time period, but don’t make the mistake of drinking/feeding too much, too early. Go slow or the vomiting can return and you’re back to step 1. Websites will say to offer food 6hrs after vomiting has stopped, but I find that is too early. Websites say not to stick to the BRAT diet necessarily, but I find that to be misleading… toast and crackers really are the first foods for an upset system, and I wouldn’t venture beyond that until those are happily digested. And websites today often say milk products are not as bad as people thought. But I have found (through experience) to stay away from dairy products for a week or more. .. until the diarrhea is gone. Stay on carbs, but make sure they are always getting enough water and Gatorade. Small doses throughout the day. Gatorade is dissed by experts, and so is water, for not having the right balance of salts. But I find that diluted juice aggravates my kids’ diarrhea whereas the sports drinks (watered down too) didn’t. I guess you should experiment for yourself.
The morale will probably come back to your child before all the symptoms abate, like 2 to 4 days later. Very low morale is a sign of dehydration, so supervise carefully in this stage, and watch for dry lips and eyes. One of my preschoolers stayed in bed for five days this past week, but my kindergartner was hopping around only two days later! So everyone is different =) Don’t take anyone to a playdate or nursery once their morale is back because rotavirus is extremely contagious. It usually appears about 24-48 hours after first contact, and it is contagious for 3 days following inception. If the child’s underwear or diaper leaks during the playdate, just even a tiny amount of stool can infect the other children… rotavirus in the stool lives for up to 4 weeks. Make sure you follow the child everywhere with bleach because that is the only thing that will kill it. We use hand sanitizers, disinfecting spray, and Clorox wipes in the house, but bleach is the only thing that is documented as true killer. So that’s your best friend while the secretions are flowing.
Obviously wash everyone’s hands as much as possible.
But the SADDEST part about rotavirus is that you can’t get immune to it. You can get it again. I don’t know if this is because there are multiple variations of rotavirus out there, but it is not uncommon for some families to get the bug a couple times within the same season. It is more common in the wintertime, and I believe there are some charts out there about the geographical spread of the virus–Southwest USA getting the most cases in Nov/Dec, Midwest peaking in Jan/Feb, and Northeast by Mar/Apr. Of course these are just approximations, but I do believe epidemiologists have noticed trends. So super-clean your whole house after everyone’s well (especially bathrooms) and be vigilant about spreading in your local area. Hibernate for awhile, especially from nurseries and public transportation, if you notice people dropping like flies =) It will pay off, even if you’re bored for awhile, to not get it again.
Coping strategies I came across this week (and we’re not done yet!) are…
1. For the vomiting stage, make sure the child’s bed has a waterproof cover on the mattress and on the pillow. Strip the sheets and lay a towel on there instead. When they throw up in the bed, you can just pull off the towel and pillowcase, wipe down the waterproof covers, and put a new towel and pillowcase back down. This is MUCH, MUCH better than cleaning continuous vomity sheets, blankets, etc.
You can also put a towel on the floor right by the child’s bed, if you are worried about carpets. Pull beds away from the walls if possible because it is hard to clean vomity walls/cracks.
2. For the diarrhea stage, give your kids a Pepto-Bismol before naps and bedtimes. The doctors will tell you not to, but it is terrible to have diarrhea while sleeping if you can avoid it. Especially if you have a baby because they might lay in it all night or get it in their mouths. It is worth taking a little Pepto (or Immodium, as I used on some of my kids this week) to keep sanity. Anti-diarrheals don’t always prevent diarrhea in this situation, but they can at least decrease the amount.
3. For any stage that is still messy, fill up your washer to soak with hot water, bleach, and laundry detergent. Then you can throw messy pants or linens in there throughout the day as they accumulate, and run when it gets full. Bleach will not take the color out of most kids’ clothing unless it is poured directly on the fabric, so it is a safe place to store messy clothing for a couple hours throughout the day.
Throw away any clothing that is too soiled to clean, or hose it down in the yard or laundry tub before soaking. Make sure you resanitize the laundry tub with bleach afterwards.
4. Try to keep little children who are still messing in areas without carpets. Put little babies in Pack N Plays, which are plastic and easier to clean. My three year old took a nap on the Pack N Play mattress, on the kitchen floor, with a blanket on top during his vomiting day. Much easier to clean than sheets and bedroom carpets. During the diarrhea stage, if children are playing on couches or carpets, or you have to take them in the carseat, have them take a plastic placemat with them to put under their bum so they don’t have accidents on the fabric. Portable seat cushion! Totally worth the reminders to take it everywhere.
5. You can teach older kids to vomit in a bucket or bowl, but most little kids can’t do this. Try keeping them in the bathroom or bathtub, or in the kitchen, or in their plastic-covered beds while things are bad. Definitely keep extra buckets or plastic trash cans in rooms and bathrooms. There are times when mess is coming out both ends, or by total surprise, that you need extra bins around!
6. Assuming they can keep at least water down, don’t worry how long it takes for your child’s appetite to return. Hold back kids who think they’re ok and want to wolf things down just because they’re not throwing up anymore. And let a child who is reluctant to eat be reluctant… they’ll eat when they are ready. Watch the pallor of the face, and the hydration most (lips, eyes, mouth, tears), and as long as it’s ok, it’s no big deal if they don’t eat for a week. They’ll be tired, but no need to fear that fasting–even for a toddler–is the end of the world. It is only a big deal for an infant, who cannot be allowed to fast. For the infant, keep nursing or bottle-feeding even though they can’t keep much in there, and consult your doctor as often as needed.
7. Do not rely on Rota-Teq, the vaccine. My two-year old had that last year and she was still sick this year.