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:
Becomes pale, mottled and feels abnormally cold to touch
Going blue around the lips or too breathless to talk / eat or drink
Becomes extremely agitated, confused or very lethargic (difficult to wake)
Develops a rash that does not disappear with pressure (the ‘Glass Test’)
Is under 3 months of age with a temperature of 38°C / 100.4°F or above (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:
Seems dehydrated: ie. sunken eyes, drowsy, sunken fontanelle (soft spot on baby’s head) or no urine passed for 12 hours
Has blood in the stool (poo)
Has constant tummy pain
Has completely stopped drinking or breastfeeding
Is unable to keep down any fluids during this illness
Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
Continues to have a fever of 38.0°C or above for more than 5 days
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
Using the advice below you can provide the care your child needs at home
This content has been developed by healthcare professionals from across the UK in collaboration with the RCPCH.
Encourage your child to drink plenty of fluids – little and often. Water is not enough and ideally oral rehydration solution (ORS) is best. ORS can be purchased over the counter at large supermarkets and pharmacies and can help prevent dehydration from occurring. This improves the taste and children are more likely to drink it whilst they are unwell
Mixing the contents of the ORS sachet in dilute squash (not “sugar-free” squash) instead of water may improve the taste
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 page
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 comes back, 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
You and/or your child should wash your hands with soap (liquid if possible) in warm running water and then dry them carefully:
After going to the toilet
After changing nappies
Before touching food
Your child should not:
Share his or her towels with anyone
Go to school or any other childcare facility until 48 hours after the last episode of diarrhoea and / or vomiting
Swim in swimming pools until 2 weeks after the diarrhoea has stopped
There are many sensory issues associated with sleep including:
Sensitivity to sound, touch, and visual stimuli which can be distracting and distressing and can affect the process of falling asleep.
Interoception difficulties, particularly recognising when hungry, full or thirsty or when the person is tired.
Some children are more sensitive to foods like sugar, caffeine and additives which keep people awake.
Look at the bedroom environment to see what may be affecting their ability to go to sleep and stay asleep. Do their pyjamas and bedclothes feel comfortable, are they too hot or cold? Is it too light or too dark, too noisy or too quiet? Perhaps it is too cluttered and stimulating. Think about your child’s diet. Are they eating too early or not having enough to eat? Are they eating food that can stimulate them close to bedtime. There can be added difficulties where children have restrictive diets but some simple adjustments of what is eaten and when can make a big difference.
Sticking to the same routine helps your child to know what to expect at bedtime and helps them feel secure. It also helps to support your child’s internal body clock and keep it on track. The age related sleep advice and information on this website can help with establishing routines. Some children will benefit from using picture timetables, timers or social stories to help them understand their bed-time routine. More information about visual supports can be found on these websites
Your child may be feeling overstimulated after a busy day and needs help to wind down, or their environment may be overstimulating with lots of toys, TVs and computers within reach. Avoiding TV and computers or hand-held devices an hour before bedtime can help your child to wind down. Activities that are good for the wind down period are jigsaws and colouring. Having a relaxing bath and milky drink can help some children, but for some children having a bath can over-excite them so they may need to have their bath earlier in the day.
Children who wake to use the toilet, wet the bed, or who wear nappies or pull-ups at night that need changing may have disturbed sleep. Eric, the children’s bowel and bladder charity are a good source of advice on this topic.
What might help
Keeping a sleep diary
A sleep diary can help you understand what may be causing difficulties with sleep. Fill it out every evening and record as much as you can. You can use it to spot patterns and make changes that may help.
The Sleep Charity have templates you can download; one for teenagers and one for younger children.
Seeking advice and help from sleep services
There are organisations that can help you if you are having difficulties with your child’s sleep. There are many national organisations, including those who specialise in sleep for SEND families, and there are also community-based services in Shropshire, Telford and Wrekin. Click the link at the bottom of page to visit our support services page.
Understanding sleep cycles
The circadian sleep cycle is a 24-hour cycle that helps govern essential bodily functions especially the sleep-wake cycle. It plays a vital role in a person’s ability to sleep in one consolidated block of time at night and to stay awake during the day. As the sun sets in the evening, the brain begins producing melatonin, a hormone that induces sleepiness. Core body temperature also drops.
As melatonin and tryptophan (an amino acid which helps produce melatonin) are naturally produced in the body, there are things you can do to help their production. Darkness helps to promote the production of melatonin which is why it is a good idea to put your child to sleep in a darkened room, and light emitting devices such as tablets and phones also can destroy Melatonin so should not be used for at least an hour before bed. New research shows that limiting exposure to screens and increasing physical activity levels during the day has a positive effect on children's overall physical, mental health and wellbeing, including sleep.
Setting a waking time consistently even in holiday times, called ‘anchoring’ the wake time, can help to reset the body clock over time. This should be accompanied with exposure to lots of light on waking to support circadian rhythm.
Melatonin and tryptophan occur naturally in some foods and drinks such as milky drinks and cereals which is why having a milky drink before bed can help settling to sleep. For more information visit Diet & Sleep - The Sleep Charity
Prescriptions of melatonin
Behavioural strategies and practical solutions are the best way to address sleep difficulties, but if they are having a significant impact on your child’s ability to function, a drug form of melatonin is sometimes prescribed for neurodivergent children. As the drug’s function is to re-set sleep and wake cycles, it works best combined with good sleep hygiene practices. It is important that is it taken under medical supervision and not purchased on-line so that it is closely monitored for dosage and side effects. It should be prescribed for the shortest period necessary as the long-term effects of the drug on children’s development are not yet known.
In Shropshire, Telford and Wrekin the Community Paediatric Service and the BeeU Service (CAMHS) can prescribe Melatonin for children and young people who meet ALL of the following criteria.
the child/young person must be open to and being treated by the service due to a neurodevelopmental/mental health need (diagnosis not required)
sleep issues are causing significant impact on the child/ young person, for example due to daytime sleeping or behavioural problems that are impacting daily functioning or educational attendance
behavioural approaches have been tried and failed. These may have been offered by the service (where available) or by community sleep support services.
GPs are unable to prescribe Melatonin although they sometimes issue repeat prescriptions when prescribing has been started by a specialist (such as a paediatrician or child psychiatrist).
Further support
Click on the link below to visit a page with information about
national websites and sleep organisations
local community services in Shropshire, Telford and Wrekin.
