Sickness bug in babies and toddlers: spotting dehydration early

Quick answer: Fewer wet nappies, a sunken soft spot, few or no tears and drowsiness are signs of dehydration, and the NHS says they can mean serious dehydration needing urgent treatment. If a child under 5 shows them, call 111 now. Call 999 if they're sleepy or hard to wake, have pale, blotchy or cold skin, or are breathing fast.

What parents need to know

Fewer wet nappies than usual, a sunken soft spot, sunken eyes and few or no tears are signs of dehydration in a baby, and the NHS says they can mean serious dehydration that needs urgent treatment. Babies and young children are more at risk of dehydration, and the NHS advises calling 111 now if a child under 5 shows signs of it.

The vomiting tends to be over quickly. The NHS says vomiting usually stops in 1 or 2 days, but diarrhoea can carry on for 5 to 7 days. Keep their fluids up for that whole stretch, and call 111 if diarrhoea lasts more than 7 days or vomiting more than 2 days.

Signs of dehydration in a baby

The NHS lists these signs of dehydration in babies. Most of them are things you can check during a nappy change or a feed.

Count wet nappies through the day and compare them with a normal day for your baby. Fewer wet nappies than usual is one of the signs on the NHS list.

• Fewer wet nappies. Compare against a normal day for your baby. Older children may wee less often, and their wee may be dark yellow and strong-smelling
• A sunken soft spot. The fontanelle on top of your baby's head looks dipped or sinks inwards
• Sunken eyes
• Few or no tears when they cry
• Being unusually drowsy or irritable

How to keep fluids going during a sickness bug

The NHS says the most important thing is plenty of fluids to avoid dehydration. Most children can be looked after at home.

Breastfed and formula-fed babies

Carry on breastfeeding or bottle feeding. If your baby is being sick, give smaller feeds more often than usual. Make formula at its usual strength. The NHS advises never making it weaker.

Babies on formula or solid foods can also have small sips of water between feeds. If your baby is under 6 months, boil the water first and let it cool.

Call 111 now if your baby stops breast or bottle feeding while they're ill, or keeps being sick and can't keep fluid down. The NHS lists both as reasons to get urgent advice.

Toddlers and babies on solids

Offer regular small sips of water, and give small children their usual diet once they feel able to eat. Avoid fruit juice and fizzy drinks, because the NHS says they can make diarrhoea or vomiting worse.

Oral rehydration solution

Rehydration solutions come as powders that you mix with water. They replace the sugar, salts and minerals lost through vomiting and diarrhoea. Ask a pharmacist which one suits your child, then give it in regular small sips. If your child is under 5 and already shows signs of dehydration, or keeps being sick and can't keep fluid down, call 111 rather than waiting to see whether the sachets help. For a child aged 5 or over, the NHS advises calling 111 now if they still have signs of dehydration after using oral rehydration sachets.

Medicines

You can give paracetamol for discomfort after checking the leaflet for your child's age. The NHS advises against giving children under 12 medicine to stop diarrhoea, and against giving aspirin to anyone under 16.

Nursery, the 48-hour rule and stopping it spreading

Norovirus spreads through poo and passes between people very easily. The NHS calls it the winter vomiting bug, although your child can catch it at any time of year.

Keep your child off nursery, childminders or school until they haven't been sick or had diarrhoea for at least 2 days (48 hours). This comes from the NHS and the UK Health Security Agency's exclusion guidance for childcare settings. Phone the nursery on the first day to tell them your child won't be in and why.

At home, wash clothes and bedding with poo or vomit on them separately, on a 60°C wash. Clean toilet seats, flush handles, taps and door handles. Don't share towels, flannels or cutlery, and try not to prepare food for anyone else while you're unwell.

Frequently asked questions

When can my child go swimming again after a sickness bug?

The NHS advises waiting until at least 48 hours after the symptoms have stopped before using a swimming pool.

Can we visit a grandparent in hospital or a care home while the bug is in the house?

Wait until whoever has had it hasn't been sick or had diarrhoea for 2 days. The NHS says the same 2-day rule applies to visiting hospitals and care homes.

Should my toddler stop eating solids while they have diarrhoea?

No. The NHS advises giving small children their usual diet. Let them eat when they feel able, and it may help to avoid fatty or spicy food for a while.