Norovirus is a highly contagious stomach bug, sometimes inaccurately called the stomach flu, that causes acute gastroenteritis. This common illness is responsible for millions of cases annually, and infants are susceptible to infection. Because the virus spreads easily from person to person, it is a frequent occurrence in environments where people are in close contact, such as daycares. The primary concern for infants who contract norovirus is the risk of rapid dehydration due to the severity of vomiting and diarrhea.
Recognizing Norovirus Symptoms in Infants
Norovirus infection typically begins with a sudden onset of symptoms, usually appearing 12 to 48 hours after exposure to the virus. The most noticeable signs are projectile vomiting and watery diarrhea, which can occur frequently. Infants may also experience stomach pain or cramping, often expressed through increased fussiness and irritability.
A low-grade fever, muscle aches, and general malaise are also commonly associated with norovirus in this age group. Symptoms generally last a short time, with most children recovering completely within one to three days. The primary threat remains the potential for rapid fluid loss during this short period.
Immediate Home Management and Hydration Strategies
The central focus of home care for an infant with norovirus is preventing dehydration, which is the most significant complication. Oral Rehydration Solutions (ORS), such as Pedialyte, are recommended because they contain the precise balance of water, sugar, and electrolytes needed to replace lost fluids. Avoid giving infants high-sugar liquids like fruit juice or soft drinks, as these can worsen diarrhea.
Administering the ORS must be done slowly and frequently to prevent triggering more vomiting. Start by offering very small amounts, such as one teaspoon or 5 milliliters, every five minutes over a period of a few hours. This slow, methodical approach helps the infant’s irritated stomach retain the fluid.
If the infant is breastfed, continue breastfeeding throughout the illness, as breast milk provides both nutrition and necessary fluids. For formula-fed infants, continue giving undiluted formula, but offer small sips of ORS between feeds. The goal is to consistently replace lost fluids without overwhelming the digestive system.
Preventing the Spread of Norovirus
Norovirus is highly contagious and spreads easily through the fecal-oral route, meaning the virus in stool or vomit can be transferred to a person’s mouth. Proper hand hygiene is the most effective way to prevent transmission, especially after changing diapers or cleaning up vomit. Hands must be washed thoroughly with soap and water for at least 20 seconds, as alcohol-based hand sanitizers are generally not effective against norovirus.
Environmental disinfection is also an important measure to stop the virus from spreading throughout the home. Norovirus can survive on surfaces for days, so frequently clean and disinfect high-touch areas like doorknobs, toilet handles, and changing tables. Use a household bleach solution or an EPA-registered disinfectant that is specifically effective against norovirus.
Immediately remove and wash any clothing, bedding, or toys soiled with vomit or diarrhea. These items should be handled carefully, without shaking, and washed in hot water on the maximum cycle length, followed by machine drying at the highest heat setting. Keep the infected infant isolated from siblings and other family members as much as possible for at least 48 hours after symptoms have completely stopped.
Identifying When to Seek Medical Care
While most norovirus cases resolve at home, infants can quickly develop severe dehydration. The most significant indicator is a decrease in wet diapers, with fewer than three per day or none in six to eight hours being a sign of concern. Other physical signs of fluid loss include dry mouth, cracked lips, and crying with few or no tears.
The infant’s behavior can also signal a need for urgent attention, such as unusual sleepiness, lethargy, or extreme fussiness. A sunken soft spot on the head (fontanel) or sunken eyes are physical markers of significant dehydration. Seek immediate medical attention if the infant has severe symptoms, such as vomiting that does not stop for more than 12 hours, blood in the stool or vomit, or difficulty staying awake.