An upset stomach in children often includes nausea, vomiting, diarrhea, or abdominal pain. These common symptoms frequently stem from viral infections. Parents seek safe and effective ways to alleviate their child’s discomfort and promote recovery. Understanding appropriate interventions, from home care to recognizing when medical attention is necessary, is important.
Over-the-Counter Medications
Several over-the-counter (OTC) medications can offer relief for some upset stomach symptoms in children. Careful consideration of age restrictions and dosages is necessary. For nausea and vomiting, antihistamines like dimenhydrinate (Dramamine) are sometimes used, particularly for motion sickness. Dimenhydrinate is available for children aged 2 to 12 years. Specific chewable tablet dosages are: 12.5-25 mg every 6-8 hours (max 75 mg/24 hours) for children 2 to under 6 years, and 25-50 mg every 6-8 hours (max 150 mg/24 hours) for children 6 to under 12 years. Antihistamine effects are not well-studied in children under 2, and accidental overdoses have been reported in this age group.
Antidiarrheal medications like loperamide are generally not recommended for young children without specific medical advice. They can have serious side effects and may prolong illness by preventing the body from expelling the cause of diarrhea. Bismuth subsalicylate (Pepto-Bismol) is not appropriate for children under 12 years, especially if the child has a viral infection. For general discomfort or fever, acetaminophen or ibuprofen can be administered according to age and weight-appropriate dosing guidelines. Always consult product labels for precise instructions and discuss with a pediatrician or pharmacist before administering any new medication.
Home Remedies and Supportive Care
Practical home interventions play a significant role in a child’s comfort and recovery from an upset stomach. Preventing dehydration is paramount, particularly with vomiting or diarrhea, as children are more susceptible to fluid loss than adults. Oral rehydration solutions (ORS), containing specific amounts of water, salts, and sugars, are highly effective for replenishing lost fluids and electrolytes, even during vomiting or significant diarrhea. ORS are available commercially and should be used as directed, rather than attempting homemade electrolyte solutions. For children who refuse ORS, small, frequent sips of diluted fruit juice, clear broths, or popsicles can be offered, especially for those over one year of age.
Dietary adjustments are important once fluids are tolerated. Historically, the BRAT diet (Bananas, Rice, Applesauce, Toast) was a common recommendation due to its bland, easily digestible nature. While gentle on the stomach and helpful for firming stools, current guidance suggests expanding the diet to other bland options like crackers, plain pasta, or boiled potatoes once symptoms improve, as the BRAT diet lacks sufficient nutrients for recovery. Foods high in fat, sugar, or spice should be avoided as they can worsen symptoms. Providing comfort through rest, a warm compress to the stomach, or gentle massage can also help alleviate discomfort, and ginger (like flat ginger ale or ginger tea) is traditionally used for nausea and may be offered to older children.
When to Consult a Doctor
Recognizing when an upset stomach warrants professional medical attention is important. Signs of dehydration are a primary concern, and medical evaluation is necessary if these symptoms appear:
- Decreased urination (fewer wet diapers in infants, or no urination for eight hours in older children)
- Dry mouth
- Absence of tears when crying
- Sunken eyes
- Unusual lethargy or irritability
Other specific red flags also indicate immediate medical attention. Consult a healthcare provider if:
- High fever, especially in infants under three months (over 100.4°F or 38°C) or over 102.2°F (39°C) in older children.
- Severe or persistent vomiting, particularly if it is green (bile), projectile, or contains blood.
- Blood in the stool (black, tarry, or bright red).
- Severe abdominal pain, especially if localized, causing the child to double over, awakening them from sleep, or accompanied by abdominal rigidity or distension.
- The child is unable to keep fluids down, appears unusually weak, unresponsive, or confused.
- Symptoms persist for more than 24-48 hours.
- The child has a known underlying medical condition (e.g., diabetes, compromised immune system), recent injury, or possible ingestion of a non-food item.
What Not to Give
When managing an upset stomach in children, it is important to know what substances and practices to avoid. Adult medications should never be given to children, as their dosages are typically too high and dangerous. A particularly important warning concerns aspirin and products containing it, such as bismuth subsalicylate, due to the risk of Reye’s syndrome. This rare but severe condition causes brain swelling and liver damage, primarily affecting children and teenagers recovering from viral infections.
Unapproved herbal remedies or dietary supplements should be avoided due to lack of regulation and potential for adverse effects or interactions. Undiluted fruit juice or other sugary drinks, including soda, can worsen diarrhea and dehydration by drawing more water into the intestines. Solid foods that are fatty, spicy, or difficult to digest should not be introduced too soon after vomiting or diarrhea, as they can irritate the recovering digestive system. Antiemetic or antidiarrheal medications not specifically approved for children, or those given without a doctor’s consultation, should be avoided, as their use in young children can be risky and may mask more serious conditions.