Stomach bug season is starting. What sho

Switch from plain water to oral rehydration solution (ORS) mixed exactly as the packet says, and give it in small, frequent sips from now on — a child who is vomiting loses salts as well as water, so water alone can leave them worse off. Keep a note of every vomit (time and roughly how much), keep the ORS packet or box within reach, and if you end up at a clinic tonight, take the packet with you so they can see what was given.

I can't diagnose this or tell you what's causing it — vomiting has many causes — and I won't suggest changing or dosing any medicine. What follows is home-care guidance for tonight plus a clear point where professional care takes over. Tell me your country or city, the child's age, and when the vomiting started, and I'll name the local emergency and after-hours route.

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1. What you've tried vs. the better alternative

Tonight's 15-minute setup (do it once, then just sip and log): mix the ORS as the packet says and put it where the child can see it; put the paper and pen next to the bucket; set a repeating note on your phone for when the last vomit was; put a bowl of familiar foods in the fridge (not in front of the child); put hand soap by the sink and a separate towel for whoever is closest to the sick child.

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2. What to avoid

• Plain water as the only fluid, diluted formula, juice, soda, sports or energy drinks — none of these replace fluid and salts properly.
• Any leftover medicine from the cupboard — anti-diarrhoeal tablets, antibiotics, adult anti-sickness pills — unless a clinician told you to give it.
• Online remedies, herbal mixes, powders, "gut health" supplements, or anything bought without a prescription.
• Force-feeding or forcing drinks into a child who doesn't want them, and waking a very sleepy child to force fluids.
• Sharing cups, spoons, or food with the sibling, and sitting the sibling at the same table as the vomiting child.
• Early breakfast-school runs if the child is still vomiting; a quiet day at home is part of the treatment.

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3. What to watch for tonight

Check every few hours, and write it down:

• Alertness — playing, talking, responding normally between episodes.
• Breathing — easy and quiet, no grunting or fast chest.
• Vomits — number, time, how much, and colour (yellow, green, or blood streaks).
• Urine — wet nappies or toilet trips; roughly how many today.
• Drinking — can they keep ORS down, and for how long?
• Temperature and whether they look warmer or more tired than usual.

Infection control for the household: wash hands with soap after every clean-up and before food, use separate utensils and towels, and keep the sibling's hands away from the bucket. This is the part that protects the rest of your week.

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4. Decision tree — when to stop home care

Call your local emergency number now if any of these are true:

• The child cannot keep any fluids down at all, or vomits everything offered.
• Hard to wake, limp or floppy, unresponsive, or only moves when nudged.
• Breathing fast, deep and heavy, grunting, or lips looking blue.
• A fit or seizure.
• Blood in the vomit, or blood in the stool.
• Severe abdominal pain, or a swollen, hard belly.
• Dark green (bile-coloured) vomit.
• Signs of significant dehydration: sunken eyes, very dry mouth, no tears, cold hands and feet, blotchy or mottled skin, and almost no urine.

When you call, say plainly: *"My child has been vomiting since [time]. They cannot keep fluids down."* Follow the dispatcher's instructions, keep the child with you, and keep them warm.

Go to a clinician the same day (or call your after-hours line tonight) if:

• The vomiting is still going after a day.
• There is any fever, or the child is worsening rather than steady.
• The child cannot manage ORS, or the vomit is yellow-green or streaked with blood.
• Very few wet nappies or very little urine.
• The child is a baby under six months — a young infant who vomits needs urgent same-day review, even without a fever.
• Anyone in the household is immunosuppressed or has a chronic illness.

Home care tonight is reasonable if: the child is alert and responsive between episodes, is passing urine, is drinking and keeping some ORS down, has no blood, and is not getting worse.

Come back immediately after being sent home if the child becomes unable to drink, becomes sicker, develops a fever, starts breathing fast or with difficulty, or has blood in the stool.

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5. Screenshot-ready scripts

To a clinic or after-hours line:
> "Hi — my child is [age] and has been vomiting since [time]. I've been giving ORS mixed as directed. Last urine at [time]. [Number] vomits, no blood. They're alert and breathing normally. Should we come in tonight or first thing in the morning?"

To school in the morning:
> "[Name] vomited [number] times overnight and I've been giving ORS. They're drinking and passed urine. They're staying home today. I'll let you know how today goes."

To the sibling or whoever's helping:
> "No juice, sports drinks or fizzy drinks — just the ORS. No medicine from the cupboard without asking me. Keep the bucket by the bed and write the time of each vomit on the sheet."

To anyone offering food:
> "Small bits of toast, rice or banana are perfect. No juice, please — just water or the ORS."

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6. What a good 24 hours looks like

Not a cure, and no promises — but a good next day looks like: vomiting stops or drops noticeably and the gaps between episodes get longer; the child is alert and wants to play again; they can drink and keep the ORS down; they pass urine several times through the day; and they pick at their usual food in small portions. That is the goal to aim for tonight.

If instead the vomiting runs past the next day, or any red flag appears sooner, that is a reason to get seen — not a sign you did anything wrong.

Source: rch-cpg https://www.rch.org.au/clinicalguide/guideline_index/Dehydration/
Source: who-iris https://iris.who.int/handle/10665/81170