Tuesday, December 28, 2010

Coping with the Stomach Flu - really don't read this one until you have to

This is a very timely post for me, today, as we have just had the stomach flu run through our family. Of course, it had to hit the day before we were going on Christmas holidays, but that is another story. As I write this, i want to remind you that I am not a doctor, just a mom with a few years of experience with kids and flus.

Please, please, if you have any serious concerns or questions about your child, take them to your family doctor, the emergency, the walk in clinic, or phone the local health line (do you have those in the US? I LOVE provincial health lines and health guide books. They have saved me so many trips to the emergency for things I could deal with at home).

That being said, here are some practical tips for making it through the nastiest parts of the stomach flu:

The thing about small children, I would say under 5 or 6, is that they don't actually have enough body memory of sickness to know when they will throw up. They don't have that adult "I'm about to be sick" instinct. They know something is wrong, they sit up in bed (or on the couch, or at the dinner table) and everything erupts from their stomach onto the closest surface. So, while you can sort of teach them to use a bowl, you need to know that their first throw up will probably be on one or more items of furniture or carpet. The first thing to do with a kid who has just thrown up is to pick them up and put them into an empty bathtub. This keeps them contained and somewhere easy to clean.

If I have other kids awake and running around, i deal with the vomit first so no one gets into it. I quickly gather supplies: paper towel, a plastic bag, a laundry basket, a few rags and a bucket of soapy water. I move through the soiled area as quickly as possible. First, pick up what you can with paper towel and put them immediately in the plastic bag to try to keep the contamination down. Then, throw anything fabric (sheets, pillows, couch covers, placemats, rugs) into the laundry basket. These can be laundered or spot cleaned later. Then wipe the area down with one rag dipped in soapy water. Then dry the area with a second rag. With this process you can move pretty quickly through a relatively large area of vomit (like when your four year old panics and gets up and starts walking across the room, stopping to throw up on various pieces of furniture in your living room). Then tie up and throw out the plastic bag, put the bucket and rag in the kitchen sink and go to help your child. If the washing machine is on the way, throw the fabric stuff in the washing machine as you go by.

Diherria, similarly, tends not to have any warning. For a somewhat older child it can be extremely frustrating, because they have finally mastered their bowels and now they are suddenly not co-operating. Try to calm them down, stem their panic, and sit them on the toilet as quickly as possible. Keep their pants around the legs until you are ready to put them in the bath, and take their clothes off in the bathtub. This means you will have one less surface to clean. If you were lucky, you may avoid having to clean up anything other than the child's clothes. If not, follow the process for vomit, above.

Now, help your child. Remove their soiled clothes and wipe them down with a warm cloth and some soapy water. If necessary wash their hair. Get them clean, and if they feel up to it, give them a nice warm bath. Be calm and explain what has happened to them if they are a young child, as they will not understand what is going on. Get them a bowl or container to put future throw up in. A light metal bowl is perfect, because it is usually the easiest to clean.

When they are done in the bath, towel them down and get them clean, easy to remove clothes. Bring the bowl and towel with you and go and get an extra blanket or quilt. Lie the child on top of the blanket or quilt to act as a buffer between them and their bed or the couch. Put the towel nearby for catching vomit or wiping them up quickly, and put the bowl right next to them. Explain again what the bowl is for. Ask them to lie still. Get them comfy, and if it is the day time, let them watch a video or look at books or colour if they are not tired enough to sleep. After a little while offer them a drink of apple juice mixed with water.

Stay nearby so you can comfort and coach them through their next bout of sickness.

You will probably repeat this process several times before they are through with throwing up. Just be patient, and try to remember that they are not doing this on purpose to inconvenience you -- they are sick and little and need your comfort and calm.

If your child is throwing up and they can not even keep down water or apple juice, get someone to go and get some pediatric electrolyte. It will help to rehydrate the child and return some nutrients to their body. It absorbs quickly, so that even if they throw most of it up, they will still absorb some liquids and nutrients from it. If the drug stores are all closed, get someone to go to 7-11 and get you some Gatorade. It is obviously not great to give to children, but it gets the job done at 4am.

With a baby, you can use the same process, although you will also have the additional complication of cleaning your own clothes, as well. If baby is old enough to sit in the tub, put him or her there while you change your own clothes. If not, take off all their soiled clothes and lay them on a towel on the floor while you quickly get changed. If you are using cloth diapers, you might want to pick up a package of disposables to keep down the laundry until the flu has run through your clan.

If you are breastfeeding, you have an extra advantage, as you don't really have to worry about baby getting dehydrated. Just feed them as much as they want. They will absorb some, and throw up the rest, but at least they will be getting some nutrients and liquid into them because breastmilk is digested so quickly. Expect them to nurse a lot, both while they are sick and for a few days afterwords.

Once your child has stopped throwing up, gradually encourage them to drink more of the electrolyte stuff, especially if they were throwing up for 8 or 10 hours straight. After they have kept this down for a few hours, they can try some apple juice again, some crackers, toast, rice or broth. Keep them on light foods for a day or so and gradually introduce other easy to digest, non-greasy foods to their diet until they are back to eating normally. Even if they want the ice cream everyone else is having after supper, leave off on giving it to them for a few days until you are sure they are feeling better. It may simply exaserbate their stomach and start things all over again. Take it easy for a few days. Even if the child seems pretty fully recovered, try to keep things pretty low key and restful until they are back to normal.

Lastly, wash your hands religiously and get your rest. The only thing worse than a sick child is a sick mother with a sick child!

Here's to hoping that you don't need this advice this winter!

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