From the Guidelines
For a one-year-old with a stomach bug, the primary focus should be on preventing dehydration through small, frequent sips of oral rehydration solutions like Pedialyte, as recommended by the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1. The treatment approach should prioritize the use of oral rehydration solutions (ORS) to replace lost fluids and electrolytes. According to the guidelines, reduced ORS is recommended as the first-line therapy for mild to moderate dehydration in infants, children, and adults with acute diarrhea from any cause 1. Some key points to consider in the management of a one-year-old with a stomach bug include:
- Offering 1-2 teaspoons of ORS every 5-10 minutes when vomiting is present, increasing amounts as tolerated
- Continuing breastfeeding or formula if the child can keep it down, as breastfed infants should continue nursing throughout the illness 1
- Avoiding sugary drinks, juices, and sports drinks, as they can worsen diarrhea 1
- Not giving over-the-counter anti-diarrheal medications to children this young, as they can be harmful 1
- Introducing plain foods like bananas, rice, applesauce, and toast (BRAT diet) once the child is keeping fluids down and showing interest in eating
- Contacting a doctor if signs of dehydration are noticed, such as fewer wet diapers, no tears when crying, or unusual drowsiness, or if vomiting lasts more than 24 hours, there's blood in the stool, high fever over 102°F (38.9°C), or if the child appears very ill 1. It is essential to note that most stomach bugs are caused by viruses that need to run their course, typically improving within 3-7 days, and the body needs to clear the infection naturally. In cases of severe dehydration, intravenous rehydration may be necessary, and isotonic intravenous fluids such as lactated Ringer’s and normal saline solution should be administered 1. Overall, the management of a one-year-old with a stomach bug requires careful attention to hydration, nutrition, and monitoring for signs of dehydration or other complications, with the primary goal of preventing dehydration and promoting a smooth recovery.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION Loperamide hydrochloride capsules are contraindicated in pediatric patients less than 2 years of age due to the risks of respiratory depression and serious cardiac adverse reactions The FDA drug label does not answer the question.
From the Research
Treatment Options for One Year Old Stomach Bug
- The mainstay of management of acute gastroenteritis is provision of adequate fluids to prevent and treat dehydration 2.
- Oral rehydration therapy with a rehydration solution can be used to treat diarrhea in children with mild to moderate dehydration 3.
- A child with minimal or no dehydration should be encouraged to continue his or her usual diet plus drink adequate fluids, as many studies have shown that a child's regular diet reduces the duration of diarrhea 3.
Antiemetic Agents
- Ondansetron can decrease vomiting or help avoid the need for intravenous fluid, but it increases episodes of diarrhea 3.
- Ondansetron is the only intervention that revealed an effect on the cessation of vomiting, on preventing hospitalizations, and in reducing the need for intravenous rehydration 4.
- Meta-analysis of randomized, double-masked, placebo-controlled trials of ondansetron demonstrated decreased risk of further vomiting, reduced need for intravenous fluid, and decreased risk of immediate hospital admission 5.
Prevention and Management
- Good handwashing reduces the incidence of acute gastroenteritis, but not rotavirus 3.
- The introduction of two rotavirus vaccines in the United States in 2006 significantly reduced the incidence of rotavirus gastroenteritis 3.
- Probiotics can be used to shorten the course of diarrhea 2, 3.
- Antiemetics allow for improved tolerance of oral rehydration solution, and, when used appropriately, can decrease the need for intravenous fluids and hospitalization 6.