Protecting your little one from tummy bugs
Babies are born with immature immune systems, which leave them more vulnerable to the viruses and bacteria that many of us unknowingly come into contact with most days. One such virus is norovirus, which is highly contagious and the most common cause of sickness and diarrhoea (gastroenteritis) in the UK. Norovirus is also known as the ‘winter vomiting bug’ because it tends to be more prevalent during the winter months; however, don’t be lulled into a false sense of security — norovirus can occur at any time of the year!
It has been estimated that in the UK norovirus effects between 600,000 and 1 million people each year. This is because the virus spreads very easily from person to person and can survive for several days once it has been brought into an enclosed environment. It is for this reason that norovirus outbreaks are very common in places such as schools, nurseries, hospitals and nursing homes.
There are many different types of norovirus, so it is possible to get recurrent bouts of the infection. This is because the immunity that a person acquires from having norovirus only lasts for a few months (ie around 14 weeks). The concern with babies is that their young immune systems are not sufficiently developed to fight off infection and they can become very ill very quickly, so being able to recognise the potential signs and symptoms of norovirus is important.
What are the symptoms that I should be looking out for?
The symptoms of norovirus tend to become evident around 24-48 hours after the initial contact with the virus; however, in some instances, symptoms can develop after 12 hours. The first symptom of norovirus is the sudden onset of nausea, followed by projectile (violent and uncontrollable) vomiting, which is accompanied by watery diarrhoea. These symptoms can also be accompanied by stomach cramps, aching limbs, a mild fever and headaches. Symptoms normally last for between 12–60 hours and most people tend to have recovered from their symptoms within a day or two, although the diarrhoea can take a little longer to resolve. However, the difficulty with babies and very young children is that they are unable to tell you how they are feeling. In many cases, the first sign that your little one could be brewing a stomach bug is that they seem out of sorts, are more unsettled than usual or fussy/irritable (a sign of tummy ache), have a raised temperature and have lost interest in their food. Where this is the case, it is important to remain vigilant and monitor your child more closely.
Can you treat norovirus?
Unfortunately, the simple answer is ‘no’ — there is no specific treatment for norovirus and you just have to allow the illness to run its course. Parents tend to think that avoiding all food (starving) will help speed up their child’s recovery; however, this isn’t the case with norovirus. Small portions of light, easily digestible foods such as rice, bread and pasta can be offered and your baby should continue to be given their normal food. Encouraging plenty of oral fluids, whether this is offering more frequent breastfeeds or giving a formula-fed baby pre-boiled water to drink, is also very important as this helps to replace the fluid that has been lost through the diarrhoea and vomiting, reducing the risk of dehydration. However, as a precaution, should your baby start vomiting and/or develop diarrhoea you should always call your GP and/or health visitor for early advice. Alternatively, you can phone NHS Direct (Tel: 0845 4647).
What are the signs of dehydration to look out for?
When babies have diarrhoea they can become dehydrated extremely quickly. Signs to look out for are as follows:
- your baby has fewer wet nappies, or you notice that their wet nappies don’t feel as heavy as usual and/or their urine is a darker colour
- the inside of your baby’s mouth and their lips look dry
- your baby is breathing rapidly while at rest/sleeping (ie not crying or agitated)
- your baby is drowsy
- the fontanelle (soft spot) on your baby’s head is sunken.
Having a sunken fontanelle is at the more extreme end of the signs and symptoms of dehydration and it is unlikely that your baby would reach this condition. However, if you are concerned that your baby shows any of the above symptoms, you should get them checked over immediately, whether this is at your local GP surgery or Accident & Emergency (A&E) department.
How can I protect my baby from picking up a stomach bug?
Norovirus is spread through contact with an infected person (ie someone who already has norovirus and is contagious), even though they may not be showing any actual symptoms at that point in time. The virus can also be picked up by eating/drinking contaminated food/water, or by being in contact with surfaces and/or objects that have become contaminated by it. These might include; door handles, contaminated kitchen/work surfaces, as well as shared toys and play equipment that have become contaminated. You only have to consider how often babies and very young children place objects into their mouths, as part of their learning, to appreciate how very quickly norovirus can spread!
Handy hints to stop the spread
Unfortunately, there will always be instances where it is impossible to avoid getting norovirus; however, the following handy hints are practical measures that can help to minimise the spread of norovirus:
- If you, your baby, or others who will come into contact with the baby have norovirus, you should avoid direct contact with the baby, especially where this involves preparing food for them, until at least 48 hours after the sickness and diarrhoea has stopped. This does not include breastfeeding as your antibodies should be passed onto your baby and offer them some protection against getting the virus. This advice is given because you/your baby may still be contagious even though you aren’t showing any symptoms.
- Regular and thorough hand washing is extremely important, even in your own home, so be particularly careful after changing your baby’s nappy or using the toilet, and before preparing any food.
- Infected diarrhoea or vomit should always be flushed away down the toilet — don’t use a washbasin/kitchen sink which is likely to spread infection. Also ensure the surrounding area is kept clean and disinfected. Disposable nappies should be disposed of/binned immediately after each nappy change.
- Wash any items of clothing/bedding/cloth nappies that have become soiled with diarrhoea/vomit, which are likely to be contaminated with norovirus. Washing with hot soapy water above 40oC will kill the virus.
- Ensure that any kitchen/work surfaces or objects that might have become contaminated with norovirus are disinfected using appropriate household products. It is advisable to use a bleach-based disinfectant, which will kill the virus.
- Avoid eating raw or unwashed foods.
It is always upsetting to see your child unwell and because most of the causes of sickness and diarrhoea are due to viruses, there is no treatment for them. However, by being vigilant and following the health hygiene measures as listed above, you can minimise the risks to you, your baby, and other family members. Where you have any concerns or queries, there are plenty of people you can talk to including your midwife, GP and health visitor.