Tea-Time Talk: GI Bugs
Every afternoon at the farm, I make a cup of matcha and sit down for a little "tea-time talk" with you — a quiet moment to pause, breathe, and answer your most common questions from the week. Think of it like chatting with your pediatrician at the kitchen table: calm, cozy, and filled with details.
If your household has been hit with a stomach bug this week (or if you're bracing for one), you're in the right place. Today's tea-time talk is all about viral gastroenteritis — what to expect, how long it lasts, and how to help your little one feel better while protecting the rest of your family.
1. Understanding the Timeline: What to Expect
One of the most common questions I hear is: "When will this be over?" Let me walk you through what's typical, so you know what's normal and when to worry.
How long until their stomach feels normal again?
Most kids feel back to themselves within 3–7 days, though it can take up to 10–14 days for stools to fully normalize after norovirus. Those lingering loose stools aren't because the virus is still active — they're due to temporary irritation of the gut lining and a brief reduction in lactase (the enzyme that digests milk sugar). The intestinal lining needs time to heal.
When does the vomiting stop?
The worst vomiting typically happens in the first 8–12 hours, sometimes extending to 24 hours. After that initial wave, most kids start to keep fluids down more consistently.
What about their appetite?
Appetite lags behind all the other symptoms. Many children eat less for 3–7 days even after the vomiting has stopped. This is completely normal — their gut is recovering, and forcing food too early can sometimes backfire. Follow their lead.
How long does the fever last?
Fever usually resolves within 24–72 hours. If fever goes away and then comes back days later, that's worth a call to your pediatrician — it could signal a secondary infection or complication.
When will their poops be normal again?
Up to 2 weeks of looser stools is completely normal, especially after norovirus. As the gut lining heals and good bacteria repopulate, things will gradually firm up.
Late-day vomiting returning on day 5?
You asked: "Why did my child throw up again on day 5 when they seemed better?" This can happen — the gut is still irritated, and sometimes a "relapse episode" occurs. As long as hydration and energy levels stay stable, this is usually just part of the recovery curve, not a new illness.
Fainting or dizziness after vomiting?
Some kids experience a vasovagal response (a brief drop in blood pressure) after intense vomiting, which can cause them to feel faint or even briefly pass out. If they recover quickly and are alert afterward, this is usually not dangerous. But if they remain unresponsive or seem very lethargic, call your doctor immediately.
2. Is It a Stomach Bug or Something Else?
Sometimes it's hard to tell what's causing the vomiting and diarrhea. Here's how to think through the possibilities.
Could this be FPIES instead of a virus?
FPIES (Food Protein-Induced Enterocolitis Syndrome) looks different from a typical stomach bug:
FPIES: Delayed vomiting 1–4 hours after eating a trigger food, often with pallor and lethargy, typically no fever
Viral gastroenteritis: Often has fever or sick contacts, more variable timing, spreads within households
If you suspect FPIES — especially if this pattern repeats with specific foods — talk to your pediatrician about allergy testing.
How long does it take to "catch" a stomach bug?
Incubation periods vary by virus:
Norovirus: 12–48 hours
Rotavirus: 24–72 hours
Adenovirus: 3–10 days
This helps explain why siblings or family members get sick on different days.
Do we need testing?
Almost never. Viral gastroenteritis is a clinical diagnosis — we diagnose it based on symptoms and history. Testing is usually only done if your child is hospitalized or if we suspect something more complex.
Is food poisoning contagious?
It depends. Toxin-mediated food poisoning (from bacteria like Staph aureus or Bacillus cereus) is not contagious — the toxin made you sick, not the bacteria itself. But viral foodborne illness (like norovirus from contaminated shellfish) is absolutely contagious.
Does a stomach bug wipe out the good bacteria?
Temporarily, yes. The gut microbiome takes a hit during gastroenteritis, but it typically recovers over 1–4 weeks as your child eats normally and the intestinal lining heals.
3. Stopping the Spread (or at Least Trying)
Let's be honest: stomach bugs spread like wildfire through households. But there are real steps you can take to lower the risk.
How does it actually spread?
Both through the fecal-oral route (contaminated hands, surfaces, food) and through vomit aerosol. Yes, when someone vomits, tiny viral particles can become airborne and land on nearby surfaces. Norovirus particles are incredibly hardy and can survive on surfaces for days.
Are they contagious before symptoms start?
Yes — kids can shed the virus hours before they start vomiting. This is one reason it's so hard to contain.
Can you actually stop it from spreading between siblings?
You can't guarantee it, but you can significantly lower the risk:
Use EPA approved cleaners to make sure that they are effective (check EPA List G for norovirus-killing disinfectants)
Handwashing for 20 seconds with soap and water (hand sanitizer doesn't work well against norovirus)
Separate towels, toothbrushes, cups
Wear gloves when cleaning up vomit — and ventilate the area
When are we "in the clear"?
If no new symptoms appear within 72 hours of the last person getting sick, the likelihood of another family member getting it drops significantly.
Do you get immunity after having it?
Yes, but it's short-lived and strain-specific — usually just weeks to months. So you could theoretically get another stomach bug (or even the same virus again) later in the season.
Can the first person who got sick get it again from their siblings?
Rare during the same outbreak. Once they've recovered, they usually have temporary immunity to that specific virus.
Why does it spread so easily?
Because the infectious dose is as low as 18 viral particles. That's almost nothing — it's why norovirus is notorious for outbreaks in schools, cruise ships, and households.
4. Hydration & Treatment at Home
The most important job during a stomach bug is keeping your child hydrated. Here's how to do it well.
What's the best way to rehydrate?
The evidence-based approach:
Wait 30–60 minutes after vomiting
Offer ½–1 teaspoon every 2–3 minutes
Gradually increase as tolerated
Oral rehydration solution (ORS like Pedialyte) is better than juice, sports drinks, or plain water because it contains the right balance of electrolytes and sugar to help the gut absorb fluid.
What if my 12-month-old won't drink Pedialyte?
You have options:
Breastmilk or formula (these are excellent)
ORS popsicles
Starchy foods like pasta, banana, bread
Small, frequent sips of 1/2 apple juice and 1/2 water
The goal is hydration, not perfection.
What about Zofran (ondansetron)?
The American Academy of Pediatrics and CHOP support its use when prescribed by your pediatrician, especially if vomiting is preventing hydration. It can be a real game-changer for getting kids to keep fluids down.
Does Emetrol work?
Not routinely recommended. There's minimal evidence compared to oral rehydration solution, and it's not first-line in pediatric guidelines.
Should I give probiotics like Florastor?
Probiotics have some evidence for reducing antibiotic-associated diarrhea, but they don't prevent or treat norovirus. The data is not incredibly compelling, so I wouldn’t consider it a primary treatment during acute gastroenteritis.
What about tube-fed children?
If your child is tube-fed, you can adjust feeds during illness:
Smaller, more frequent feeds
Consider ½-strength formula short-term
Add ORS between feeds
Monitor urine output and hydration status closely
Work with your pediatrician or feeding team on adjustments.
5. School & Return-to-Care: When Can They Go Back?
This is always a tough call. Here's what CHOP and the CDC recommend:
Your child can return to school or daycare when:
They've been vomit-free for 24 hours
Fever-free for 24 hours (without medication)
They're well-hydrated and back to baseline energy
Diarrhea alone is not an exclusion unless it's uncontrolled
The 24-hour vomit-free rule is the most important one — it protects other children and gives your child's gut time to stabilize.
6. Protecting Newborns & Understanding Risk by Age
If you have a newborn at home during a stomach bug outbreak, I know you're worried. Here's what helps.
How do we protect the baby?
Strict handwashing before touching the baby
Assign older siblings a "kissing spot" (feet only!)
Separate burp cloths, bottles, pacifiers
Breastmilk provides protective antibodies if you are able
Watch hydration closely (count wet diapers)
Can newborns actually get stomach bugs?
Yes, and they dehydrate quickly. Poor feeding or fewer than 3–4 wet diapers per day in a newborn requires immediate evaluation. Don't wait.
Are older kids less likely to catch it?
Somewhat. Older children have more mature immune systems and (usually) better handwashing habits, but norovirus is still highly contagious regardless of age.
7. Managing Anxiety Around Stomach Bugs
Many parents — and kids — have real anxiety around vomiting and stomach illness. Let's talk about it.
Does the anxiety get better over time?
Yes. Understanding the physiology, having a concrete plan, and naming the fear all help reduce panic. For parents with emetophobia (fear of vomiting), exposure therapy and cognitive behavioral therapy (CBT) are effective.
How do I help my child who saw someone vomit at school?
Name what happened
Validate their discomfort ("That can be scary to see")
Explain the body's protective mechanisms ("Vomiting is the body's way of getting rid of something that upset the stomach")
Reinforce the steps that give them control: handwashing, rest, hydration
When is it actually ER-worthy?
Go to the emergency department if your child has:
No urine for ≥8 hours
Severe, unrelenting abdominal pain
Lethargy or listlessness (not just tired — truly unresponsive)
Blood in stool or vomit
Signs of dehydration per CHOP's clinical pathway (sunken eyes, no tears, dry mouth, very decreased activity)
Should I worry about them aspirating vomit while sleeping on their back?
No. Normal back sleeping is safest. The gag reflex prevents aspiration in healthy children. Do not prop them up — this can create other risks.
8. Immunity, Vaccines & What's Next
Is there a norovirus vaccine?
Not yet, though several candidates are in Phase II/III clinical trials. Hopefully within the next few years.
Do kids have immunity after getting sick?
Yes, but it's short-term and strain-specific (weeks to months). They could get a different stomach bug — or even the same virus again — later in the season.
Does breastfeeding protect babies?
Breastmilk contains IgA antibodies and antiviral factors that reduce the severity of illness, but it doesn't fully prevent infection. It's still one of the best protections you can offer.
And Just Remember…
GI bugs are miserable. There's no sugarcoating it. But they're also usually self-limited, and most kids bounce back beautifully with just time, hydration, and your steady presence.
The fact that you're reading this — that you're looking for information, thinking ahead, trying to understand what's normal — means you're already doing everything right. Trust your instincts, follow the hydration plan, and know when to call for help.
You're going to get through this. Just take it one sip, one hour, one day at a time. You’re doing so great.
Sending you a big hug,
Anjuli
Disclaimer: This blog post is for informational purposes only and should not replace the specific instructions provided by your child's surgeon or healthcare provider. Always follow the post-operative care instructions given by your medical team.
References:
Children's Hospital of Philadelphia (CHOP). Clinical Pathway: Acute Gastroenteritis, Dehydration Management.
American Academy of Pediatrics. AAP Textbook of Pediatric Care, Viral Gastroenteritis.
Centers for Disease Control and Prevention (CDC). Norovirus Clinical Overview.
King CK et al. Managing Acute Gastroenteritis Among Children. MMWR Recomm Rep 2003;52(RR-16).
Freedman SB et al. Viral Gastroenteritis in Children. N Engl J Med.
Leonard SA et al. Viral Gastroenteritis in Children. Pediatr Clin N Am.
Nowak-Wegrzyn et al. FPIES Guidelines. JACI (2017).
Hall AJ et al. Norovirus Disease in the United States. Emerg Infect Dis.
Lopman BA et al. Environmental Transmission of Norovirus. Curr Opin Virol.
Freedman SB et al. Zofran for Pediatric Gastroenteritis. JAMA Pediatrics.
Szajewska H et al. Probiotics in Gastroenteritis. J Pediatr Gastroenterol Nutr.
AAP Clinical Report: Oral Rehydration Therapy.
CDC Childcare Illness Guidelines.
Goldman AS. The immune system in human milk. Pediatr Clin N Am.
Boschen MJ. Emetophobia Treatment Review. Clin Psych Review.
Atmar RL et al. Norovirus Immunity and Vaccine Development.