The following information is to be used as a guide to and at the discretion of the end-user and should not replace a doctor’s opinion.
OVERVIEW
Gastroenteritis, commonly known as “gastro” or “stomach flu,” is an inflammation of the stomach and intestines, often caused by infections that lead to diarrhoea, vomiting, fever, and stomach cramps.
Gastro is often spread through contact with infected vomit or faeces, sharing contaminated food or drinks, or touching contaminated objects like toys. Gastro can also spread through the air when an infected person vomits. It spreads easily in settings like daycare centres, and particularly in winter, when children tend to be kept indoors and in close contact.
Gastro is one of the most common illnesses in toddlers (typically aged 1-3 years) and can lead to severe dehydration and malnutrition if not managed promptly. You can help prevent it by practicing good handwashing and ensuring children are vaccinated against rotavirus, a common cause.
The main concern with gastro in toddlers is dehydration, so offering frequent, small sips of an oral rehydration solution, watered-down juice, or breast milk is crucial. Watch for signs of dehydration like dry mouth, reduced urination, and lethargy, and seek medical attention if your toddler cannot keep down fluids, as they may need IV fluids.
By acting quickly, keeping little ones hydrated, and practicing good hygiene, parents can protect their children from the serious dangers of gastroenteritis.
GASTRO IN SOUTH AFRICA
In South Africa, gastro remains a significant public health concern, particularly among young children. According to our National Department of Health, diarrhoeal disease remains a leading cause of illness and death among children under five in South Africa, especially in areas with poor access to clean water and sanitation.
A 2023 report from the South African Medical Research Council highlighted that acute gastroenteritis accounts for approximately 20-25% of paediatric hospital admissions. The WHO estimates that in sub-Saharan Africa, including South Africa, there are about 1.7 billion cases of childhood diarrheal disease each year, with South Africa reporting 25 000 to 30 000 cases in children under 5 annually.
SYMPTOMS OF GASTRO
Symptoms of gastro in toddlers usually appear suddenly and can last from 1-10 days, depending on the cause. Common signs include:
- Diarrhoea: Frequent loose or watery stools, sometimes with blood or mucous.
- Vomiting: Often projectile and occurring multiple times a day.
- Abdominal pain or cramps: Toddlers may clutch their stomachs or cry inconsolably.
- Fever: Mild to high, indicating an infection.
- Loss of appetite and lethargy: The child may seem unusually tired or irritable.
- Dehydration signs: Dry mouth, reduced urine output, sunken eyes, or fontanelle (soft spot on the head) in younger toddlers.
- Unusual sleepiness or weakness
CAUSES OF GASTRO
Gastro in toddlers is primarily caused by viral, bacterial, or parasitic infections. The most common culprits include:
- Viruses: Rotavirus is the leading cause globally and in South Africa, responsible for up to 40% of severe cases in children under 5. Norovirus and adenovirus are also frequent.
- Bacteria: Pathogens like E. coli, Salmonella, and Campylobacter often stem from contaminated food or water.
- Parasites: In areas with poor sanitation, parasites such as Giardia or Cryptosporidium can cause prolonged gastro.
- Other factors: Non-infectious causes include food intolerances, antibiotics, or toxins, but infections account for 80-90% of cases.
In South Africa, rotavirus remains prevalent despite vaccination programs introduced in 2009. A 2024 study in The Lancet Global Health reported that unvaccinated toddlers have a 25% higher risk of severe gastro.
Children get gastroenteritis though:
- Contaminated food or water
- Unwashed hands after using the toilet or changing nappies
- Contact with infected children or adults
- Poor hygiene when preparing bottles, snacks, or meals
TREATMENT FOR GASTRO
Unfortunately, there is no medicine to cure gastro. And over-the-counter medicines that reduce vomiting and diarrhoea may be harmful for children. Treatment for gastro in toddlers focuses on symptom relief and preventing complications, as most cases eventually clear on their own.
Dehydration is the biggest risk in toddlers with gastro, making hydration the key to caring for gastro at home. It can be hard to ensure your child drinks enough fluids when they are vomiting and do not want to drink. Try to give your child small amounts of fluid often – even if they are vomiting. This will help replace any fluids they lose due to vomiting and diarrhoea.
PREVENTING GASTRO
- Vaccination: Ensure toddlers receive the rotavirus vaccine (part of South Africa’s Expanded Programme on Immunisation since 2009), which prevents up to 70% of severe cases.
- Hygiene practices: Wash hands with soap before meals and after nappy changes. Sanitise toys and surfaces regularly. Teach toddlers to wash their hands after playing, eating, or using the toilet.
- Safe water and food: Boil or treat drinking water, especially in rural areas. Avoid undercooked meats and unpasteurised dairy.
- Breastfeeding: Exclusive breastfeeding for the first 6 months strengthens your child’s immunity. The World Health Organisation reports that this reduces your child’s risk of gastro by up to 50%.
FURTHER READING
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