Wednesday, March 13, 2013

Nursing through Stomach Flu

We were struck with a stomach bug this past weekend. It started with 18-month-old G suddenly throwing up on the kitchen floor on Friday evening while I was in the middle of cooking dinner, hands covered in bread dough (I was attempting to make naan to go with my attempt at tofu vindaloo). I didn't think anything of it at first: G sometimes throws up for no apparent reason, often if he's eaten too much too quickly, or if he gags on food because he has too much in his mouth. It's usually nothing, he recovers quickly, and a little cleanup removes all evidence. Fortunately, my mom was there, and she helped get the mess and the baby cleaned up while I finished kneading the naan dough.

Unfortunately, 10 minutes later, G threw up again. And again 10 minutes after that. And again. And again. He threw up in the bath. He threw up in his bed. And again, and again. He fell asleep and was throwing up in his sleep, waking slightly to turn his head, bring up whatever little bit was still in his stomach, then falling back asleep. It was scary. Very scary.

After about two hours of this, I called the advice nurse for help. She asked a bunch of questions to make sure I didn't need an ambulance, then read off her script that we should be concerned if the vomiting persists for over 24 hours. A whole DAY of vomiting every 10 minutes?! Surely not. A few minutes after I hung with her, she called back to say that she'd spoken with her supervisor, and she felt now that, given the frequency of the vomiting, we might consider going to the ER. She said it was, of course, up to me, but that was her new advice.

This was hardly my first stomach flu, just the first time I'd seen a kid throw up so often. We decided to wait and see if the vomiting slowed down on its own. Armed with a pile of towels, the washing machine running almost nonstop, I slept in G's bed, offering to nurse him in between bouts of vomiting, hoping to keep him hydrated and calm, hoping the milk would somehow help wash out whatever had gotten into his system. He slept on a towel, and whenever he threw up, I'd wipe his mouth, change out the towel, and lie down with him again.

The vomiting slowed to once an hour, then longer, thankfully. I called to make an appointment with his doctor in the morning, and they suggested I first speak with the pediatric advice nurse, so I did that. She said it sounded like a classic case of stomach virus, that I should go ahead and keep nursing him, and offer PediaLyte and other fluids, then graduate to bland foods. She promised that it would probably turn into diarrhea after about 24 hours. She also told me that it was probably highly contagious, and I should be prepared for the rest of the family to get it, too. I should stock up on Gatorade and Popsicles for hydrating the kids, and when the diarrhea struck, be ready with BRAT (bananas, applesauce, white rice, toast, crackers, chicken broth) foods. She said a doctor's visit wasn't necessary, that there wasn't much they could do except give IV fluids if he became dehydrated.

The two older boys seemed fine through Sunday, but on Sunday morning, I threw up. I didn't see how I could possibly avoid it, having slept with my face practically in G's vomit all night on Friday. My husband took the boys out so that I and the baby could rest, and in the hope of keeping their exposure down. I nursed the baby and tried to stay hydrated myself. By Sunday evening, he seemed better and had indeed moved on to some pretty gnarly diapers. I was trying to stick to bland foods and Gatorade, hoping not to vomit again myself, and not even certain I was producing milk with how little I was eating and drinking. I didn't vomit the rest of the day, but I didn't feel too hot, either.

The two older boys still seemed miraculously fine until Sunday evening, when S, who's four, and no stranger to vomiting, declared that he had a tummy ache. Uh-oh. Around midnight, he came to our bed, asking to sleep with us because he couldn't sleep in his bed because his tummy hurt. We both knew - we knew - he was going to throw up in our bed, but we felt bad that he was so miserable. Sure enough, around 3:00 a.m., up his Sunday dinner came. Sigh.

I kept N and S home with me on Monday, though N still wasn't exhibiting any symptoms, to keep this thing from spreading beyond our house. I threw up again on Monday morning and felt fairly crummy all day, but by Tuesday evening, everyone seemed on the mend. N went to school on Tuesday, and S would have except he suddenly threw up in the morning. He was fine the rest of the day and went back to school on Wednesday. N, however, finally succumbed and was complaining of a stomach ache Tuesday night and Wednesday morning, so I let him stay home again on Wednesday. Hopefully that'll be the end of it!

The stomach flu seems interminable and unsurvivable when it's making its way through your family, but the good news is that it typically only lasts a day or two, and if you keep up the fluids, everyone should recover quickly.

Information on Nursing with Stomach Flu

If your breastfed baby is vomiting or has diarrhea due to a stomach virus, you may continue breastfeeding him normally. Breastmilk is soothing to the throat and stomach and will not upset the stomach further. It will help to replace vital nutrients and fluids lost through vomiting and diarrhea and can be his only source of food as long as he is ill, even if he is older and usually takes solids. Breastmilk is processed quickly by the body, so even if he vomits up some of the milk, if as little as 10 minutes have gone by, he's likely absorbed at least some of the fluids and nutrients from that feeding. You may want to wait 30 to 60 minutes after vomiting to offer the breast, if the baby can wait, to ensure that the stomach has settled and to maximize absorption of fluids.

If you are vomiting or have diarrhea and are nursing a baby, it is very important that you stay hydrated. Drink small amounts of Gatorade or other hydrating fluids frequently. Even if you are not able to keep solid foods down, you can still produce milk to nourish your baby. Breastfeeding requires additional fluids, so be extra sure to drink as much as you can. You may experience a temporary dip in your supply if you do become dehydrated. When you recover, simply continuing to nurse your baby on demand should quickly bring your supply back up. If you continue to experience low supply after recovering from a bout of vomiting and/or diarrhea, you may want to try increasing your fluid intake and eating foods that encourage milk production such as whole oatmeal. If the supply dip is severe, pumping immediately after a feeding can help stimulate additional milk production as well. If you are concerned about your milk supply after an illness, you can also contact a lactation consultant for advice on regaining your supply.

1 comment:

  1. It is really scary for a mother to have her kid contract the stomach flu. Vomiting is usually associated with overeating or indigestion. Luckily mothers has options nowadays on calling their GP or other health providers for a bit of a first aid diagnosis before checkup. Anyway, I hope G has grown into a happy young boy. Take care!

    Malachi Cates @ Indian Crest Pediatrics