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My LO 3 1/2 Yr Old. She Is 15kg. Suddenly

Posted on Wed, 19 Aug 2020

Question: My LO 3 1/2 yr old. She is 15kg. Suddenly complained of tummy ache an hour ago and developed fever of 100.5 with chills. She threw up after that twice. I had given syrup. Calpol but she threw up immediately after that. No cough and cold as of now.

Follow up: Dr. Muhammed Aslam TK (4 minutes later)

just now checked the temperature and she is having 103c..please let us know what needs to be done

Answered by Dr. Muhammed Aslam TK (30 minutes later)

Brief Answer:
Probably viral fever

Detailed Answer:
Hi dear,
I have gone through your query, and understand your concern.

I guess she do not have loose stools(suggesting gastroenteritis), pain during urination or frequent urge to urinate(suggesting urine infection)

In the absence of above said symptoms, sudden onset of abdominal pain, fever and vomiting suggests a viral illness. To control vomiting, give her ondansetron suspension(2mg/5ml) 5ml now, and then continue 2-3 times a day for next 48 hours. Give this 1 hour before of food/paracetamol for better control. Continue Calpol suspension(250mg/5ml) 5ml 3-4 times daily for 3 days. Give food and fluids in small frequent aliquots- this will enhance retention. Let her take some rest. She will be fine in 3-4 days.

If the fever does not come down by 72 hours, she develops fresh complaints, or become very lethargic and not at all feeding, we will need further evaluation and management accordingly.

Hope I have answered your query
Let me know if I can assist you further
Take care

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Muhammed Aslam TK (9 hours later)

hello doctor....kid is complaining of tummy pain and threw up paracetmol and had loose stools twice...plz let me know what needs to be done...thankyou

Answered by Dr. Muhammed Aslam TK (1 hour later)

Brief Answer:
Suggests acute gastro enteritis

Detailed Answer:
Hi dear,

Now this suggests a diagnosis of acute gastroenteritis.

Had you given her ondansetron? If yes, when was the last dose given, and when she vomited last?

Does the stool contains mucus or blood staining?
Any pain on passing stools?

Kindly get back with details soon.
Meanwhile, give her frequent sips of ORS solution to prevent dehydration
Thank you

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Muhammed Aslam TK (36 minutes later)

i have given ondan last nyt at 9 pm...5ml...stool doesnt cotain any blood or mucous....

Follow up: Dr. Muhammed Aslam TK (4 minutes later)

i have given DOMPERIDONE 4ml ystrdy at 9pm.......she has thrown up yestrdy nyt 4AM...no pain while passing motion..but consistently complaining about tummy pain

Answered by Dr. Muhammed Aslam TK (11 minutes later)

Brief Answer:
Need not worry

Detailed Answer:
Hi, thanks for the information.

Most cases of acute gastro enteritis in children are viral, and need supportive treatment only. For such cases, I used to give Zinc supplementation and a probiotic, along with paracetamol and antiemetic.

Continue paracetamol every 6 hours, even if no fever. This will reduce tummy pain. For pain not responding to this, I used to give Tab. Meftal spas (mefanemic acid 250mg+Dicyclomine 10mg). For a 15 kg child, half tab is to be given after food 2-3 times a day. But this is a PRESCRIPTION DRUG.

For vomiting, I prefer ondansetron over domperidone. As said earlier, give 5ml 3 times daily, 1 hour before food/other drugs. Continue for next 48 hours.

Apart from this, give her ORS in small frequent sips(around 150ml to be taken after each stools), Z&D drops 1ml once daily for 2 weeks, and a probiotic (either enterogermina XXXXXXX bottle once daily or Econorm XXXXXXX twice daily) for 5 days. If fever continues beyond 48 hours, stool become mucus/blood stained, or she develops pain WHILE passing stools (tenesmus) we will need antibiotics too, as these symptoms suggests dysentery.

Avoid fruits/juices/sugary items until recovery, as these items exacerbates loose stools. Avoid giving tea/plain water. Instead give ORS/salted rice water.

Take her to a nearby doctor without further delay if she develops signs of dehydration(sunken eyes, dried out mouth/tongue, low urine output, drowsy and not taking orally), or vomiting persists despite antiemetic.

Hope I have answered your query
Let me know if I can assist you further
Take care

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Muhammed Aslam TK (3 days later)

hello doctor....she is passing around 6 to 8 times semi solid stools. No fever or vomiting since monday. but she complains tummy ache every time we feed and immedately wants to go for restroom and ache persists for another 10-15min. Currently we are only giving ors otherwise no other syrup .plz let me know if anything else to do. thanks

Answered by Dr. Muhammed Aslam TK (1 hour later)

Brief Answer:
Give Zinc and probiotic too

Detailed Answer:
Hi dear,

Good that she do not have fever or vomiting now. In the absence of blood or mucus in stools, we need not worry much. Stool frequency might take few more days to settle.

If not given already, kindly give her Z&D drops 1ml once daily for 14 days and Econorm XXXXXXX twice daily for 5 days. Give paracetamol or half of Cyclopam tablet(paracetamol500mg+ Dicyclomine 20mg) for abdominal pain as and when required, upto 4 times a day. Avoid spicy/fried items for 1 week.

If pain and frequency is not coming down in 3-4 days, I would prefer getting a CBC(complete blood count) and stool routine test done to decide regarding antibiotic therapy.

Let me know if I can assist you further
Take care

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Above answer was peer-reviewed by : Dr. Kampana