Stomach bugs in children are extremely contagious, break out within half a day to two days and cause vomiting and diarrhoea for one to three days. The child stays home from förskola (municipal preschool, from age one) until 48 hours after the last vomit or bout of diarrhoea, according to Folkhälsomyndigheten (the Public Health Agency of Sweden). The most important thing at home is fluids in small amounts, often, and hand washing with soap, not hand sanitiser. Seek medical help if the child is passing little urine, is listless, has blood in their stool or is under one with both vomiting and diarrhoea.
At two in the morning you hear that sound from the children's room, and then it begins: changing sheets, showering the child, comforting, fetching a bucket. Vinterkräksjukan, the winter vomiting bug, always arrives at night and always without warning, and almost every family with a child at förskola gets it at least once a year between November and April. Here is what actually makes a difference: how to limit the spread within the family, what to do in the first hours and when it is time to call.
How it spreads
The most common virus, the one behind the winter vomiting bug, spreads through vomit and stool and via hands, door handles, toys and surfaces. It takes only a few virus particles to get ill, and the virus survives both cold and ordinary hand sanitiser. When a child vomits, small droplets also spread through the air in the room. That is why the whole family is often ill within a week and why förskolor close groups during big outbreaks. The child is most contagious while vomiting and having diarrhoea, but the virus stays in the stool for a few days more, and that is why the 48-hour rule exists.
The first hours
- A bucket, a towel and a change of clothes by the bed, for the child and for you. A lamp on low.
- No food, but fluids as soon as the child has stopped vomiting for the moment. Oral rehydration solution from the pharmacy is best, because it contains the right amount of salt and sugar. Always keep a pack at home from October onwards.
- A teaspoon every other minute. It sounds like too little, but it stays down. Big gulps come straight back up. Increase after an hour without vomiting.
- If the child refuses rehydration solution: diluted squash, broth, ice lollies made of squash, water. Anything is better than nothing. Breastfeeding continues, shorter and more often.
- Wash your hands with soap after every contact with vomit, a nappy or the toilet. That is what decides whether you get ill yourselves.
- Register for VAB (paid leave to care for a sick child) and cancel the weekend plans. Expect at least three days at home.
Dehydration: what to watch for
| Seek medical help | Wait at home |
|---|---|
| Passing much less urine than usual, a dry nappy for six hours or more | Passing urine as usual or slightly less |
| Listless, hard to wake, no energy to play at all: call 112 (the emergency number) if very listless | Tired and whiny but awake and responding |
| Dry mouth, no tears, sunken eyes or a sunken fontanelle | Moist mouth, cries with tears |
| Vomits everything they drink for more than 24 hours | Keeps down small amounts of fluid |
| Blood in the stool or the vomit | Watery diarrhoea without blood |
| A child under one with vomiting and diarrhoea at the same time | A child over one with the usual course |
| High fever and severe stomach pain, especially on the right side | Mild fever, stomach ache before diarrhoea that then eases |
| Symptoms lasting more than a week | Better after one to three days |
Förskola and the 48-hour rule
The recommendation from Folkhälsomyndigheten is clear: children with a stomach bug stay home until two full days after the last vomit or bout of diarrhoea, even if the child perks up sooner. A child who last vomited on Monday evening therefore goes back on Thursday morning, not Wednesday. It feels strict when the child is bouncing around the flat on Tuesday, but it is those last days that decide whether the virus stays in your family or moves on to fifteen others. According to the recommendation, healthy siblings can go to förskola, but many förskolor have their own routines during outbreaks, so ask. Always tell the förskola what your child has, so they can keep an eye out.
How to limit the spread within the family
- Soap and water for hands, not hand sanitiser. Wash for at least twenty seconds, dry with your own towel or paper.
- A separate toilet for the sick child if you have two, otherwise wipe the seat, flush button and handle after every visit.
- Wash bedding, towels and vomited-on clothes at 60 degrees, and remove solid vomit before putting things in the machine.
- Wipe up vomit straight away with paper, put it in a bag, tie it up, clean the surface with detergent and wash your hands.
- Whoever is ill doesn't cook. That goes for you too, for two days after you have recovered yourselves.
- No shared towels, bottles or dummies this week.
- Expect it not to be enough. Siblings and parents often get ill anyway. That is not a failure, it is a stubborn virus.
Food when the appetite returns
Often as soon as a day later. Then there is no reason to wait, small portions of ordinary food are fine: porridge, bread, boiled potatoes, banana, chicken. Hold off for a few days on fatty and fried food, juice and large amounts of milk if the stomach is still loose. We have written a separate guide to Stomach bug in children with more detail. The diarrhoea can linger for a few days after the vomiting, which is normal as long as the child is drinking and passing urine.
How we do it with our families
A stomach bug is the illness that clashes with work most often: the child is lively on days two and three but isn't allowed at förskola. Our nannies take those days when they are free, and they know the rules. Sanna was with a family in Bromma in February: she arrived with her own towels in her bag, washed her hands so often that the five-year-old asked why, stuck to small snacks and wrote on the note how many times he had passed urine during the day. That was the task the parents had asked for, because it is what decides whether everything is all right.
This article is general information and does not replace advice from BVC (the child health clinic every family is enrolled in), your vårdcentral (local health centre) or 1177. If you are worried about your child, call 1177. In an emergency, call 112.
Would you like a nanny who knows your child, knows how they usually are and notices when something is different? Book a free first meeting with the nanny in your home.
Read more: Stomach bug in children · VAB · A nanny when your child is sick · FAQ
Frequently asked questions
How long should my child stay home from förskola?
Two full days, that is 48 hours, after the last vomit or bout of diarrhoea, according to the recommendation from Folkhälsomyndigheten. That applies even if the child is lively and eating on day two. With a stomach bug it is the contagion, not the energy level, that decides, unlike a cold, where the child goes back as soon as they feel up to it.
Can healthy siblings go to förskola?
It varies. Folkhälsomyndigheten says healthy siblings can go, but many förskolor have their own rules during an ongoing outbreak and ask the whole family to wait. Ask your förskola what applies there. The sibling often catches it anyway within a couple of days, so plan for the whole week to go.
How quickly does it spread?
The winter vomiting bug breaks out within half a day to two days of infection, and very small amounts of virus are enough. That is why half the group is ill the same week. The child is most contagious while vomiting and having diarrhoea, and for a couple of days afterwards.
Does hand sanitiser help?
Poorly against the winter vomiting virus. Soap and water is what works: wash hands thoroughly after every toilet visit, nappy change and before food. Wash bedding and towels at 60 degrees or more, and wipe the toilet, flush button and door handles with ordinary detergent every day until everyone is well.
When should we seek medical help?
If the child is passing much less urine than usual, is listless and hard to get a response from, has blood in their stool, vomits everything they drink for more than 24 hours, has a high fever and severe stomach pain, or is under one and has vomiting and diarrhoea at the same time. Call 1177, and 112 if the child is very listless.