3yo not well - seen Nurse and GP

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So my just shy of being 3yo DD has been unwell since Wednesday. She vomited 1am Wednesday but then was totally fine all day. This is the 3rd time in a month this has happened where she has vomited and then been fine and no one else in the house had the same, but then by 7pm Wednesday she vomited again (projectile this time). And that was it until 7am Thursday, but this time she wasn’t keeping anything down, she wanted drink constantly, but 20 minutes later it was back up. This was constant all day, between her napping. I called our GP because I was concerned that a. This is the 3rd episode in the last month, and b. She isn’t keeping anything at all down. Nurse asked could it be a bug (which she asked last time this happened), and I said no one in her nursery has a bug, no one in the house has etc. it’s also happened before. Nurse prescribed omeprazole just in case it’s reflux, also saw DD right tonsil is inflamed so keep an eye in case spots appear. Ice cream given for dinner just so had something, but it came back up.
DD vomited for the last time at 2am Friday morning. She woke up 9am Friday, had a little coco pops and a drink and went back to sleep 9.30 until 1pm. Woke up briefly and said wanted a sandwich but had one bite and spat out and went back to sleep until I woke her at 3.40pm, as I made another GP appointment because she was clearly very lethargic, only had a wee in the morning. She fell asleep on me in the waiting room. He checked her obs, all is fine except she has an ulcer on her tonsils and he said it was viral and that’s why she’s feeling a bit poorly, said to give her anything she wants, ice cream, fizzy (but flat) drinks, just so she replaces what she’s lost, and he prescribed amoxicillin, took her to the shop for chocolate, she had 1 little bite and didn’t want more. Sips of drinks And had 1 dose of amoxicillin but fell asleep on the sofa before last dose so I took her to my bed. Slept until 7am this morning, fairly good mood, smiling, wanted yoghurt, had 1 small spoonful, sips of drinks. Very unsettled then, complaining of leg pain and belly ache, crying but refusing calpol and amoxicillin, not happy at all. Wanted a hot dog for lunch, when we got them from the shop and made them at 11am she didn’t want it, wanted to sleep. And that’s pretty much it.

anyone had something similar with their child? Not sure if I need to ring 111 with her being lethargic and potentially dehydrated but I can’t win if she cries when I try and push a drink for her, or the medicine, it just comes out of her mouth when she’s crying.

Amoxicillin for a viral infection but why?
Common amoxicillin side effects include
nausea and vomiting so might be one of the reasons?

I’m unsure why myself but something to do with the ulcer. but this was prescribed after the bouts of vomiting, plus she’s refusing it anyway. This was prescribed yesterday afternoon. She had 1 dose after we got it but isn’t entertaining it now, or calpol, or food.

Have they swabbed her for strep?

She needs to take the prescribed antibiotics. It's really foolish to not ensure she takes them.

This sounds quite normal for a stomach bug.

in addition amoxicillin can cause nausea and vomiting in some people - it makes me horrifically ill which is why I try not to take it unless I am really really suffering.

I’m not quite sure why you were prescribed an antibiotic which is well known for causing nausea and vomiting for vomiting. It seems odd.

@LapinR0se no, but there wasn’t any white spots so maybe that’s why? When she wakes I will try and see if she has any spots around her tonsils. The nurse on Thursday thought she may be coming down with tonsillitis but GP yesterday said ulcer so who knows really!! But I will definitely check when she wakes up.

With the other symptoms it sounds like when my daughter has strep. Does she have a fever

Has she has any fevers? If so, paracetamol comes in a suppository form so will get absorbed even if she is vomiting. Any diarrhoea?

I personally wouldn't be offering ice cream, chocolate and hot dogs- all are very high in fat. I'd also swap the flat fizzy drink for diluted squash or ice lollies made from squash. You can also make ice lollies from dioralyte, but they still taste pretty foul. Try jelly and follow the BRAT diet.

@PrincessofWells the GP himself said it was viral but he would just give antibiotics anyway so it’s not like other times when DD did have strep or urine infection and had to have antibiotics. Nurse (advanced clinician) on Thursday was reluctant to prescribe antibiotics because it’s counterproductive as she didn’t have tonsillitis but may be getting, and would prescribe if we went again and she had tonsillitis. So I don’t think it’s that foolish to have missed a couple of doses in this situation. And anyway, the calpol I did try and give her came out with drool from her crying so unsure how I would be able to force her to swallow antibiotics, please advise if you can because I would prefer it if she did take it BUT I also don’t want to add to her distress unless I seriously have to.

@LapinR0se no, no fever. Not had a high temp at all this whole time which is just so strange. Her temp as fine on both times to see Nurse and the GP. It just doesn’t add up to me the vomiting, then ulcer (not caused by vomiting GP said when I asked) and now her being so lethargic. Although that could be due to dehydration I suppose.

You can't just skip it if it's prescribed. I just wondered.

@7238SM I only did this as per GP’s advice because I said she hadn’t eaten since Wednesday PM. He specifically said Ice Cream although I said I already tried and failed with that. He also said fizzy (but flat) drink with a little salt in it. I bought diarolyte sachets for her but she refused them. Hot dog we only went for as she asked for them and wasn’t eating anything else, but didn’t even take a bite anyway. I will have a look at BRAT diet now.

I’m definitely not skipping it, she is refusing it, and by refusing I mean won’t let me put the spoon / syringe in her mouth. And is very distressed.

If you think dehydration you need to act on it. You could give her a tablespoon of water every 10 minute. It often works well.
Some children like ice lollies and it's a good way to go too.

@ShetlandishMum she normally loves a Mr.freeze but refused 😢 it’s so hard, she’s never been this bad before and to think she’s only almost 3 she’s had strep previously, urine infection, folliculitis, norovirus x2, bad flu, and then this odd vomiting thing this last month. But she’s never been so lethargic and refusing absolutely everything. She just wants to sleep all the time. When she wakes I will check her tonsils, make sure she drinks, try and get her to eat, and if any of these don’t work and her tonsils are worse, 111 will be called.

You have to work out how to give medication and water. It's not a choice for a 3 yo.
Of course, you can and should call 111 if you are in doubt about your child's health but the main thing to deal with is water and medication. Eating isn't important for a short time.

This sounds like my DS when he was very little. I was told not tonsillitis by the urgent care place and our GP. I coslept with him and then a week or so later I had tonsillitis!

her throat and mouth are probably very sore and she doesn’t want to accept the medicine or drink in case it hurts more.

If she stops weeing much and is taking virtually nothing in and is very lethargic take her to a&e , sometimes they need to go on a drip to be rehydrated .

I have a child who won't take medicine of any kind, it's a horrible ordeal for all involved if it's needed. We don't push any medicine except antibiotics.
I totally appreciate how hard it is when they won't take it, but you do need to do whatever is necessary to get it in her. The only way you'll know if it's something she can't fight herself is by her taking the antibiotics and seeing if she improves. I know full well how upsetting it is as the adult to have to force medicine so I don't say that lightly.

My eldest also doesn't get temperatures with a lot of things, including Strep throat and Scarlet Fever. So no temp doesn't mean no infection in all cases.

Her immune system seems to have had a battering lately (which can happen with winter and nursery) do you have any vitamins? You can get chewy sweet type ones most children like if not. Does she like cucumber at all? It's like 90+% water and easy to swallow with a sore throat. Suck on ice cubes or ice lollies too for fluids. It's really tricky when they go through a patch of being ill constantly. Your doing a great job OP trust your instincts and hopefully she improves.

I'm sorry but you are the parent. You do what it needs to get antibiotics and fluids into her.

Sorry to add to my post, you can also go to any local pharmacy for another opinion to double check it's not getting worse. They can look for any signs of Quincy (which is rare!) and dehydration. They are open on Saturdays so I'd try there before 111.

We had to do a fluid challenge in hospital, my DC went in with dehydration, 5ml of fluid every 10-15 minutes. Use a Calpol syringe and just drip it onto her tongue, any juice or flavour she likes.
It seems like nothing goes in, but it actually does. I spent 7 hours sat at the hospital waiting for a urine sample from my youngest, and we had no option but to keep trying, it did eventually work.

I always make sure I post on threads with a case like this because it drove me mad when our son was vomiting on/off for 7 weeks last year and despite MANY GP visits , two hospital admissions and both DH and I being doctors , NO ONE guessed the real cause - constipation.

is there any chance your child is constipated? We had no idea as our son was still pooing around the blockage but it was only on xray that all was revealed - really impacted bowel that was causing intermittent obstruction. The tonsil could be a coincidence

And our son on multiple occasions in that 7 weeks couldn’t even keep fluid down - we were having to syringe drinks into his mouth slowly but he was still vomiting , hence the hospital trips.

She most likely has a virus, but sometimes a bacteria can come along too, so the GP gave antibiotics as a precaution.
Viruses often cause vomiting in kids, partly because of the temperature, and also because the glands in the abdomen become enlarged. That’s also why kids with, for example, ear infections, say they have tummy ache.

You need to give her calpol, nurofen (if she has a temperature), and the amoxicillin, as well as fluids, and whatever food she’ll eat.

It’ll run its course and I’m sure she’ll be fine in a couple of days.

@clinellwipe on reflection of the GP visit, I asked it the ulcer was from all the vomiting, he said no, but the more I think of it surely it’s because of the vomiting, she was mostly vomiting acid in the end because she wasn’t keeping anything down. So the tonsils is a coincidence. DD has suffered with constipation in the past but she has lactose and or Movicol daily at times when she is constipated. Nurse checked her tummy and couldn’t feel anything whereas last time DD had the vomiting episode, probably 3 weeks ago, Nurse could feel the DD was constipated, also protein present in her urine then, had antibiotics as a precaution as it was the weekend but the sample that was sent to the lab came back ok 🤷‍♀️ it’s just so strange and I wish someone would consider all the facts rather than, for example, GP concentrating on the ulcer, ignoring all other facts, vomiting and being lethargic. Nurse concentrating on thinking it was a bug but didn’t consider the other episodes of vomiting, but to be fair a urine sample was taken and sent to the lab (although won’t have results until next week), sample pot given for poo for when DD does one (hasn’t in the past 2 days as hasn’t eaten), and Nurse said if it happens again possibly blood test to see if there are any intolerances.