Very ill Baby and no idea what to do

[Wineasaurous]

My 13 month old baby is really poorly.
He's gone off and point blank refusing anything but water. Can't get any milk into him or food. He's lethargic and very clingy. He suddenly won't sleep through the night, won't nap at usual times, bad cough, diarrhoea, runny nose, temperature etc.
Thing is before he got poorly, he is a very independent baby. He loves to play and explore, eat everything, slept through the night and regular nap time. I rang 111 because every time we try to feed him food or formula he vomits it back up. Effortlessly. It just pours out of him. 111 told me to get him to the hospital who just sent us away. We went to the GP who checked him over and sent us away but I'm worried. It's been since Christmas Eve and he's just getting worse. Any advice?

How are things this morning?

@mynewnameisKy if your post was directed at me re: medical knowledge I’m a GP!

www.nhs.uk/news/pregnancy-and-child/diluted-apple-juice-as-good-as-rehydration-drinks-for-children/

I would just take him home and let him rest, he's been thoroughly checked over. If he declines again id take him back.

@ChocolateDinosaur

Did you actually read the link you posted?

@Wineasaurous

Hope you are all ok this morning and managed to get some rest

I read the link and thought it said although the daily mail had reported it wrong (typical!) there was actually some merit in giving dilute apple juice for keeping fluids up as kids more included to drink it than ors?

@appleandcinnamon I think the results speak for themselves- no NICE haven’t changed their guidance yet but that’s because it takes years for review of guidance to come round.
Sorry would have linked to British Medical Journal but it’s not open access.

How is little one anyway?

Hi all,

Thank you for all your help and concern. @MynewnameisKy the links your sent were very useful. I was reading them in A&E. My main concern was getting past the rehydration phase.

To everyone else, genuinely thank you. He seems brighter this morning. Actually ate one of my toast soldiers (without being offered may I add) this morning. I'm really hoping that this is him coming out the other side

@ChocolateDinosaur

This bit of your link would rule apple juice out for me.

However, this may not work for all children, as the study didn't include any babies under six months, children with more serious stomach upsets or other conditions, and those who were already severely dehydrated.
The advice from the National Institute for Health and Care Excellence (NICE) is still to give your child rehydration solution if you're worried they may become dehydrated and to seek medical advice if they don't get better. Fruit juice could make their diarrhoea worse and the current advice is that it should be avoided.

I wouldn't go against NICE guidelines on the basis of a single study. This is a young child with a serious stomach upset and an already rightly concerned mother.

Possibly in the future apple juice will be the treatment of choice but it isn't the current recommendation.

@Wineasaurous delighted to hear he is a little better. Toast is good, be prepared to have to feed him loads over the next couple of days.

That’s fine- as a parent is always your call ultimately what you decide to do.

I just try to stay up to date for my patients as the GMC recommend and give them the information to make a decision. It may be single study but actually has been dissipated widely amongst medical profession, presented at may ‘GP update’ meetings and was recommended by paediatricians at the hospital where I did my paeds rotation as a junior.

That piece of NICE guidance was reviewed in Feb 14 so now almost 4 years out of date.

I will graciously bow out now and hope baby Wineasaurous is feeing better soon.

@ChocolateDinosaur I don't think you need to bow out. Debate is healthy and it's always interesting to hear other people's experiences and opinions.

I genuinely haven't come across the apple juice advice before. I do think there could be many people reading this who might have a child who wouldn't let ORS across their lips I have two of them and in that case Apple juice could be their life saver.

In my opinion for the time being it should be ORS if at all possible, Apple juice second and then basically any liquid at all that you can get them to take.

I feel it’s a real shame there isnt a better system for home visits. Having to drag a child with gastro out is not only horrible for the child and parents but also a massive risk to others spreading the bug around which could cause serious issues for those who are immunocompromised/have other conditions.

Yay! So glad he's a bit better, hoping this is him on the better side of it now.

So not only has he eaten toast, he's taken 2 bottle and is now playing with one of his books and some of his Christmas toys.

It's a NYE fucking miracle.

Oh great news. Happy new yr x

Yay

Yay. Glad he's turned a corner.

I'm in France and both mine have been admitted to hospital with dehydration. One DR told me that the limit is 10% of weight loss then they really need a drip.

My then 11 month old was in only overnight and it made a huge difference and really helped him fight his bug.

My then 3 year old was in for 4 nights but he had salmonella poisoning and they couldn't get his temperature down.

Happy New Tear. 😀

I often find with mine that it's when they are at the absolute worst that the tide begins to turn.

I remember once when Dd was admitted with dehydration and the consultant decided she didn't need a drip and they would just do ORS 10mls every 10minutes. 🙁 I could of done that at home.

That was 16 years ago. No money for that in today's NHS.

Sorry Happy New YEAR!

Op, absolutely delighted.

I warn you, he will be riding a horse in a steeplechase, taking on Mo Farah and Lewis Hamilton before you’ve had your first coffee! Find a relie or friend and get some rest!

Happy New Year and may 2018 be good for you all.

Wonderful news! After such a long stint worrying you can finally relax about his health! You wont feel so stressed about him getting into mischief, as at least it is a sign he is a healthy & happy little boy!

Haha oh Christ he is a right tinker normally which is why all these cuddles have been a huge red flag and lovely under different circumstances.
Still very cuddly and sleepy this morning but definitely on the mend

Glad to hear he is on the mend Wine. It's very scary when they're so poorly, you must be very relieved now!