Norovirus in Kids: Dehydration Signs and Home Care

Quick answer: Norovirus in kids is the most common cause of the sudden “stomach bug,” with vomiting, watery diarrhea, nausea and stomach cramps that usually start 12 to 48 hours after exposure. Some children also get a fever, headache or body aches. Most kids feel better in 1 to 3 days. There is no medicine that cures it, and antibiotics don’t help because it’s a virus. The main job at home is preventing dehydration with small, frequent sips of an oral rehydration solution (or breast milk or formula for babies). Call your pediatrician if your child can’t keep fluids down or shows signs of dehydration, such as no urine in 8 hours, a dry mouth or crying without tears. Keep your child home until 48 hours after the vomiting and diarrhea stop, and wash hands with soap and water, since hand sanitizer doesn’t kill norovirus well.

Norovirus season in the U.S. runs mainly from November to April, so many families meet it in the middle of the holidays. This guide explains what norovirus looks like in babies and children, how to keep your child hydrated, which signs of dehydration to watch for, how to stop it from spreading through your household, and when to call the doctor or go to the ER.

What is norovirus?

Norovirus is a very contagious virus that inflames the stomach and intestines (acute gastroenteritis). The CDC calls it the leading cause of vomiting and diarrhea from acute gastroenteritis in people of all ages, and the leading cause of foodborne illness in the United States. People often call it the “stomach flu,” but it has nothing to do with influenza, and the flu shot doesn’t prevent it.

Young children are hit hardest. According to the CDC, norovirus leads to about 465,000 emergency department visits a year in the U.S., mostly in young children, and is responsible for nearly 1 million pediatric medical visits each year. Children under 5 are more likely than people of other ages to need an outpatient or emergency visit for it.

There are many types of norovirus, and getting sick with one doesn’t protect your child from the others. That’s why a child can catch it more than once, even in the same season.

Norovirus symptoms in kids

Symptoms usually come on suddenly. The CDC lists:

Most common: vomiting, diarrhea, nausea and stomach pain or cramps
Also possible: fever, headache and body aches
In babies and toddlers: fussiness, refusing feeds, tiredness and lots of wet, loose diapers

Seattle Children’s notes that a child may vomit everything for the first 3 or 4 hours before the stomach settles, and that moderate vomiting usually stops within 12 to 24 hours. Diarrhea often lasts longer than vomiting. Mild, on-and-off diarrhea can continue for up to a week, even after your child feels better.

How norovirus spreads

Norovirus spreads through tiny particles of vomit or stool. Kids can catch it by:

Close contact with someone who is sick, such as caring for them or sharing cups and utensils
Touching contaminated surfaces like doorknobs, light switches, faucets and toys, then putting fingers in their mouth
Eating food or drinking liquids contaminated with the virus, including food prepared by someone who is sick
Eating raw or undercooked shellfish, such as oysters

The AAP notes that people can spread norovirus before they know they’re sick. The CDC says people can keep spreading it for a few days after they feel better, and in some cases for 2 weeks or more, which is why handwashing still matters once your child is back to normal.

Home care: how to prevent dehydration

Most children with norovirus can be cared for at home. The goal is to replace the fluid your child is losing, a little at a time. Big gulps on an upset stomach often come right back up.

Use an oral rehydration solution (ORS). The CDC says over-the-counter oral rehydration fluids work best for mild dehydration. ORS has the right balance of sugar and salts. Popsicle versions can help kids who refuse to drink.
Start small and go slow. Offer a spoonful or a small sip every few minutes. A syringe, medicine cup or teaspoon works for kids who won’t sip. Once your child has gone a few hours without vomiting, slowly offer more.
Keep breastfeeding or formula feeding. The AAP advises undiluted breast milk or formula for babies 6 to 12 months, switching to an ORS if they can’t keep it down. Don’t give babies plain water, and never water down formula. Seattle Children’s suggests shorter, more frequent nursing sessions while a baby is vomiting. For babies under 6 months, ask your pediatrician what to give.
Be careful with juice, soda and sports drinks. Sugary drinks can make diarrhea worse. Full-strength juice and soda are best avoided. For kids 1 and older who refuse ORS, the AAP says diluted apple juice or a sports drink mixed half and half with water can be used. The AAP’s norovirus page is stricter and suggests skipping sports drinks altogether, so ORS is the safest first choice.
Bring food back gradually. A healthy child can skip a meal or two as long as they keep drinking. Once fluids stay down (Seattle Children’s suggests waiting until about 8 hours without vomiting), offer small amounts of bland, easy-to-digest foods like crackers, cereal, bread, bananas or low-sugar yogurt. Avoid fatty or spicy foods at first.
Let them rest. Sleep as much as they need. Keep a bowl or bucket and towels close by.

What about medicine?

There’s no medicine that treats norovirus, and antibiotics won’t help. Don’t give anti-diarrhea medicine to children unless your pediatrician tells you to. The NHS advises against it for children under 12. If your child has a fever or aches, ask your pediatrician which fever reducer to use and follow the package directions for your child’s age and weight. Seattle Children’s notes that ibuprofen can upset the stomach while a child is vomiting. Never give aspirin to children or teens. Call the doctor if your child vomits a prescription medicine.

Signs of dehydration to watch for

Young children get dehydrated faster than adults because they’re smaller, so even a modest amount of fluid loss matters. Watch for these signs, drawn from the AAP, CDC and Seattle Children’s:

Peeing less often, dark yellow urine, or fewer than 6 wet diapers a day in a baby
No urine in more than 8 hours
Dry mouth, lips or tongue
Crying with few or no tears
Unusual sleepiness, fussiness or weakness
A sunken soft spot on a baby’s head, or sunken eyes
Dizziness or weakness when standing (older kids)

When to call the doctor

Call your pediatrician if your child:

Shows any signs of dehydration
Can’t keep fluids down, or vomits everything for more than 8 hours while getting small sips of clear fluids
Is under 12 weeks old and has vomited 2 or more times (not normal spit-up)
Is under 1 year old and is vomiting, or has stopped breastfeeding or bottle feeding
Has blood in the stool
Has been vomiting for more than 24 hours, or has diarrhea that lasts more than 7 days
Has a fever above 104°F (40°C), or a fever that lasts more than 3 days
Has a weakened immune system or another health condition (call at the first signs)
Vomits a prescription medicine
Just seems sicker than you’d expect, or you’re worried

When to go to the ER / call 911

Call 911 if your child can’t be woken up, is too weak to stand or move, or you think their life is in danger.

Go to the ER right away if your child:

Has green or yellow-green vomit, or vomits blood or something that looks like coffee grounds
Has sudden, severe stomach pain
Has signs of severe dehydration: very sleepy or hard to wake, not peeing at all, or confused
Is a baby under 12 weeks old with any fever. Don’t give fever medicine before they’re seen.
Has a stiff neck, pain when looking at bright light, or a sudden severe headache
Has pale, blue, gray or blotchy skin, lips or tongue, or is breathing fast and hard

A child with severe dehydration may need IV fluids, so don’t wait it out at home.

How to stop norovirus from spreading at home

Wash hands with soap and water for at least 20 seconds, especially after diaper changes, using the toilet and cleaning up vomit, and before preparing food. The AAP and NHS both say alcohol hand sanitizer doesn’t kill norovirus well, so it’s not a substitute.
Clean up vomit and diarrhea right away while wearing disposable gloves. Disinfect surfaces with a bleach solution or an EPA-registered disinfectant that works against norovirus. The AAP suggests leaving the solution on surfaces for about 5 minutes.
Wash soiled laundry in hot water with detergent, on the longest cycle, and dry on high heat.
Keep the sick child’s things separate, including cups, utensils and towels, and run dishes through the dishwasher.
Keep anyone who is sick out of the kitchen and away from preparing food for others.
Wash fruits and vegetables and cook shellfish thoroughly.

When can my child go back to school or daycare?

The CDC, AAP and NHS all advise staying home until 48 hours (2 days) after the vomiting and diarrhea have stopped, because children are still contagious. The AAP adds that babies and toddlers should stay out of child care until their stools stay contained in the diaper, and that toilet-trained children should be accident-free. Seattle Children’s uses a shorter rule, saying children can return once vomiting and fever are gone, so guidance differs. Check with your school or daycare, which may have its own policy.

For other winter illnesses, see our guides to flu in kids, RSV in babies and cold vs. flu vs. RSV vs. COVID in kids. Hosting this holiday season? Read Thanksgiving food safety for toddlers, and keep our red-flag symptom guide handy.

Frequently Asked Questions

How long does norovirus last in kids?

Most children with norovirus feel better within 1 to 3 days, according to the CDC. Vomiting usually stops within 12 to 24 hours, but mild diarrhea can come and go for up to a week. Younger children sometimes take a little longer to recover.

How long is a child with norovirus contagious?

Children with norovirus are most contagious while they’re sick and for at least 48 hours after symptoms stop. The CDC says the virus can sometimes spread for 2 weeks or more after a child feels better, so keep up careful handwashing even after recovery.

What should I give my child to drink with a stomach bug?

An oral rehydration solution, given in small sips or spoonfuls every few minutes, is the best choice for a child with a stomach bug. Babies should keep getting breast milk or full-strength formula. Avoid plain water for babies and limit full-strength juice, soda and sports drinks, which can make diarrhea worse.

What are the signs of dehydration in a child with norovirus?

Signs of dehydration include peeing less or not at all for 8 hours, dark urine, a dry mouth, crying without tears, unusual sleepiness or fussiness, and a sunken soft spot in babies. Call your pediatrician if you see any of these.

Does hand sanitizer kill norovirus?

Alcohol-based hand sanitizer does not reliably kill norovirus, according to the AAP and NHS. Wash hands with soap and warm water for at least 20 seconds instead, and clean surfaces with bleach or a disinfectant labeled to work against norovirus.

When can my child go back to daycare after norovirus?

Most experts, including the CDC and AAP, advise keeping a child with norovirus home until 48 hours after the vomiting and diarrhea stop. Daycares may also require that diapered children have stools contained in the diaper. Check your school or daycare’s policy.

Can my child get norovirus more than once?

Yes. There are many types of norovirus, and the CDC says getting sick with one type may not protect your child against the others. That’s why a child can catch norovirus again, sometimes in the same season.

Related guides

Sources

This article is for general information and is not a substitute for advice from your child’s doctor. In an emergency, call 911.

Norovirus in Kids: Dehydration Signs, Home Care and When to Call

What is norovirus?