We had to fetch the younger Free-Ride offspring from school yesterday midday on account of an unscheduled bout of vomiting.* Because, you know, the microbes and immune systems tend not to take account of things like our work schedules. (“Or whether we have a science test,” the younger Free-Ride offspring chimes in.)
Anyway, since experience has established me as the puke-parent** in the Free-Ride household (the one upon whom a child will vomit in instances where someone is vomited upon), I now have something of a procedure when I get home with a pukey kid. We cover the head of the bed, the pillow, and the floor area adjacent to the child’s bed with towels (since, in case of puke, it’s easier to remove and replace a towel or two than to strip the whole bed and change the sheets). We provide a nice big aluminum bowl next to the bed … just in case.
And we don’t even think about putting food into that tummy until the tummy shows no signs of erupting.
But then, what to put in the tummy — what counts as a “gentle” food for a kid recovering from a stomach bug — is a source of some controversy at Casa Free-Ride.
In the household in which I grew up, flat ginger ale and saltines were the canonical first foods after an upchuck. If they stayed down, maybe 24 hours later you’d get to try some baked custard, the eventually “real” food.
Sadly, we hardly ever have ginger ale in the house, and the Free-Ride offspring have declared saltines strange and disgusting. What this means is that I don’t have a well-established safe food with which to test tummy stability.
Indeed, as I was laying down towels, right before I was going to make a batch of baked custard, the younger Free-Ride offspring mentioned that a teacher at the after school program had said that eggs (an ingredient of baked custard) are not a good food for your tummy after vomiting.
This suggests to us that what people consider as the right kind of food to give a kid who’s been throwing up must be pretty strongly shaped by what kind of food they were given as kids trying to get better from crummy tummies. Also, it suggests that there is no clear unified theory of the optimal macronutrient composition for these foods — at least not one upon which a clear majority of grown-ups taking care of these kids agree.
My strategy, drawn from my childhood, has been: fluids with a little flavor (because water tastes funny when you’re sick), then carbohydrates with negligible fiber (the dreaded saltines), then some not-too-wobbly protein, and none of it very far from a flavor range it would be fair to describe as “bland”. Probably a banana somewhere in there, too.
But, see, now the younger Free-Ride offspring and I are wondering if this strategy is bunkum.***
So, because the younger Free-Ride offspring tells me that a PubMed search would not be a relaxing way to spend a sick day, we’re appealing to those more likely to have an actual evidence base here (Pal? Pascale? Other medical/nutrition types?) to tell us whether there is any informed-by-science consensus on what a kid ought to be fed (and in what sequence) once the puking subsides.
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* No, we don’t have scheduled vomiting. It’s just that these stomach bugs hardly ever happen on a day when we had nothing else to do.
** The companion role to “puke-parent” is “poop-parent”. My better-half assumed that role, but hasn’t gotten any action in it since the sprogs were in diapers.
*** My current favorite alternate theory on why to eat bland foods in the wake of a stomach-bug: You don’t want to eat foods with more interesting flavors and textures, especially foods you really like, and then throw them up (if you’ve tested the tummy too soon) lest you develop a long-lasting aversion to those foods. It took me maybe a decade to get over my aversion to spaghetti and other long pastas served with tomato-based sauces … because of a stomach flu when I was about 11. On the other hand, if you develop an aversion to saltines, it doesn’t really impact your quality of life in quite the same way.
My family also gave me saltines and ginger ale as the first post-puke food. Over time, my grandmother started also giving me Challah bread from the local bakery, with a tiny bit of butter. That was divine.
Now that I’ve discovered a gluten intolerance, post-puke foods are a bit different. Usually it’s gluten free pretzels and ginger ale or watered-down gatorade.
I grew up with post-puke foods having the acronym BRATS for banana, rice, applesauce, toast, seven-up. But, yeah, bland, and in limited quantities until there was empirical evidence that things were going to stay down. No dairy or eggs for a couple of days, IIRC.
Hope the younger sprog feels better soon.
I was also raised on the BRAT diet and it worked for us, although I just googled it to see what it was about it that was supposed to be so effective (I thought it was the increasing complexity of the carbs or something)… then it turns out that it is apparently officially not recommended anymore, although, I can’t really see how a banana would be better or worse than anything else you could immediately eat post-puke…
** The companion role to “puke-parent” is “poop-parent”. My better-half assumed that role, but hasn’t gotten any action in it since the sprogs were in diapers.
I’m sure if you put in a special request with your sprogs, they would be happy to reprise their role.
YAAAYY SPROG BLOG IS BACK! Sorry they’re sick, though.
Growing up, we always had warm jello during times after times of vomit-induced sick leave. Yes, warm jello. As in, you make jello according to the package, pour it in a mug and enjoy the steamy goodness.
I don’t know if this is a good idea or not, and it always seemed that we had cherry or strawberry flavored jello, so if the stomach wasn’t quite settled-the color of the next bout of puke was…interesting? Jello, by the way, stains clothes, walls and bedspreads. Funny enough, when I get the stomach flu now, I now crave warm Jello. My husband thinks I am nuts.
Actually, the saltines and ginger-ale isn’t a bad start. Ginger does calm the stomach, and you get simple carbs from the soda AND the saltines. Some electrolytes from the saltines, too. The main things you wish to avoid are proteins, and most importantly fats. The BRAT diet is a good start.
Milk toast yes, sweetened toast in warm milk my grandmother swore by, but I’m not sure about the fat in the milk, or the casein. After the crackers and ginger ale came chicken broth, again, low in fat and a little protein, advance as tolerated.
Tea and dry toast was the sickest of the sick stage (regularly skipped). Then Seven up and saltines. Followed by Mrs. Grass chicken soup and jello. First fatty/proteiny thing was milk, or ice cream if somach ache went with throat ache (unless stomach was very acidic, in which case milk product might come sooner).
In ancient times, when doctors made house calls, our doc prescribed ginger ale and saltine crackers for upset stomach, and also a small bowl of crushed ice.
Common in US medical circles is:
Subject to known allergies, etc:
1) Clear liquid diet to include such things as Gatorade, broth, flavored gelatin and the like. If tolerated that day or patient noticeably improved, go to step 2.
2) Full-liquid diet, to include such foods as ice cream. If tolerated that day or patient noticeably improved, go to step 3 or step 4.
3) Soft or bland diet, to include such foods as white bread and poached or boiled eggs. If tolerated that day or patient noticeably improved, go to step 4.
4) Bland or normal diet. If bland diet tolerated that day or patient improved, go to step 5. If normal diet, it may be prudent to omit spicy foods for a day or two.
5) Normal diet, omitting spicy foods if prudence dictates.
Bake a potato (overbake it, actually — pre digestion if you will)…no oil, just scrub clean, poke some holes, wrap in foil, and toss in the oven at 450 for an hour or more. Add some salt and pepper for taste.
This might be too colorful, but on some BBC special (5th gear?) where an unsuspecting TV host was taken into a jet plane, the pilot laughingly recommended you eat bananas before you go up. They taste pretty much the same the second time.
And brace yourself if this is getting too gross… but this is extra important when you consider the phase “suck it up” was coined by jet pilots.
So yes, I completely agree that you should only eat food that won’t hurt your lifestyle if you choose to avoid them for 5 years or so.
When a university student I always found that refrigerator-cold leftover pizza from the previous evening would settle a queasy, upset stomach just fine. That could be due to the specific causes of my condition though.
My parents used to slightly squash a lemon without breaking the rind, poke a hole in the end, and let us suck the juice out of it. This was something we couldn’t stand on other occasions, but after puking it tasted just right. I’m not sure if it did us any good or not.
As someone with chronic illness leading to dealing with the issue regularly, I completely agree with S Seguin about bananas. There is relatively little disgust level experiencing them the second time.
On the other hand, I find that sweet things (like bananas) tend to exacerbate repuking necessity.. but that may be a personal thing. And juice is very not good-the acidity seems to be enhanced on failure mode.
Based on my anecdotes, weak herbal tea with light honey, dilute gatorade/juice, and saltines/toast/cream of wheat/nibbles of other bread-like substance as first go: small amounts key, with bananas in comfortable quantities as second is a viable method.
Although it seems that whatever reduces misery of patient or caretaker is really the best for self-limited puking.
Oh, addendum:
Probably everybody knows this already, but if there is any predictable possibility of puking, fish is really really really really awful. Icky gross icktastic aftertaste never never goes away.
Vera – oh, yes. My son, when about 6, caught a bad stomach bug. The last meal he had before the symptoms hit was tuna fish. He couldn’t eat tuna for years afterward.
My mom always gave us ginger ale and saltines. We always got better eventually, but I don’t know how much these items contributed to our recovery
When I had a particularly nasty stomach issue a few years ago (norovirus?), I followed more or less the guidelines provided by JakeR: Sips of plain tap water, then popsicles and Gatorade, then bland, soft, and non-greasy food. It worked pretty well, so long as I took small experimental tastes of every item before eating any quantity of it.
The thought of eating a banana while severely nauseated has made me a bit nauseated right now; yuck.
I think your third theory about not eating flavorful foods/foods you like is spot on- when i was about 4 or 5 i ate pancakes with syrup and drank milk with it, then threw up a few minutes later. 15 years later I still can’t eat pancakes and drink milk without feeling nauseous, and I really don’t think there’s anything about that particular combination that would make me feel any more ill than the myriad other things I’ve eaten for breakfast over the years.