Conditions
Diarrhea and vomiting in children: video visits in Puerto Rico
Diarrhea and vomiting in children are usually caused by a virus and get better in a few days; the main job is preventing dehydration. We see your child by video, tell you how to give oral rehydration solution and what to eat and, if appropriate, the doctor prescribes and we send your prescription to your pharmacy. We see children of all ages.
Is it an emergency? Call 911.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Green or bloody vomit
- Blood, mucus or pus in the stool
- Barely peeing: no wet diaper in 6 hours for a baby, or only once or twice a day
- Sunken eyes, sunken soft spot, cold hands or unusual sleepiness
- Vomiting everything they drink
- Severe belly pain in one spot, especially the lower right
- Very listless or hard to wake
- A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher
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At a glance
Diarrhea and vomiting in children
Common symptoms
- Diarrhea (frequent, watery stools)
- Vomiting and nausea
- Stomach pain
- Sometimes fever, headache or body aches
- Other names
- Stomach bug in children · Gastroenteritis in children
- Usual test
- Usually no tests are needed; the assessment focuses on hydration
- Treatment
- Oral rehydration solution; antibiotics do not help viral diarrhea
- Possible complication
- Dehydration
On this page(10)
What causes diarrhea and vomiting in children?
The most common cause is a viral stomach bug such as norovirus, which spreads easily at home, at school and in daycare. Symptoms usually start 12 to 48 hours after exposure and most children get better in a few days.
The main risk is dehydration, especially in babies and young children, who lose water and salts faster. If the sick person is an adult, see stomach bug in adults.
How we treat diarrhea and vomiting in children by video
You see Dr. Diana Nieves Castro, a Puerto Rico–licensed general practice physician with several years of emergency-department experience, in English or Spanish. The doctor evaluates your child by video with you on camera: she asks how often your child has vomited or had diarrhea, how many wet diapers or trips to the bathroom, and watches how your child looks, whether the mouth is dry and how alert they are.
From that she tells you how to give oral rehydration solution, what to feed your child and what to watch for. If appropriate, the doctor prescribes, dosed by weight, and we send your prescription to your pharmacy. If a test is needed, we give you a lab order for a lab near you.
You need to be physically in Puerto Rico during the visit; visitors are welcome. Patients under 21 need a parent or legal guardian on camera with ID. More about our online doctor visit for children.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request your visit.
Book a visit and choose "Doctor visit". You pay by card when you request it.
See the doctor by video.
We send you a secure video link. It works on your phone, tablet or computer. Keep the rehydration solution and any medicines you have given nearby.
Get your plan.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. If needed, you get a lab order and a doctor’s note for school.
What the visit costs
Diarrhea and vomiting are handled in a US$79 doctor visit, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the visit can’t take place. A doctor’s note after your visit is included at no extra charge.
We do not bill insurance; the lab and the pharmacy charge separately. See all prices. The service is run by The Health Initiative, a nonprofit.
Symptoms and signs of dehydration
The most common symptoms are:
- Diarrhea (frequent, watery stools)
- Vomiting and nausea
- Stomach pain
- Sometimes fever, headache or body aches
Mild to moderate dehydration: plays less than usual, pees less (in babies, fewer than 6 wet diapers a day), has a dry mouth, cries with few tears, or has a slightly sunken soft spot.
Severe dehydration, go to the ER: very fussy or very sleepy, sunken eyes, cool or discolored hands and feet, wrinkled skin, or peeing only once or twice a day.
Treatment, and when a test is ordered
The main treatment is oral rehydration solution from the pharmacy, which replaces lost water and salts. Do not water it down. Antibiotics do not help viral diarrhea, and do not give a child over-the-counter diarrhea medicine without asking a doctor first.
Usually no test is needed: the assessment focuses on hydration. If the diarrhea lasts longer than expected or the doctor considers it necessary, she gives you an order for a test at a lab near you, and we go over the result with you in a follow-up visit.
- If your child is vomiting: start with very small, frequent sips, using a syringe or small spoon. If it stays down, slowly give more.
- For babies with diarrhea: offer the solution in small, frequent amounts, on top of breast milk or formula.
- How much depends on your child’s age and weight: follow the label or the doctor’s advice.
- Keep breastfeeding. If you use formula, mix it at full strength unless a doctor tells you otherwise.
- Do not give sports drinks to young babies, or full-strength fruit juice or soda: they can make diarrhea worse.
What to eat, and stopping the spread
Once the diarrhea starts to ease and your child is hungry, slowly go back to their usual food. Bananas, crackers, toast, pasta and cereal are usually well tolerated. Avoid apple juice, fried foods and full-strength fruit juice. There is no need to withhold food.
Norovirus keeps spreading for days after a child feels better. The CDC advises staying home until 48 hours after symptoms stop; check your school or daycare’s rules too. Wash hands with soap and water for at least 20 seconds, especially after the bathroom or diaper changes.
Diarrhea and vomiting at every age
Babies: they dehydrate faster. Count wet diapers and book a visit soon if there are fewer than usual: we evaluate your baby by video with you on camera. For safety: a baby under 3 months with a temperature of 100.4 °F (38 °C) or higher needs the emergency room right away. See also fever in children.
Toddlers: watch how often they pee and whether they keep fluids down. Give the solution a little at a time, even if they will not eat.
School-age children and teens: severe pain in the lower right belly, testicular pain or dizziness on standing are not part of an ordinary stomach bug: go to the ER. See our online doctor for kids.
When to go to the ER
For your child’s safety, go to the emergency room or call 911 for these signs. See when to go to the ER.
- Green or bloody vomit
- Blood, mucus or pus in the stool
- Barely peeing: no wet diaper in 6 hours for a baby, or only once or twice a day
- Sunken eyes, sunken soft spot, cold hands or unusual sleepiness
- Vomiting everything they drink
- Severe belly pain in one spot, especially the lower right
- Very listless or hard to wake
- A baby under 3 months with a temperature of 100.4 °F (38 °C) or higher
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
What should I give my child for vomiting and diarrhea?
Can a doctor see my child for diarrhea by video?
How can I tell if my child is dehydrated?
Does my child need antibiotics for diarrhea?
When can my child go back to school after a stomach bug?
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-09-30 · Updated: 2026-10-02
Sources (5)
- Diarrhea in infants (MedlinePlus, U.S. National Library of Medicine) (opens in a new tab) (accessed 2026-09-30)
- Dehydration (AAP, HealthyChildren.org) (opens in a new tab) (accessed 2026-09-30)
- Treating dehydration with electrolyte solution (AAP, HealthyChildren.org) (opens in a new tab) (accessed 2026-09-30)
- About norovirus (CDC) (opens in a new tab) (accessed 2026-09-30)
- Fever in under 5s, NG143 (NICE) (opens in a new tab) (accessed 2026-09-29)