What is diarrhea?
Diarrhea is the passage of watery stools.
What causes diarrhea?
Most diarrhea in children is caused
by one of several diarrhea-causing viruses and gets
better by itself within a week. Although there can
be many causes of diarrhea, the treatment suggested
here is appropriate for acute illness (sudden onset,
short lasting), which occurs most commonly.
A child with viral diarrhea has a fever
and often starts the illness with some vomiting. Shortly
after these symptoms appear, the child develops diarrhea.
Often children with viral diarrhea “feel bad,”
but do not act ill.
You should call your pediatrician if your child is
less than 6 months of age
or has any of the following:
• blood in stool
• frequent vomiting
• abdominal pain
• urinates less frequently (wets fewer than
6 diapers per day)
• no tears when crying
• loss of appetite for liquids
• high fever
• frequent diarrhea
• dry, sticky mouth
• weight loss
• extreme thirst
It is not necessary to call your pediatrician
if your child continues to look
well even though there may be:
• frequent or large stools
• lots of intestinal gas
• green or yellow stools
How long will the diarrhea
last?
Most of the time mild diarrhea lasts
from 3 to 6 days. Occasionally a child will have loose
stools for several days longer. As long as the child
acts well and is taking adequate fluids and food,
loose stools are not a great concern.
Mild illness and diet
Most children should continue to eat
a normal diet including formula or milk
while they have mild diarrhea. Breastfeeding should
continue. If your baby
seems bloated or gassy after drinking cow’s
milk or formula, call your pediatrician to discuss
a temporary change in diet.
Special fluids for mild illness
These are not usually necessary for
children with mild illness.
Moderate illness
Children with moderate diarrhea can
be cared for easily at home with close supervision,
special fluids, and your pediatrician’s advice.
Your pediatrician will recommend the amount and length
of time that special fluids should be used. Later,
a normal diet can be resumed. Some children are not
able to tolerate cow’s milk when they have diarrhea
and it may be temporarily removed from the diet by
your pediatrician. Breastfeeding should continue.
Special fluids for moderate
illness
Special fluids have been designed to
replace water and salts lost during
diarrhea. These are extremely helpful for the home
management of mild to
moderately severe illness. Do not try to prepare these
special fluids yourself.
It is too easy to get confused by some
of these complex recipes. You could
accidentally make a bad fluid for your baby. Use a
fluid that is made by one of the reputable manufacturers.
The two most widely available products that you will
find in nearly every pharmacy are:
- Pedialyte (Ross Laboratories)
- Infalyte (Mead Johnson Nutritionals)
- Other brands of special fluids are
available and equally effective.
- Many drug stores have their own
generic brands of special fluids. Ask the pharmacist
for assistance.
If a child is not vomiting, these fluids
can be used in very generous
amounts until the child starts making normal amounts
of urine again.
Severe illness
If your child develops the warning signs
of illness listed on the first page, he or she may
require IV fluids in the emergency department for
several hours to correct dehydration. Usually hospitalization
is not necessary. Immediately seek your pediatrician’s
advice for the appropriate care if symptoms of severe
illness occur.
Commonly asked questions:
Question: Should a
child with diarrhea be fasted?
Answer: Absolutely
not! Once she is rehydrated, let the child eat as
much or as little of the usual diet as she wants.
If she is vomiting, offer small amounts of liquids
frequently.
Question: What
about soft drinks, juices, or boiled skim milk?
Answer: A child
with mild diarrhea can have regular fluids. But, if
there is enough diarrhea to make your child thirsty,
he must have special fluids (see Special fluids for
moderate illness). Soft drinks, soda pop, soups, juices,
sports drinks, and boiled skim milk have the wrong
amounts of sugar and salt and may make your child
sicker.
Question: What
about anti-diarrhea medicines?
Answer: These
medicines are not useful in most cases of diarrhea
and can sometimes be harmful. Never use them unless
they are recommended by your pediatrician.
Question: Which
therapy is best?
Answer. Because diarrhea is so common, there are many
different home remedies that have been tried through
the years. Some of these old ideas may not be effective
and some may actually make things worse. The recommendations
in this brochure are based on the best information
available at this time. If you have any questions
about them, please check with your pediatrician.
Reminder, do’s and don’ts
DO
- Watch for signs of dehydration which
occur when a child loses too much
fluid and becomes dried out. Symptoms of dehydration
include a decrease
in urination, no tears when baby cries, high fever,
dry mouth, weight loss,
extreme thirst, listlessness, and sunken eyes.
- Keep your pediatrician informed
if there is any significant change in how
your child is behaving.
- Report if your child has blood in
his stool.
- Report if your child develops a
high fever (more than 102ºF or 39ºC).
- Continue to feed your child if she
is not vomiting. You may have to give
your child smaller amounts of food than normal or
give your child foods
that do not further upset his or her stomach.
- Use diarrhea replacement fluids
that are specifically made for diarrhea if
your child is thirsty.
DON’T
- Try to make special salt and fluid
combinations at home unless your pediatrician instructs
you and you have the proper instruments.
- Prevent the child from eating if
she is hungry.
- Use boiled milk or other salty broth
and soups.
- Use “anti-diarrhea”
medicines unless prescribed by your pediatrician.
The American Academy of Pediatrics is
an organization of 55,000 primary care pediatricians,
pediatric medical subspecialists, and pediatric surgical
specialists dedicated to the health, safety, and well-being
of infants, children, adolescents, and young adults.
The information contained in this publication
should not be used as a substitute for the
medical care and advice of your pediatrician. There
may be variations in treatment that your pediatrician
may recommend based on individual facts and circumstances.
