What is diarrhea?
Diarrhea is defined as the sudden increase in the frequency and looseness of bowel movements (BMs). Mild diarrhea is the passage of a few loose or mushy BMs. Severe diarrhea is the passage of many watery BMs. The best indicator of the severity of the diarrhea is its frequency. The main complication of diarrhea could be dehydration from the loss of too much body fluid.
Symptoms of dehydration are a dry mouth, the absence of tears, infrequent urination (for example, none in 12 hours, or less than 3 urine voids in 24 hours), and a darker, concentrated urine. The main goal of diarrhea treatment is to prevent dehydration.
What is the cause?
Diarrhea is usually caused by a viral infection of the lining of the intestines (gastroenteritis). Sometimes it may be caused by bacteria or parasites. Bacterial causes of diarrhea are more likely to result in blood in the stool or crampy abdominal pain.
How long will it last?
Diarrhea from a viral infection usually lasts several days to 2 weeks, regardless of any type of treatment. The main goal of treatment is to prevent dehydration. Your child needs to drink enough fluids to replace the fluids lost in the diarrhea. Don't expect a quick return to solid bowel movements.
What should I feed my child?
For frequent, watery diarrhea:
- Fluids: Encourage your child to drink plenty of fluids to prevent dehydration. Give your child water or Pedialyte as the main fluid for the first 24 hours of watery diarrhea. A child who is taking table foods doesn't need to get calories from milk. On day 2, offer some milk as well as water. Avoid fruit juices and sweeter fruits, because they all make diarrhea worse. Bananas, apples, and applesauce are o.k.. If your child refuses solids, give your child milk (or formula) rather than water. Diarrhea can cause a temporary lactose intolerance, so you may need to switch to soy milk, lactose-free milk, or Pediasure temporarily.
- Table foods: Keep giving your child table foods while he has diarrhea. The choice of food is important. Starchy foods are digested best. Examples of such foods are dried cereals, grains, bread, crackers, rice, noodles, and mashed potatoes. Pretzels or saltine crackers can help meet your child's need for sodium. On the second day of the diarrhea, soft-boiled eggs, bland meats, and yogurt are easily digested and provide some protein.
For mild diarrhea (loose BMs):
- Follow a regular diet with a few simple changes:
- Eat more foods containing starch. Starchy foods are easily digested during diarrhea.
- Examples are cereal, breads, crackers, rice, mashed potatoes, and noodles.
- Drink more water. Avoid all fruit juices and carbonated drinks.
- Milk and milk products are fine.
- Avoid beans or any other foods that cause loose bowel movements.
How can I take care of my child?
- Avoid over the counter anti-diarrhea medications as they can be dangerous in children.
- Probiotics contain healthy bacteria (lactobacilli) that can replace unhealthy bacteria in the GI tract. Yogurt like DanActive or Activia are a good source of these bacteria. If your child is over 1 year old, give 2 to 6 ounces (60 to 180 ml) of yogurt twice daily. Another option is a probiotic supplement like Culturelle Kids, Florastor Kids, FloraQ, or VSL#3. These powders have live bacteria that can be added to any food or drink 1-2 times daily and are found at many pharmacies or health food stores.
- A multi-vitamin containing zinc and iron may help the intestines to heal and may slow down the diarrhea.
- Diarrhea can be very contagious. Always wash your hands after changing diapers or using the toilet. This is crucial for keeping everyone in the family from getting diarrhea.
- The skin in the diaper area can become irritated by the diarrhea. Wash the area near the
- anus after each bowel movement and then protect it with a thick layer of petroleum jelly or other diaper ointment. This protection is especially needed during the night and during naps. Changing the diaper quickly after bowel movements also helps.
- For children in diapers, diarrhea can be a mess. Place a cotton washcloth inside the diaper to trap some of the more watery BM. Use disposable superabsorbent diapers to cut down on cleanup time. Use the diapers with snug leg bands or cover the diapers with a pair of plastic pants. Wash your child under running water in the bathtub.
- If your child has vomited more than twice, follow your doctor's recommended treatment for vomiting instead of this treatment for diarrhea until your child has gone 8 hours without vomiting.
When should I call my child's healthcare provider?
Call IMMEDIATELY if:
- There are signs of dehydration (no urine in more than 12 hours, very dry mouth, no tears).
- Any blood appears in the diarrhea.
- The diarrhea is severe (more than 8 BMs in the last 8 hours).
- The diarrhea is watery AND your child also vomits repeatedly.
- Your child starts acting very sick.
Call during office hours if:
- Mucus or pus appears in the BMs.
- A fever lasts more than 3 days.
- Mild diarrhea lasts more than 2 weeks.
- You have other concerns or questions.