Diarrhea

When To Call

Call 911 Now (your child may need an ambulance) If

• Not moving or too weak to stand

Call Your Doctor Now (night or day) If

• Your child looks or acts very sick
• Signs of dehydration (e.g., no urine over 8 hours, no tears with crying and very dry mouth)
• Blood in the stool
• Weak immune system (sickle cell disease, HIV, chemotherapy, organ transplant, chronic steroids, etc)
• Abdominal pain present over 2 hours
• Vomiting clear liquids 3 or more times
• Age under 1 month with 3 or more diarrhea stools (mucus, bad odor, increased looseness)
• Passed more than 8 diarrhea stools in the last 8 hours
• Severe diarrhea while taking a medicine that could cause diarrhea (e.g., antibiotics)
• Fever over 104° F (40° C) and not improved 2 hours after fever medicine
• Age under 12 weeks with fever above 100.4° F (38.0° C) rectally (Caution: Do NOT give your baby any fever medicine before being seen.)
• You think your child needs to be seen urgently

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think your child needs to be seen, but not urgently
• Pus in the stool present for over 2 days
• Loss of bowel control in a toilet trained child occurs 3 or more times
• Fever present for more than 3 days
• Close contact with person or animal who has bacterial diarrhea
• Contact with reptile (snake, lizard, turtle) in previous 14 days
• Travel to country at risk for bacterial diarrhea within past month 

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns
• Diarrhea persists over 2 weeks
• Loose stools are a chronic problem

Parent Care at Home If

• Mild diarrhea (probably viral gastroenteritis) and you don't think your child needs to be seen

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information. For more information, click here.

Care Advice

Home Care Advice for Diarrhea

1. Reassurance:
• Most diarrhea is caused by a viral infection of the intestines.
• Diarrhea is the body's way of getting rid of the germs.
• Here are some tips on how to keep ahead of the fluid losses.
2. Mild Diarrhea:
• Continue regular diet.
• Eat more starchy foods (e.g., cereal, crackers, rice).
• Drink more fluids. Formula or milk are good balanced fluids for diarrhea. (EXCEPTION: avoid all fruit juices and soft drinks because they make diarrhea worse).
3. Formula-Fed Infants WITH frequent, watery diarrhea: Start Oral Rehydration Solutions (ORS)
• ORS (e.g., Pedialyte or the store brand) is a special electrolyte solution that can prevent dehydration. It's readily available in supermarkets and drug stores.
• Start ORS for frequent, watery diarrhea (Note: Formula is fine for average diarrhea).
• Use ORS alone for 4 to 6 hours to prevent dehydration. Offer unlimited amounts.
• If ORS not available, use formula prepared in the usual way (unlimited amounts) until you can get some.
• Avoid Jello water, sports drinks, or fruit juice.
4. Returning to Formula
• Go back to formula by 6 hours at the latest. (Reason: needs the calories)
• Use formula prepared in the usual way. (Reason: It contains adequate water).
• Offer the formula more frequently than you normally do.
• Lactose: Regular formula is fine for most diarrhea. Lactose-free formulas (soy formula) are only needed for watery diarrhea persisting over 3 days.
• Extra ORS: also give 2-4 ounces (60-120 mls) of ORS after every large watery stool.
5. Solids
• Infants over 4 months old: Continue solids (e.g., rice cereal, strained bananas, mashed potatoes, etc).
6. Breastfed Infants WITH frequent, watery diarrhea:
• Continue breastfeeding at more frequent intervals.  Continue solids as for formula-fed.
• Offer 2-4 ounces (60-120 mls) ORS (e.g., Pedialyte) after every large watery stool (especially if urine is dark) in addition to breastfeedings.
7. Older Children (over 1 year old) WITH frequent, watery diarrhea:
• Fluids: Offer unlimited fluids. If taking solids, give water or half-strength Gatorade. If refuses solids, give milk or formula.
• Avoid all fruit juices and soft drinks. (Reason: makes diarrhea worse)
• ORS (e.g., Pedialyte) is rarely needed, but for severe diarrhea, also give 4-8 ounces (120-240ml) of ORS after every large watery stool.
• Solids: Starchy foods are absorbed best.  Give dried cereals, oatmeal, bread, crackers, noodles, mashed potatoes, rice, etc.  Pretzels or salty crackers can help meet sodium needs.
8. Probiotics:
• Probiotics contain healthy bacteria (Lactobacilli) that can replace unhealthy bacteria in the GI tract.
• YOGURT is the easiest source of probiotics. If over 12 months old, give 2 to 6 oz (60 to 180 ml) of yogurt twice daily. (Note: Today, almost all yogurts are "active culture".)
• Probiotic supplements in granules, tablets or capsules are also available in health food stores.
9. Diaper Rash: Wash buttocks after each stool to prevent a bad diaper rash. Consider applying a protective ointment (e.g., petroleum jelly) around the anus to protect the skin.
10. Contagiousness: Your child can return to child care or school after the stools are formed and the fever is gone. The school-aged child can return if the diarrhea is mild and the child has good control over loose stools.
11. Expected Course: Viral diarrhea lasts 5-14 days. Severe diarrhea only occurs on the first 1 or 2 days, but loose stools can persist for 1 to 2 weeks.
12. Call Your Doctor If:
• Signs of dehydration occur
• Diarrhea persists over 2 weeks
• Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

To find a pediatrician, click here.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information. For more information, click here.

Photos

First Aid - Shock

• Lie down with the feet elevated (Reason: counteract shock).

Note: In this illustration the individual in shock is laying down and his feet have been placed up on a stack of blankets.

Source: LMS Inc.
Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information. For more information, click here.