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Diarrhea in Children: What Parents Need to Know

When children suddenly get loose, watery and more frequent bowel movements, they have diarrhea. Diarrhea is a common symptom of illness in young children. In the United States, children younger than 4 years may have diarrhea 1 or 2 times each year.

Here are some questions you may have if your child has diarrhea, tips to help manage it, and when to call the doctor.

What's the best way to treat or manage diarrhea?

  • Mild diarrhea without vomiting. Diarrhea often goes away in a couple of days on its own. Most children with mild diarrhea do not need to change their diet and electrolyte solutions are usually not needed. You can keep giving human (breast) milk, formula, or cow's milk. However, if your child seems bloated or gassy after drinking formula or cow's milk, ask your child's doctor if these should be avoided.

  • Mild diarrhea with vomiting. Children who have diarrhea and are vomiting will need to stop their usual diets. Electrolyte solutions should be given in small amounts, often until the vomiting stops. In most cases, they're needed for only 1 to 2 days. Once the vomiting has lessened, slowly return to your child's usual diet. Some children are not able to tolerate cow's milk when they have diarrhea and it may briefly be removed from the diet by your child's doctor. Breastfeeding should continue.

  • Severe diarrhea. Call your child's doctor for severe diarrhea. Children who have a watery bowel movement every 1 to 2 hours, or more often, and signs of dehydration may need to stop eating for a short period (such as 1 day or less) to focus on drinking to replenish fluid lost in those stools. They need to avoid liquids that are high in sugar, high in salt, or very low in salt (ie, water and tea). For severe dehydration, children may need to be given fluids through the vein (IV) in the emergency department.

Diarrhea and dehydration

Children with viral diarrhea have a fever and may vomit. Soon after these symptoms appear, children get diarrhea. The most important part of treating diarrhea is to prevent your child from becoming dehydrated.

Call your child's doctor right away if your child shows any signs and symptoms of dehydration (see here).

Also, call your pediatrician if your child has diarrhea and:

  • Fever that lasts longer than 24 to 48 hours

  • Bloody stools

  • Vomiting that lasts more than 12 to 24 hours

  • Vomit that looks green, tinged with blood, or like coffee grounds

  • Abdomen (stomach, belly) that looks swollen

  • Will not eat or drink

  • Severe abdominal (stomach, belly) pain

  • Rash or jaundice (yellow color of skin and eyes)

Does my child need electrolyte solutions?

Most children with mild diarrhea do not need electrolyte solutions. Electrolyte solutions are very helpful for the home management of moderately severe diarrhea.

Electrolyte solutions are special fluids that have been designed to replace water and salts lost during diarrhea. Soft drinks (soda, pop), soups, juices, sports drinks, and boiled milk have the wrong amounts of sugar and salt and may make your child sicker.

Do not try to prepare your own electrolyte solutions at home. Use only commercially available fluids—store brand and name brand work the same. Your child's doctor or pharmacist can tell you what products are available.

Should my child with diarrhea fast (not eat)?

Fasting is not a treatment for diarrhea. However, some children may benefit from reducing their intake of solid food if they are vomiting. It is appropriate to continue to offer small amounts of fluids, particularly electrolyte solutions, in these cases. As children recover, it is fine to let them eat as much or as little of their usual diet as they want.

Does the BRAT diet help?

The bananas, rice, applesauce, toast (BRAT) diet, once recommended while recovering from diarrhea, is no longer considered useful. Because BRAT diet foods are low in fiber, protein, and fat, the diet lacks enough nutrition to help a child's gastrointestinal tract recover. Some pediatricians believe that it may actually make symptoms last longer. Ideally, children can resume eating a normal, well-balanced diet appropriate for their age within 24 hours of getting sick. That diet should include a mix of fruits, vegetables, meat, yogurt, and complex carbohydrates.

What about antidiarrheal medicines?

Over-the-counter antidiarrheal medicines are not recommended for children younger than 2 years. They can also be harmful in older children. Always check with your child's doctor before giving your child any medicine for diarrhea.

Also, do not give your child homemade remedies. Some may not be effective and some may actually make things worse.

Do probiotics help diarrhea?

Probiotics are types of "good" bacteria that live in the intestines. They may have beneficial health effects with regard to diarrhea, although more studies are needed.

How can I reduce my child's risk of diarrhea?

Most diarrhea in children is caused by viruses. Diarrhea can also be caused by bacteria, parasites, changes in diet (such as drinking too much fruit juice), problems with the intestines (such as allergy to foods), and the use of some medicines. Here are some ways to help prevent diarrhea:

  • Stop germs from spreading. Wash hands frequently with soap or using a hand sanitizer. Try to keep your child away from children who have diarrhea or are vomiting.

  • Do not give your child raw (unpasteurized) milk or foods that may be contaminated.

  • Avoid medicines, especially antibiotics, if they are not needed.

  • Breastfeed your baby. Breast milk has many substances that formulas don't have that help protect your baby from many diseases and infections.The American Academy of Pediatrics recommends breastfeeding as the sole source of nutrition for your baby for about 6 months. When you add solid foods to your baby's diet, continue breastfeeding until at least 12 months. You can continue to breastfeed after 12 months if you and your baby desire.

  • Limit the amount of juice and sweetened drinks.

  • Make sure your child has received the rotavirus vaccine.The rotavirus vaccine protects against the most common cause of diarrhea and vomiting in infants and young children.

More information

Last Updated
5/25/2021
Source
Adapted from Diarrhea and Your Child (American Academy of Pediatrics (Copyright © 2020)
The information contained on this Web site 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.
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