What is diarrhea?
Diarrhea is 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 is dehydration from the loss of
too much fluid from the body. Symptoms of dehydration are a dry
mouth, the absence of tears, infrequent urination (for example,
none in 8 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 is caused by
bacteria or parasites. Occasionally a food allergy or drinking too
much fruit juice may cause diarrhea. If your child has just one or
two loose bowel movements, the cause is probably something your
child ate. A diet of nothing but clear fluids (such as Pedialyte)
for more than 2 days may cause green, watery bowel movements
(called "starvation stools").
How long will it last?
Diarrhea caused by a viral infection usually lasts several days to
2 weeks, regardless of the 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?
Increased fluids and dietary changes are the main treatment for
diarrhea.
Note: One loose bowel movement can mean nothing. Don't start
dietary changes until your child has had several loose bowel
movements.
Mild diarrhea (loose BMs)
Continue a regular diet with a few simple changes. Give
full-strength formula--as much as your baby wants. If your baby
eats solid foods, offer more rice cereal, mashed potatoes,
applesauce, strained bananas, and strained carrots. Avoid all
fruit juices because they make diarrhea worse.
Frequent, watery diarrhea
- Oral glucose-electrolyte solutions for 4 to 6 hours
If your child has severe diarrhea and dark urine or not much
urine, buy Kao Lectrolyte or Pedialyte at your pharmacy or
supermarket. (These special solutions are not needed for
diarrhea that is not severe.) If your child doesn't like the
flavor, add a bit of KOOL-Aid powder or 2 drops of NutraSweet.
Give as much of the special liquid as your baby wants (at
least 10 ml for every pound your child weighs each hour).
Diarrhea makes children thirsty, and your job is to satisfy
that thirst and prevent dehydration. Never restrict fluids
when your child has diarrhea.
Until you get one of these special solutions, continue giving
your baby full-strength formula in unlimited amounts. Avoid
giving your baby Jell-O water mixtures or sports drinks (they
do not contain enough sodium). Fruit juice will make the
diarrhea worse.
- Returning to formula
After being given electrolyte fluids for 4 to 6 hours, your
baby will be hungry, so begin her full-strength formula. Offer
it more often than you normally do. If the diarrhea continues
to be severe or doesn't improve after 3 days, change to a
lactose-free formula (a soy formula or milk-based Lactofree).
Often there is less diarrhea with soy formulas than with cow's
milk formulas because the soy formulas don't contain milk
sugar (lactose). If you need to start soy formula, plan to
keep your baby on it until the diarrhea is gone for 3 days.
- Continuing solids
Foods that contain a lot of starch are more easily digested
than other foods during diarrhea. If your baby is over
4 months old, continue solid foods. Good choices are cereals
and other high-fiber foods. Applesauce, strained bananas,
strained carrots, and mashed potatoes are also good.
How can I take care of my child?
There is no effective, safe drug for diarrhea. Extra fluids and
diet therapy work best.
- Common mistakes
Using boiled skim milk can cause serious complications for
babies with diarrhea because it contains too much salt.
KOOL-Aid, soda pop, or water should not be used as the only
food because they contain little or no salt. Use only the
fluids suggested here.
Do not dilute your baby's formula or give only clear fluids.
This will not provide your baby with enough calories.
The most dangerous myth is that the intestine should be "put
to rest." Restricting fluids can cause dehydration.
There is no effective, safe drug for diarrhea. Extra fluids
and diet therapy work best.
- Prevention
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.
- Diaper rash from diarrhea
The skin near your baby's anus 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 ointment. This protection is especially needed
during the night and during naps. Changing the diaper quickly
after bowel movements also helps.
- Overflow diarrhea in a child not toilet-trained
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.
- Vomiting with diarrhea
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. A good approach is for your child to take
one swallow of fluid at a time every 5 minutes. (See
information on vomiting.)
When should I call my child's healthcare provider?
Call IMMEDIATELY if:
- There are signs of dehydration (no urine in more than 8 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 repeatedly vomits.
- 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.
Written by B.D. Schmitt, MD, author of "Your Child's Health," Bantam Books.
This content is reviewed periodically and is subject to
change as new health information becomes available. The
information is intended to inform and educate and is not a
replacement for medical evaluation, advice, diagnosis or
treatment by a healthcare professional.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.