Diarrhea

Diarrhea consists in frequent, loose bowel movements. The best indicator of the severity of the diarrhea is its frequency. The main complication of diarrhea is dehydration from excessive loss of body fluids. Symptoms of dehydration include a dry mouth, the absence of tears, a reduction in urine production (i.e., none in 12 hours), and a darker, concentrated urine. It is the dehydration you need to worry about, not the presence of diarrhea.

​Diarrhea is usually caused by a viral infection of the intestines. Occasionally, it is caused by bacteria or parasites. It also can be due to drinking too much fruit juice or to a food allergy. Diarrhea usually lasts from several days to a week, regardless of the treatment. The main goal of therapy is to prevent dehydration. Don’t expect a quick return to solid stools. Since one loose stool can mean nothing, don’t start dietary changes until there have been at least two. Infectious diarrhea is very contagious. Good hand washing is essential for preventing everyone in the family from getting diarrhea.
For a child of any age with mild diarrhea (a few loose or mushy stools), continue a regular diet
with a few simple changes:

• Continue full-strength formula or milk and encourage an increased intake of these fluids and extra water.
• Reduce the intake of fruit juices—if given, make them half strength with water or Infalyte.
• Avoid raw fruits and vegetables, beans, spicy foods, and any foods that cause loose stools.

For bottle-fed infants with frequent, watery diarrhea:

• Use oral rehydration solutions (ORS) such as Pedialyte or Infalyte for the first 6 to 24 hours. Give as much ORS as your baby wants. Diarrhea makes children thirsty, and your job is to satisfy that thirst and prevent dehydration. Never restrict fluids when your child has diarrhea without vomiting.
• You may continue with your regular formula after 6 to 24 hours, starting when your baby becomes hungry. If the diarrhea persists for more than a week or if your child is suspected of having rotavirus, you may switch to a soy based formula or a lactose-free formula. When the stools are watery, green and foul smelling, your child may have rotavirus. This virus isespecially prevalent during the winter months and in the daycare setting. It is extremely contagious. The stool may be tested for rotavirus. No special treatment or diet is required. Plan to keep your baby on the soy formula until 4 days after the diarrhea is gone.
• Solid foods that contain a lot of starch are most easily digested when your child has diarrhea. If your baby is over 4 months old, has had diarrhea for over 24 hours, and wants to eat solid food, give him/her the following starchy foods until the diarrhea is gone: any cereal, mashed potatoes, apple-sauce, strained bananas, strained carrots, and other highfiber foods(if the baby has already been on these foods).

For breast-fed infants with frequent, watery diarrhea:

• No matter how they look, the stools of breast-fed infants are considered normal unless they contain mucus or blood or develop a foul odor. The normal number of stools in breast-fed infants may vary from as few as one every seven days to as frequent as one after each feeding. Diarrhea in breast-fed infants can be diagnosed if your baby’s stools abruptly increase in number. Additional clues are if your baby feeds poorly, acts sick, or develops a fever.
• Continue breast-feeding, but at more frequent intervals. Breast-feeding should never be discontinued because of diarrhea.
• If urine production is decreased, offer ORS between breast-feedings for the next 6 to 24 hours.

For children over 1 year of age with frequent, watery diarrhea:

• The choice of solids is the key factor – starchy foods are absorbed best. Give cereals (especially rice cereal), oatmeal, bread, noodles, mashed potatoes, carrots, applesauce, etc. Pretzels or salty crackers can help meet your child’s sodium needs.
• For fluids, use Pedialyte, Infalyte, Gatorade, flat sodas, or herbal or decaffeinated tea. If solids are not being consumed, encourage a high fluid intake.
• Avoid all fruit juice or other drinks containing fructose because they usually make diarrhea worse.
• You may give milk if desired. Active culture yogurt is fine for babies over 9 months of age.
• If your child has rotavirus, you may switch to soy milk until four days after the symptoms have resolved.
  
  

Call our office immediately if:

• Blood appears in the diarrhea.
• Signs of dehydration occur (no urine in more than 12 hours, very dry mouth, no tears).
• Diarrhea is associated with severe abdominal pain.
• The diarrhea is frequent and watery and your child also vomits the clear fluids four or more times. (Note: If your child has vomited more than once, treatment of the vomiting has priority over the treatment of diarrhea until your child has gone 6 hours without vomiting).
• Your child starts acting very sick.

Call our office during regular hours if your child has:

• A fever lasting more than 3 days.
• Mild diarrhea lasting more than 2 weeks.
• You have other questions or concerns.