GUIDE FOR PARENTS

Caring for the child with diarrhea

Diarrhea is common in children and usually lasts from three to seven days. The main danger from diarrhea is that children can lose a great deal of fluid and salt in the frequent stools and become dehydrated. If dehydration is severe, the child may need to be hospitalized for fluid replacement. You can prevent dehydration fairly easily when your child has diarrhea. Here's how:

Give liquids as soon as diarrhea starts. The best liquid to give is an oral rehydration solution (Pedialyte). These solutions replace the water and salts lost to diarrhea. You can buy them at the grocery story or drug store. You do not need a prescription. Do not give plain water since drinking only water can be harmful. You can give a small amount of water along with the oral rehydration solution if your child wants it.

DO NOT GIVE the following liquids, which contain a lot of sugar or sweetener and can make diarrhea worse: Juices, cola or other soft drinks, sports drinks such as Gatorade, and drinks such as Kool-Aid. However, if your child refuses Pedialyte, you may have to give one or more of the above, with the understanding that getting fluid in your child is the primary goal. Choose the least sweetened fluid that your child will take. Also avoid tea, chicken broth, boiled skim milk, and homemade solutions to which salt is added.

Give 1/2 cup (4 oz) of rehydration solution for every watery stool, using a small spoon, if your child is under 2 years of age. If your child is over 2 years, give 1/2 cup to one cup (8 oz) for every watery stool. Give the solution until the diarrhea stops. If your child is vomiting, give one teaspoon of the solution every two to three minutes until the vomiting stops, then gradually return to the regular amount.

Continue to feed your child. Eating is important to maintain health. If your child is nursing, continue to breastfeed. If he is taking formula, continue with the same formula. Isomil DF (diarrhea formula) is acceptable for no more than 5 days.

If your child is eating solid foods, continue with the regular diet. Good foods to give include cooked cereal, bananas, cooked meat, noodles, crackers, rice, vegetables, potatoes, and yogurt. Avoid foods with a lot of sugar (such as Jello, ice cream, and sweetened cereals) and fried, fatty foods.

Do not give medication without consulting your child's doctor. Most children with diarrhea get better without medication. Artificially stopping diarrhea only prolongs the illness. Some over-the-counter medicines for diarrhea can even be harmful (especially PeptoBismol). Remember that food and fluids are the most important treatment for diarrhea.

Take steps to prevent the spread of infection. Hand washing is the most important means of preventing diarrhea from spreading. Wash your hands and exposed arms with soap and warm water after caring for your child, especially after diaper changes. Keep your fingernails clean and trimmed. Teach your child to wash her hands before eating and, especially, after using the toilet.

Call your child's doctor if:

  • The diarrhea is not improving after 24 hours.

  • The diarrhea gets worse (after 48 hours).

  • The diarrhea has blood or mucous in it.

  • Your child is vomiting along with having diarrhea and does not urinate at least twice in 24 hours

  • Your child has a severe stomachache.

  • Your child shows any signs of dehydration:
    Decreased urination (less that 2 episodes in 24 hours)
    Sunken eyes
    No tears when crying
    Extreme thirst
    Unusual drowsiness or fussiness

  • Your child is under 6 months of age.

From: Contemporary Pediatrics. February 1999, with editing by Springs Pediatrics