Tips for taking care of children: Diarrhea

It can be tricky to know the best way to take care of children when they have diarrhea. When that child is an infant it can be even harder to know the best treatment options. What foods and fluids are best? What should you do - and what should you avoid? Read on to learn how to help your kids when diarrhea strikes.

What is diarrhea?

Diarrhea is the sudden increase in the frequency and looseness of stools. Mild diarrhea is the passage of a few loose or mushy stools. Severe diarrhea is the passage of many watery stools. The best indicator of the severity of the diarrhea is its frequency.

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 stools.

What to feed babies with diarrhea

Increased fluids and dietary changes are the main treatment for diarrhea. One loose stool can mean nothing. Don't start dietary changes until your child has had several loose stools.

If your breastfed or bottle-fed baby has diarrhea, treatment is straightforward. Continue feeding but at more frequent intervals. Don't stop feeding your baby because your baby has diarrhea. For severe (watery and frequent) diarrhea, offer Pedialyte or other electrolyte solutions between feedings for 6 to 24 hours, but only if your baby is urinating less frequently than normal.

If breastfeeding, remember that something in the mother's diet may cause a breastfed baby to have more frequent or looser stools—for example, coffee, cola, or herbal teas. If you suspect this, take it out of your diet and see what happens.

Treating mild diarrhea in babies (loose stools)

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, strained bananas, and strained carrots. Avoid all fruit juices because they make diarrhea worse.

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 with solid foods. Good choices are: any cereal, strained bananas, mashed potatoes, and other high-fiber foods.

Treating mild diarrhea in kids (loose stools)

Follow a regular diet with a few simple changes:

• Eat more foods containing starch. Starchy foods are easily digested during diarrhea. Examples are cereal, breads, crackers, rice, mashed potatoes, and pasta.
• Can drink normal amounts of milk. Drink extra water.
• Avoid all fruit juices.
• Avoid beans or any other foods that cause loose stools.

Treating frequent, watery diarrhea in babies

• Oral glucose-electrolyte solutions for 4 to 6 hours
• If your child has severe diarrhea and dark urine or not much urine, buy Pedialyte or the store brand at your pharmacy or supermarket. (These special solutions are not needed for diarrhea that is not severe.) Give as much of the special liquid as your baby wants (at least 2 teaspoons or 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 fruit juice because it 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 and doesn't improve after 3 days, change to a soy formula. Often there are fewer diarrheas 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. Strained bananas, strained carrots, and mashed potatoes are also good.

Treating frequent, watery diarrhea in kids

Encourage your child to drink lots of fluids to prevent dehydration. Offer water and milk. Avoid fruit juices, because they all make diarrhea worse. If your child refuses to eat solid food, give your child milk rather than water.

Keep giving your child food while he has diarrhea. The choice of food is important. Starchy and soft foods are digested best. Good food choices when your child has diarrhea are dried cereals, grains, bread, crackers, rice, pasta, mashed potatoes, and bananas. Pretzels or saltine crackers can help meet your child's need for sodium. Soft-boiled eggs or yogurt are easily digested and provide some protein.

Diarrhea care do’s:

• Prevention: Diarrhea is 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 stool 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 stools also helps.
• Overflow diarrhea: For children in diapers, diarrhea can be a mess. Place a cotton washcloth inside the diaper to trap some of the more watery stools. Use 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 baby vomits once, make no changes. If your baby vomits twice, continue breast-feeding but nurse on only one side for 10 minutes every 1 to 2 hours. If your baby vomits 3 or more times, nurse for 4 to 5 minutes every 30 to 60 minutes. As soon as 8 hours have passed without vomiting, return to normal nursing on both sides. Read our article: Tips for taking care of your child: vomiting
• Probiotics: Probiotics contain healthy bacteria (lactobacilli) that can replace unhealthy bacteria in the GI tract. Yogurt is the easiest source of probiotics. Give your child 2 to 6 ounces (60 to 180 ml) of yogurt twice daily. Today almost all yogurts are "active culture", which means that they contain live and active bacteria.

Diarrhea care don’ts:

• Kool-Aid and soda pop should be avoided because they contain no salt and too much sugar. Use only the fluids suggested here.
• Fruit juices should be avoided because they are too concentrated and make the diarrhea worse.
• The most dangerous myth is that the intestine should be "put to rest." Restricting fluids can cause dehydration.

When should I call my child's doctor?

Call IMMEDIATELY if:

• There are signs of dehydration (no urine in more than 12 hours, very dry mouth, no tears).
• Any blood appears in the diarrhea.
• The diarrhea is severe (more than 8 stools in the last 8 hours).
• The diarrhea is watery AND your child also vomits repeatedly.
• Your child starts acting very sick.

Call during office hours if:

• Mucus or pus appears in the stools.
• A fever lasts more than 3 days.
• Mild diarrhea lasts more than 2 weeks.
• You have other concerns or questions.

Is your child sick?

Use our online resources to help guide care for your sick child. From dosage information to guidelines on when to call the doctor, Northpoint Pediatrics is here to help.

Check out our app NP PEDS MD for further information and home care advice.