Recommendations

Diarrhea has many causes, including:

• Antibiotics
• Consuming too much fruit or fruit juice
• Food sensitivity
• Illness
• Infection

Diet:

What the child eats or drinks may make diarrhea worse. Changing the diet may relieve some types of diarrhea.

In most cases, you should continue feeding your baby or child as usual. Most children can keep up with the nutrients they lose through diarrhea if they increase the amount of food they take in. For babies, always continue breast-feeding or formula feeding.

Many children develop mild and temporary lactose intolerance. Continuing dairy foods may make the diarrhea last longer, but it can also allow a faster return to a regular diet. Babies who eat solid foods may continue to do so as long as they can keep the food down.

A full appetite is often the last behavior to return after an illness. Children should be allowed to take their time returning to their normal eating habits. No specific diet is recommended for diarrhea, but children usually tolerate bland foods better. Bulking agents, such as starches, fresh fruits, and vegetables sometimes help create more solid stool. Fruit juices can loosen stool.

For some children, a return to their regular diet can also bring a return of diarrhea. This is usually due to mild difficulty the gut has in absorbing regular food. This type of diarrhea usually doesn't last long and is different from the diarrhea that came during the actual illness. It requires no treatment as long as there are no other symptoms.

Diarrhea caused by antibiotics may be reduced by giving the child yogurt with live active cultures (look for a statement on the label). If the diarrhea persists, contact your health care provider to discuss changing or stopping the antibiotic. Do not stop antibiotic treatment without checking with your child's doctor.

Fluids:

Fluid is very important because it is easy for a child with diarrhea to become dehydrated. Dehydration is a serious condition in babies and young children. Lost fluids need to be replaced. Replace fluids (rehydration) through drinking for all but the most seriously dehydrated children, or those who can't keep fluids down.

For most children, any fluid they normally drink should be enough. Too much water alone, at any age, can be harmful, because water does not have any sugars or important electrolytes, such as sodium.

Rehydration solutions include Rehydralyte and the World Health Organization’s oral rehydration solution. Other products, such as Pedialyte and Infalyte, may help keep a child properly hydrated and prevent dehydration. Some of these solutions are available at the supermarket or pharmacy and do not need a prescription. However, you should consult your doctor before using them in infants.

Popsicles or Jell-o can be excellent sources of clear fluids, especially if the child is vomiting. You can get large amounts of fluids into the child slowly this way, and avoid overfilling the stomach. This is especially important if the stomach is already irritated by an infection.

For most children, drinking more fluids is enough, but occasionally it is necessary to give fluids through a vein (by IV). Fluids given by IV correct dehydration faster than those given by mouth.

CONTACT YOUR HEALTHCARE PROVIDER IF:

• Your child is much less active than normal (not sitting up at all or looking around)
• Diarrhea contains blood or mucus
• Diarrhea develops within 1 week of travel outside of the United States, or after a camping trip (the diarrhea may be due to bacteria or parasites that require treatment)
• Diarrhea is accompanied by multiple vomiting episodes, fever, or abdominal cramping
• Diarrhea is severe, or lasts longer than 2 to 3 days
• Diarrhea keeps returning, or the child is losing weight
• The child has signs of dehydration (call immediately):
  • Dry and sticky mouth
  • Has not urinated for 6 hours
  • No tears when crying
  • Sunken eyes

Your doctor may prescribe medication to help control the diarrhea. Call your doctor before using over-the-counter medications for diarrhea, because they may be either ineffective or potentially dangerous.

References

Bhutta ZA. Acute gastroenteritis in children.In: Kliegman RM,Behrman RE, Jenson HB, Stanton BF, eds.Nelson Textbook of Pediatrics.19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 332.

Canavan A, Arant BS Jr. Diagnosis and management of dehydration in children. Am Fam Physician. 2009;80:692-696.

Updated: 4/7/2012

Reviewed by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.