Diarrhea
Diarrhea is a common childhood illness that usually lasts from three to seven days and then is over. Aside from the nuisance of frequent diaper changes and cleanups, the only real concern in diarrhea is that so much fluid (and the mineral salts dissolved in the fluid) is lost in the stools that the child may become dehydrated. Dehydration can have serious medical consequences, but it's relatively easy to prevent by making sure that a child who has diarrhea drinks enough of the right kind of liquids.
What should my child drink?
GOOD choices are oral rehydration solutions such as Pedialyte and Infalyte, which you can buy without prescription at the supermarket or drug store. These solutions contain water, sugar, and salt that your child needs. Breastfed babies should continue to nurse but may need to nurse more often. Don't substitute plain water for oral rehydration solutions; drinking nothing but water can be harmful, though children may drink small amounts of water in addition to the solution if they want to.
AVOID fluids that contain a lot of sugar such as soft drinks, juices, or fruit punch. These drinks can make diarrhea worse. Sports drinks such as Gatorade or Powerade may contain too much sugar, sodium and potassium.
How much should my child drink?
Children with diarrhea need at least twice as much fluid as they usually drink. Allow them to drink as much of the rehydration solution as they want. For the first four to six hours, a l year old child should drink at least four ounces an hour, or one ounce every 15 minutes. Older children need a little more, younger children a little less. After that, let them drink whenever they want to.
Don't keep the child on the oral rehydration solution for more than a day. It is very important that your child return to a regular diet as soon as possible.
What if my child is vomiting?
Give the rehydration solution in very small amounts, two to three teaspoons every five minutes, until the vomiting stops. Then slowly increase to the amounts suggested above.
Breast-fed babies who are vomiting should nurse for shorter periods of time and more frequently. Expressed breast milk may be given from a spoon if baby won't latch on and nurse.
Can a child with diarrhea continue to eat?
Maybe. If the diarrhea is only 3-4 times per day it is ok but eliminate milk and juices from the diet for a few days.
If the diarrhea is more than a few each day adjustments in the diet should be made.
1. Infants may need an additional bottle of non-lactose containing formula, more frequent nursings, or a supplement of oral rehydration fluid.
2. In older children replace the regular diet with the "BRATY" diet (Bananas, Rice, Applesauce, Toast, Yogurt) using age appropriate substitutes such as saltines, or teething biscuits. Other acceptable foods include noodles, oatmeal or baked potato. Avoid foods with a lot of sugar (jellys, ice cream, sweetened cereals, carbonated beverages) and fatty, fried, or spicy foods.
Does my child need medication?
Most children with diarrhea get better without special medicines. Some of the diarrhea remedies you can buy without a prescription can actually be harmful to your child. Please ask your doctor before you give your child any special medications. The most important treatment for any child with diarrhea is fluids.
When should I call the doctor?
Call our office if:
- Your child is vomiting and cannot keep any fluids down.
- Continuous refusal to drink liquids
- Your child is less than 6 months old
- Your child has signs of dehydration, regardless of age
- Dry mouth
- No tears when crying
- Sunken eyes
- Urinating less frequently (if your child is urinating or wetting a diaper 3 to 5 times each 24 hours,
his condition should be all right. If your child has not wet or urinated for over 12 hours, contact our office) - Unusually sleepy or fussy
- Your child has a severe stomachache
- The diarrhea has blood in it
- The diarrhea gets worse
- Painful bowel movements
Vomiting
Nausea and vomiting are usually caused by a virus, although other causes exist such as food poisoning, head injury, or migraine headaches. The following information pertains primarily to viral infections.
- Keep your child as quiet as possible.
- Give one of the recommended rehydration solutions (Pedialyte or Infalyte are best and Powerade is acceptable in older children) or breast milk in very small amounts, two to three teaspoons every 5 minutes, until the vomiting stops.
- When your child has gone at least 60-90 minutes without vomiting, gradually increase to the
volumes described in the section on diarrhea. Add other fluids and foods as described in that
section. Breast-fed babies should continue to breast-feed. - Shorter frequent nursings are recommended and can be returned to regular feeding in 8-12hours.
- If vomiting starts again, return to the small, frequent amounts of rehydration fluids describe
above. - This modified diet should be continued for 24-36 hours. Other foods should be added one at a time back into your child's diet.
- Foods to be added very slowly are cow's milk, milk products, and anything that is fried, fatty, or
greasy, and juices. - Medication can be helpful at times. "Anti-nausea" suppositories can be prescribed for persistent
vomiting, but they do not help in the beginning and can have undesirable side effects if used at the wrong time or are over used. Call the office for instructions before giving any leftover medications that you might have at home. Emetrol and Dramamine are available without prescriptions, may be helpful for nausea and vomiting.
It is important to watch for the below:
1. Urination- (If your child is drinking and not vomiting and is urinating or wetting the diapers 3 to 5 times each 24 hours, this condition should be all right).
2. A severely painful or tender abdomen (belly or stomach) in which the pain is always in the same place.
3. Any of the following signs, especially if your child is under 2 years of age:
- Pallor - the loss of natural skin color o Obvious decrease in activity o Continuous refusal to drink liquids/Noticeable weight loss
- Noticeable weight loss
- Sunken eyes and/or "soft spot"
- Not wetting or urinating for 12 hours or more
- Bloody or black bowel movements
Any of the above signs should be reported to the office.
