Diarrhea Instructions

Diarrhea is defined as an increase in frequency and volume of bowel movements. Diarrhea is also looser or more watery than regular stools. Most children should continue to eat a normal diet including formula or milk while they have diarrhea. Breastfeeding should continue. If your baby seems bloated or gassy after drinking cow's milk or formula, sometimes changing to a lactofree formula or Lactaid milk for a week can be helpful.

Pediatricians used to recommend a “BRAT” diet for children who had diarrhea. A BRAT diet consists of bananas, rice, applesauce and/or toast. More recent studies show that returning to a regular diet as soon as possible helps the gut heal more quickly and prevents malnutrition in cases of prolonged diarrhea. The one thing we do recommend avoiding in your child’s diet when they have diarrhea is fruit juice.

Special fluids have been designed to replace water and salts lost during diarrhea. The three most widely available products that you will find in nearly every pharmacy and grocery store are:

• Pedialyte
• Infalyte
• ReVital

Many pharmacies and grocery stores have their own generic brands of special fluids which are equally effective. The two flavors which we have found to be the best tasting are apple and fruit punch but every child is different and your child may prefer a different flavor. If you have a child less than 12 months who refuses to take one of these special fluids, sometimes mixing it with a little formula or pumped breast milk will disguise the taste. Two other acceptable fluid options for older children are Gatorade or Powerade although these are not ideal due to their higher sugar content.

If your child develops severe diarrhea, he may require IV fluids in the emergency department for several hours to correct dehydration. Usually hospitalization is not necessary.

While this illness runs its course, here are some general “dos” and “don'ts” that you should keep in mind:

DO:

• Watch for signs of dehydration which occur when a child loses too much fluid and becomes dried out. Symptoms of dehydration include a decrease in urination (less than 3 wet diapers or 3 voids in a 24 hr time span), no tears with crying, dry mouth, weight loss, extreme thirst and listlessness.
• Keep us informed if there is any significant change in how your child is behaving.
• Let us know if your child has blood in his or her stool.
• Let us know if your child develops a high fever (more than 104º F).
• Use diarrhea replacement fluids that are specifically made for diarrhea if your child is thirsty.
• Give a probiotic such as Culturelle to help decrease the length of time that your child may have diarrhea. You can give 1 capsule once a day for children under age 6 and 1 capsule twice a day to children over age 6. The capsules can be opened and sprinkled into food or drink. Give the probiotic for 7 days.

DON'T

• Try to make special rehydration fluid combinations at home.
• Prevent the child from eating if he or she is hungry.
• Use over the counter "anti-diarrhea" medicines. These medicines can slow the evacuation of harmful bacteria from the colon.