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Dehydration: How to Recognize
Definition of Diarrhea in Breastfed Infants
Definition of Diarrhea in Formula-Fed Infants
Return to School
|When to Call Your Doctor|
|Call 911 Now (your child may need an ambulance) If|
|Call Your Doctor Now (night or day) If|
|Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If|
|Call Your Doctor During Weekday Office Hours If|
|Parent Care at Home If|
|HOME CARE ADVICE FOR DIARRHEA|
- Most diarrhea is caused by a viral infection of the intestines.
- Diarrhea is the body's way of getting rid of the germs.
- Here are some tips on how to keep ahead of the fluid losses.
- Mild Diarrhea:
- Continue regular diet.
- Eat more starchy foods (e.g., cereal, crackers, rice).
- Drink more fluids. Formula or milk are good balanced fluids for diarrhea. (EXCEPTION: avoid all fruit juices and soft drinks because they make diarrhea worse).
- Formula-Fed Infants WITH frequent, watery diarrhea: Start Oral Rehydration Solutions (ORS)
- ORS (e.g., Pedialyte or the store brand) is a special electrolyte solution that can prevent dehydration. It's readily available in supermarkets and drug stores.
- Start ORS for frequent, watery diarrhea (Note: Formula is fine for average diarrhea).
- Use ORS alone for 4 to 6 hours to prevent dehydration. Offer unlimited amounts.
- If ORS not available, use formula prepared in the usual way (unlimited amounts) until you can get some.
- Avoid Jello water, sports drinks, or fruit juice.
- Returning to Formula
- Go back to formula by 6 hours at the latest. (Reason: needs the calories)
- Use formula prepared in the usual way. (Reason: It contains adequate water).
- Offer the formula more frequently than you normally do.
- Lactose: Regular formula is fine for most diarrhea. Lactose-free formulas (soy formula) are only needed for watery diarrhea persisting over 3 days.
- Extra ORS: also give 2-4 ounces (60-120 mls) of ORS after every large watery stool.
- Infants over 4 months old: Continue solids (e.g., rice cereal, strained bananas, mashed potatoes, etc).
- Breastfed Infants WITH frequent, watery diarrhea:
- Continue breastfeeding at more frequent intervals. Continue solids as for formula-fed.
- Offer 2-4 ounces (60-120 mls) ORS (e.g., Pedialyte) after every large watery stool (especially if urine is dark) in addition to breastfeedings.
- Older Children (over 1 year old) WITH frequent, watery diarrhea:
- Fluids: Offer unlimited fluids. If taking solids, give water or half-strength Gatorade. If refuses solids, give milk or formula.
- Avoid all fruit juices and soft drinks. (Reason: makes diarrhea worse)
- ORS (e.g., Pedialyte) is rarely needed, but for severe diarrhea, also give 4-8 ounces (120-240ml) of ORS after every large watery stool.
- Solids: Starchy foods are absorbed best. Give dried cereals, oatmeal, bread, crackers, noodles, mashed potatoes, rice, etc. Pretzels or salty crackers can help meet sodium needs.
- Probiotics contain healthy bacteria (Lactobacilli) that can replace unhealthy bacteria in the GI tract.
- YOGURT is the easiest source of probiotics. If over 12 months old, give 2 to 6 oz (60 to 180 ml) of yogurt twice daily. (Note: Today, almost all yogurts are "active culture".)
- Probiotic supplements in granules, tablets or capsules are also available in health food stores.
- Diaper Rash: Wash buttocks after each stool to prevent a bad diaper rash. Consider applying a protective ointment (e.g., petroleum jelly) around the anus to protect the skin.
- Contagiousness: Your child can return to child care or school after the stools are formed and the fever is gone. The school-aged child can return if the diarrhea is mild and the child has good control over loose stools.
- Expected Course: Viral diarrhea lasts 5-14 days. Severe diarrhea only occurs on the first 1 or 2 days, but loose stools can persist for 1 to 2 weeks.
- Call Your Doctor If:
- Signs of dehydration occur
- Diarrhea persists over 2 weeks
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 11/14/2011
Last Revised: 11/14/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.