Health Encyclopedia > Symptom Checker

Diarrhea, Age 11 and Younger

Topic Overview

Diarrhea occurs when there is an increase in the frequency of bowel movements or bowel movements are more watery and loose than normal. Diarrhea has many causes.

Dietary changes

A child may develop diarrhea from a change in his or her diet. A baby's or child's digestive tract may not tolerate large amounts of juice, fruit, or even milk. Diarrhea may be caused by an increase in the amount of juice or fruit a child drinks or eats. Diarrhea that is caused by a change in the child's diet is not usually serious.

Infection

Diarrhea is often caused by a viral or bacterial infection, such as rotavirus, stomach flu (gastroenteritis), or food poisoning. Diarrhea is the body's way of quickly clearing any viruses, bacteria, or toxins such as botulism from the digestive tract. Most cases of diarrhea are caused by a viral infection and will usually clear up in a few days.

Diarrhea may also be caused by a parasitic infection, such as Giardia lamblia. This parasite, as well as other viral and bacterial infections, may be spread by drinking untreated water, unpasteurized dairy products, or by poor hand-washing.

Other causes

On rare occasions, diarrhea can be a symptom of a more serious condition, such as:

Children, especially those younger than 6 months of age and those with other health risks, need special attention when they have diarrhea because they can quickly become dehydrated. Careful observation of your child's appearance and how much fluid he or she is drinking can help prevent problems.

Check your child's symptoms to decide if and when your child should see a doctor.

Note:

Normal stool during infancy may be runny or pasty, especially if the baby is breast-fed. The presence of mucus in the stool is not uncommon. Unless there is a change in your baby's normal habits, loose and frequent stools are not considered to be diarrhea.

Check Your Symptoms

Does your child have diarrhea?
Yes
Diarrhea
No
Diarrhea
How old are you?
Less than 3 months
Less than 3 months
3 to 5 months
3 to 5 months
6 months to 3 years
6 months to 3 years
4 to 11 years
4 to 11 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Is your child having belly pain that does not go away after he or she passes stools?
With diarrhea, it's normal to have cramping pain that goes away after the child passes stools. But if the pain is constant, there may be another problem.
Yes
Abdominal pain
No
Abdominal pain
Do you think your baby might be very sick?
A sick baby probably will not be acting normally. For example, the baby may be much fussier than usual or not want to eat.
Yes
Baby might be very sick
No
Baby might be very sick
How sick do you think your baby is?
Extremely sick
Baby is very sick (limp and not responsive)
Sick
Baby is sick (sleepier than usual, not eating or drinking like usual)
Do you think your baby may be dehydrated?
Yes
May be dehydrated
No
May be dehydrated
Are the symptoms severe, moderate, or mild?
Severe
Severe dehydration
Moderate
Moderate dehydration
Mild
Mild dehydration
Do you think your child may be dehydrated?
It can be harder to tell in a baby or young child than it is in an older child.
Yes
May be dehydrated
No
May be dehydrated
Are the symptoms severe, moderate, or mild?
Severe
Severe dehydration
Moderate
Moderate dehydration
Mild
Mild dehydration
Is your child having trouble drinking enough to replace the fluids he or she has lost?
Little sips of fluid usually are not enough. The child needs to be able to take in and keep down plenty of fluids.
Yes
Unable to drink enough fluids
No
Able to drink enough fluids
Does your child have symptoms of a serious illness?
Yes
Symptoms of serious illness
No
Symptoms of serious illness
Are your child's stools black or bloody?
Yes
Black or bloody stools
No
Black or bloody stools
How much blood is there?
More than a few drops. Blood is mixed in with the stool, not just on the surface.
More than a few drops of blood on stool or diaper
A few drops on the stool or diaper
A few drops of blood in stool or diaper
Do you think your baby has a fever?
Yes
Fever
No
Fever
Did you take a rectal temperature?
Taking a rectal temperature is the only way to be sure that a baby this age does not have a fever. If you don't know the rectal temperature, it's safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious.
Yes
Rectal temperature taken
No
Rectal temperature taken
Is it 100.4°F (38°C) or higher?
Yes
Temperature at least 100.4°F (38°C)
No
Temperature at least 100.4°F (38°C)
Do you think your child has a fever?
Yes
Fever
No
Fever
Did you take your child's temperature?
Yes
Temperature taken
No
Temperature taken
How high is the fever? The answer may depend on how you took the temperature.
High: 104°F (40°C) or higher, oral
High fever: 104°F (40°C) or higher, oral
Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral
Mild: 100.3°F (37.9°C) or lower, oral
Mild fever: 100.3°F (37.9°C) or lower, oral
How high do you think the fever is?
High
Feels fever is high
Moderate
Feels fever is moderate
Mild or low
Feels fever is mild
How long has your child had a fever?
Less than 2 days (48 hours)
Fever for less than 2 days
From 2 days to less than 1 week
Fever for more than 2 days and less than 1 week
1 week or longer
Fever for 1 week or more
Does your child have a health problem or take medicine that weakens his or her immune system?
Yes
Disease or medicine that causes immune system problems
No
Disease or medicine that causes immune system problems
Does your child have shaking chills or very heavy sweating?
Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off the child or soaking through his or her clothes.
Yes
Shaking chills or heavy sweating
No
Shaking chills or heavy sweating
Does the fever come and go?
Yes
Recurrent fever
No
Recurrent fever
Has your child traveled to another country in the past 6 weeks?
Yes
Recent travel
No
Recent travel
Has your baby had large stools every 1 to 2 hours for longer than 4 hours?
Yes
Large stools every 1 to 2 hours for more than 4 hours
No
Large stools every 1 to 2 hours for more than 4 hours
Has your baby had large stools every 1 to 2 hours for more than 8 hours?
Yes
Large stools every 1 to 2 hours for more than 8 hours
No
Large stools every 1 to 2 hours for more than 8 hours
Has your child had 6 or more large, loose stools in 12 hours?
Yes
6 or more large, loose stools in 12 hours
No
6 or more large, loose stools in 12 hours
Does your child have diabetes?
Yes
Diabetes
No
Diabetes
Is your child's diabetes getting out of control because your child is sick?
Yes
Diabetes is affected by illness
No
Diabetes is affected by illness
Do you and your child's doctor have a plan for what to do when your child is sick?
Yes
Diabetes illness plan
No
Diabetes illness plan
Is the plan helping get your child's blood sugar under control?
Yes
Diabetes illness plan working
No
Diabetes illness plan not working
How fast is it getting out of control?
Quickly (over several hours)
Blood sugar quickly worsening
Slowly (over days)
Blood sugar slowly worsening
Does the diarrhea come and go?
Yes
Recurrent diarrhea
No
Recurrent diarrhea
Is your child having diarrhea more often?
Yes
More frequent diarrhea episodes
No
More frequent diarrhea episodes
Has your child had diarrhea off and on for more than 1 month?
Yes
Diarrhea off and on for more than 1 month
No
Diarrhea off and on for more than 1 month
Do you think that a medicine could be causing the diarrhea?
Think about whether the diarrhea started after your child began taking a new medicine or a higher dose of a medicine.
Yes
Medicine may be causing diarrhea
No
Medicine may be causing diarrhea
Has your child been taking antibiotics in the past 2 weeks?
Many antibiotics can cause diarrhea.
Yes
Antibiotic in the past 2 weeks
No
Antibiotic in the past 2 weeks

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

What you are looking for is a change in your child's usual bowel habits.

  • Diarrhea means that the child is having more stools and looser ones than usual.
  • Constipation means that the child is having fewer stools than usual.

Every baby and child has different bowel habits. What is "normal" for one child may not be normal for another. In general:

  • Many newborns have at least 1 or 2 bowel movements a day. By the end of their first week, they may have as many as 5 to 10 bowel movements a day. They may pass a stool after each feeding.
  • By 6 weeks of age, your baby may not have a bowel movement every day. This usually isn't a problem as long as the baby seems comfortable and is growing as expected, and as long as the stools aren't hard.
  • By about 4 years of age, it's normal for a child to have as many as 3 bowel movements a day or as few as 3 a week.

Anywhere in these ranges can be considered normal if the habit is normal or usual for your child.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:

  • Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
  • Steroid medicines, which are used to treat a variety of conditions.
  • Medicines taken after organ transplant.
  • Chemotherapy and radiation therapy for cancer.
  • Not having a spleen.

Babies can quickly get dehydrated when they lose fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For example:

  • The baby may be fussy or cranky (mild dehydration), or the baby may be very sleepy and hard to wake up (severe dehydration).
  • The baby may have a little less urine than usual (mild dehydration), or the baby may not be urinating at all (severe dehydration).

Symptoms of serious illness in a baby may include the following:

  • The baby is limp and floppy like a rag doll.
  • The baby doesn't respond at all to being held, touched, or talked to.
  • The baby is hard to wake up.

Severe dehydration means:

  • The child's mouth and eyes may be extremely dry.
  • The child may pass little or no urine for 12 or more hours.
  • The child may not seem alert or able to think clearly.
  • The child may be too weak or dizzy to stand.
  • The child may pass out.

Moderate dehydration means:

  • The child may be a lot more thirsty than usual.
  • The child's mouth and eyes may be drier than usual.
  • The child may pass little or no urine for 8 or more hours.
  • The child may feel dizzy when he or she stands or sits up.

Mild dehydration means:

  • The child may be more thirsty than usual.
  • The child may pass less urine than usual.

Severe dehydration means:

  • The baby may be very sleepy and hard to wake up.
  • The baby may have a very dry mouth and very dry eyes (no tears).
  • The baby may have no wet diapers in 12 or more hours.

Moderate dehydration means:

  • The baby may have no wet diapers in 6 hours.
  • The baby may have a dry mouth and dry eyes (fewer tears than usual).

Mild dehydration means:

  • The baby may pass a little less urine than usual.

Temperature varies a little depending on how you measure it. For children up to 11 years old, here are the ranges for high, moderate, and mild according to how you took the temperature.

Oral (by mouth), ear, or rectal temperature

  • High: 104 F (40 C) and higher
  • Moderate: 100.4 F (38 C) to 103.9 F (39.9 C)
  • Mild: 100.3 F (37.9 C) and lower

Armpit (axillary) temperature

  • High: 103°F (39.5°C) and higher
  • Moderate: 99.4 F (37.4 C) to 102.9 F (39.4 C)
  • Mild: 99.3°F (37.3°C) and lower

Note: For children under 5 years old, rectal temperatures are the most accurate.

A baby that is extremely sick:

  • May be limp and floppy like a rag doll.
  • May not respond at all to being held, touched, or talked to.
  • May be hard to wake up.

A baby that is sick (but not extremely sick):

  • May be sleepier than usual.
  • May not eat or drink as much as usual.

If you're not sure if a child's fever is high, moderate, or mild, think about these issues:

With a high fever:

  • The child feels very hot.
  • It is likely one of the highest fevers the child has ever had.

With a moderate fever:

  • The child feels warm or hot.
  • You are sure the child has a fever.

With a mild fever:

  • The child may feel a little warm.
  • You think the child might have a fever, but you're not sure.

An illness plan for people with diabetes usually covers things like:

  • How often to test blood sugar and what the target range is.
  • Whether and how to adjust the dose and timing of insulin or other diabetes medicines.
  • What to do if you have trouble keeping food or fluids down.
  • When to call your doctor.

The plan is designed to help keep your diabetes in control even though you are sick. When you have diabetes, even a minor illness can cause problems.

It is easy for your diabetes to become out of control when you are sick. Because of an illness:

  • Your blood sugar may be too high or too low.
  • You may not be able take your diabetes medicine (if you are vomiting or having trouble keeping food or fluids down).
  • You may not know how to adjust the timing or dose of your diabetes medicine.
  • You may not be eating enough or drinking enough fluids.

Blood in the stool can come from anywhere in the digestive tract, such as the stomach or intestines. Depending on where the blood is coming from and how fast it is moving, it may be bright red, reddish brown, or black like tar.

A little bit of bright red blood on the stool or on the toilet paper is often caused by mild irritation of the rectum. For example, this can happen if you have to strain hard to pass a stool or if you have a hemorrhoid.

Certain medicines and foods can affect the color of stool. Diarrhea medicines (such as Pepto-Bismol) and iron tablets can make the stool black. Eating lots of beets may turn the stool red. Eating foods with black or dark blue food coloring can turn the stool black.

If you take a medicine that affects the blood's ability to clot, such as aspirin, warfarin (Coumadin), enoxaparin (Lovenox), or clopidogrel (Plavix), it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms.

Symptoms of serious illness may include:

  • A severe headache.
  • A stiff neck.
  • Mental changes, such as feeling confused or much less alert.
  • Extreme fatigue (to the point where it's hard for you to function).
  • Shaking chills.

Many prescription and nonprescription medicines can cause diarrhea. A few examples are:

  • Antibiotics.
  • Antidepressants.
  • Antacids.
  • Proton pump inhibitors, such as omeprazole (Prilosec) and lansoprazole (Prevacid).
  • Medicines used to treat cancer (chemotherapy).

You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever.

Symptoms of dehydration can range from mild to severe. For example:

  • You may feel tired and edgy (mild dehydration), or you may feel weak, not alert, and not able to think clearly (severe dehydration).
  • You may pass less urine than usual (mild dehydration), or you may not be passing urine at all (severe dehydration).

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.
Abdominal Pain, Age 11 and Younger
Diarrhea, Age 12 and Older

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Home Treatment

As soon as you notice that your child has diarrhea, it is important to take action to prevent dehydration. Oral rehydration solutions (ORSs) are used to prevent or correct dehydration in young children. ORSs contain the right mix of salt, sugar, potassium, and other minerals to help replace body fluids lost from diarrhea. It may be wise to keep some ORS on hand so that if your child develops diarrhea, you can start replacing lost fluids immediately. ORS will help prevent dehydration, but it will not stop the diarrhea.

The amount of ORS your child needs depends on the severity of his or her dehydration. The more severe the dehydration, the more ORS you will need to give your child.

Newborns and babies through 1 year of age

Don't wait until signs of dehydration develop to replace lost fluids. Signs of dehydration include your baby being thirstier than usual and having darker urine than usual.

  • If you breast-feed your baby, feed your baby more often to replace lost fluids. Give an oral rehydration solution (ORS) between feedings only if signs of dehydration develop.
  • If you use a bottle to feed your baby, increase the number of feedings to make up for lost fluids. The amount of extra fluid your baby needs depends on your baby's size and the severity of his or her diarrhea. For example, a newborn may need as little as 1 fl oz (30 mL) at each extra feeding, while a 12-month-old baby may need as much as 3 fl oz (90 mL) at each extra feeding. Give an ORS between feedings only if signs of dehydration develop.
  • If signs of mild or moderate dehydration develop, the amount of breast milk, formula, or ORS your baby needs depends on his or her weight and the degree of dehydration present. You can give the ORS in a dropper, spoon, or bottle. Continue to give the ORS until your baby's stools return to normal.
  • If your baby has started eating cereal, you may replace lost fluids with cereal. Offer the cereal mixture after each diarrhea stool. You may also offer any other foods that your child has had before.

Children 1 year through 11 years of age

  • Oral rehydration solution (ORS) or plain water (if the child is eating food) may be used to replace fluids lost from diarrhea.
    • Offer your child 0.5 cup (120 mL) to 1 cup (240 mL) of fluids after each diarrhea stool.
    • Allow your child to drink as much fluid as he or she wants.
  • If diarrhea is persistent or if your child is dehydrated, using an ORS as the main source of replacement fluids is the safest approach.
    • The amount of ORS your child needs depends on his or her weight and the degree of dehydration present.
    • Keep giving the ORS until your child's stools return to normal.
  • If your baby is eating a cereal mixture, it can also be used to replace lost fluids. Offer 0.5 cup (120 mL) to 1 cup (240 mL) of the cereal mixture after each diarrhea stool.
  • Give your child frequent small meals, at least 6 a day, while he or she is having diarrhea.
    • The best foods for your child are easily digestible foods, such as rice cereal, pasta, breads, cooked beans, mashed potatoes, cooked carrots, applesauce, and bananas.
    • Pretzels or salty crackers can help your child replace the salt lost from diarrhea.
    • Foods containing large amounts of sugar or fat should be avoided.

General tips

  • Avoid giving your child juice, chicken broth, soda pop, sports drinks, ginger ale, or tea. These drinks do not contain the right mixture of minerals and sugar to replace lost fluids and may make the diarrhea worse.
    • Do not offer soda pop, juice, ice cream, or candy, because they contain a lot of sugar and lack the calories and minerals your child needs.
    • You may use plain water to replace lost fluids if your child is older than 1 year of age and is eating food.
  • Do not withhold food from your child. Studies have shown that children who are fed easily digestible foods have shorter episodes of diarrhea.
  • If your child drinks cow's milk, he or she may continue to drink it.
  • Do not give your child prescription or nonprescription medicine to stop diarrhea unless you are told to do so by your child's doctor.
  • Protect the diaper area with zinc oxide or another cream. Diaper rash is common after diarrhea.
  • Wash your hands and your child's hands thoroughly after each diaper change and before each feeding.
  • Until your doctor has assured you that your child's diarrhea is not infectious, your child should not attend school or day care.
  • Learn how to clean up diarrhea safely. Protect your hands with gloves while cleaning up. Wash your hands after you are done cleaning up.

If your child is also vomiting, learn about home treatment for vomiting.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Blood in diarrhea develops.
  • Signs of dehydration develop. These include your child being thirstier than usual and having darker urine than usual.
  • Your child has diarrhea and a fever.
  • Symptoms become more severe or frequent.

Prevention

Do not allow your child to drink untreated or unfiltered water from a lake or stream or unpasteurized milk. Untreated water and unpasteurized milk are sources for viral, bacterial, and parasitic infections, such as Giardia lamblia. Avoid having your child brush his or her teeth with untreated water. Even a small amount of untreated water can contain enough parasites, virus, and bacteria to cause diarrhea.

Diarrhea can spread because of poor hygiene.

  • Practice good hand-washing.
    • Be sure to wash your hands and your child's hands after each diaper change or trip to the bathroom.
    • Teach your child to wash his or her hands after using the bathroom and before every meal.
    • Do not place soiled diapers on surfaces that are used to prepare or serve food.
  • If your child attends school or day care, keep your child at home until your doctor has determined that his or her diarrhea can't be passed to others (is not infectious).

Food poisoning is a common cause of diarrhea in children and adults. Most cases of food poisoning at home may be prevented by taking a few precautions when preparing and storing food. Perishable foods, such as eggs, meats, poultry, fish, shellfish, milk, and milk products, should be treated with extra care. Also, precautions should be taken if you are pregnant, you have an impaired immune system or a chronic illness, or you are preparing foods for other high-risk groups, such as young children or older people.

The following steps are recommended to prevent food poisoning:

Many counties in the United States have extension services listed in the phone book. These services can answer your questions about safe home canning and food preparation.

When you travel in wilderness areas or to other countries of the world, it is common to get traveler's diarrhea from food or water because the methods of food preparation are different.

Rotavirus vaccine (What is a PDF document?) helps protect babies and young children from getting a rotavirus infection, which can cause diarrhea and dehydration. Talk to your child's doctor about this vaccine for your child.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your child's condition by being prepared to answer the following questions:

  • How long has your child had diarrhea?
  • How many times per day does your child have diarrhea?
  • Describe your child's diarrhea:
    • What color is it?
    • Is it mushy or watery?
    • Does it contain blood or mucus?
    • Have you noticed an unusual odor?
  • Does your child have other symptoms such as fever, vomiting, or abdominal pain?
  • Has your child taken any new prescription or nonprescription medicines?
  • Do you regularly give your child laxatives or stool softeners?
  • Has your child been eating new or different foods?
  • Has your child been exposed to other children or adults who have diarrhea?
  • Has your child drunk untreated lake, stream or well water?
  • Has your child recently visited a foreign country where clean water or proper food preparation was not available?
  • Has your child been exposed to farm animals?
  • Does your child have a history of chronic disease such as cystic fibrosis or celiac disease?
  • Does your child have any health risks?

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Last Revised May 1, 2013

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