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Diarrhea, Age 11 and Younger

Topic Overview

Every baby or child has different bowel habits. Many newborns who are breast-fed have 5 to 10 bowel movements a day. They may have as few as 1 or 2. After 2 weeks, breast-fed babies' bowel movements might be less frequent. Bottle-fed babies tend to have 1 or 2 fewer bowel movements a day than breast-fed babies. Babies sometimes go 2 days or longer between bowel movements. This usually is not a problem as long as:

  • The baby seems comfortable and is healthy and growing.
  • The stools are not hard.

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.

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.

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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 January 15, 2013

Last Revised: January 15, 2013

Author: Healthwise Staff

Medical Review: William H. Blahd, Jr., MD, FACEP - Emergency Medicine & H. Michael O'Connor, MD - Emergency Medicine

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