Diarrhea

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Diarrhea (loose, watery bowel movements) is a common problem in young children. It is usually caused by a virus. It can also be caused by bacteria, something that the child eats or drinks (like too much fruit juice) or starting a new medicine. It rarely means a child has a serious illness.

The biggest risk of diarrhea is dehydration (being dried out). This means that the child has lost too much fluid and does not have enough electrolytes (salts) in their body for it to work the right way. Your child may need extra liquids given in smaller amounts and more often, until they are well. Mild diarrhea usually goes away in a couple of days.

Read below to see what to do.

Mild Diarrhea (2 to 5 Watery Bowel Movements a Day)

Keep your child on their regular diet.

Offer more breast milk or formula in smaller amounts and more often.

Do not give fruit juices or liquids that are high in sugar, such as Hawaiian Punch®, Hi-C®, Kool-Aid®, sodas or syrups. These can make diarrhea worse. Do not give teas or broths.

If your child eats solid foods, choose more starchy foods like cereal and crackers.

Moderate to Severe Diarrhea (6 or More Watery Bowel Movements a Day)

With moderate to severe diarrhea, your child may need to drink an ORS (oral rehydration solution) like Pedialyte® to help prevent dehydration. An ORS replaces the electrolytes (salts) and fluids that your child needs. Sports drinks and home remedies should not be used instead.

ORS store brands are just as good as a brand name. You can buy ORS in liquid or powder form or as popsicles at most pharmacies without a prescription.

ORS should not be given as the only fluid for more than 6 hours. Do not dilute or mix an ORS with formula.

Children Younger Than 1 Year of Age

  • ORS (oral rehydration solution)
  • Breast milk or formula mixed the normal way (if tolerated). Do not stop breastfeeding.
  • No water except when used to make formula
  • Do not give fruit juices or liquids that are high in sugar, such as Hawaiian Punch®, Hi-C®, Kool-Aid®, sodas or syrups. Do not give teas or broths. These liquids do not have the right mix of electrolytes and can make diarrhea worse.
  • If your child eats solid foods, give more starchy foods like cereal and crackers. Avoid red-colored foods that might look like blood in diarrhea or in vomit.
  • Try to go back to a normal diet after one day.

Children Older Than 1 Year of Age

Same as above, andMeasure the amount of liquid your child needs.

  • Water
  • Milk, if tolerated
  • Ice popsicles made from ORS
  • Flavored gelatin cubes
  • Starchy foods like breads, pasta, mashed potatoes, pretzels
  • Yogurt

Amount of Liquid to Give to Prevent Dehydration

Measure the amount of liquid your child needs based on their weight (Picture 1). Gradually work up to giving the following amounts:

Child's Weight

Minimum Goal to Give Every Hour*

7-10 lbs. At least 2 ounces (4 tablespoons or 1/4 cup)
11-15 lbs. At least 2 1/2 ounces (5 tablespoons)
16-20 lbs. At least 3 1/2 ounces (1/2 cup)
21-40 lbs. At least 6 1/2 ounces (3/4 cup)
41-60 lbs. At least 10 ounces of liquid every hour (1 1/4 cups per hour)

* Minimum fluid goals per hour may increase if diarrhea, vomiting or fever are present.

WARNING: Do not give medicines to stop the diarrhea unless your doctor specifically orders it. These medicines can be very dangerous to children if they are not used properly.

Skin Care

You may need to change your child’s diapers more often until the diarrhea stops. Wash your child’s bottom after each bowel movement. If needed, use diaper rash cream to help protect the skin.

Signs of Dehydration

Watch for signs of dehydration while treating your child’s diarrhea (Picture 2).

  • No wet diaper or does not urinate (pass water) for 6 or more hours, very dark urineSigns of dehydration.
  • No tears when crying
  • Dry or sticky mouth
  • Hard or fast breathing
  • Sunken-looking eyes
  • Soft spot on baby’s head is flat, sunken or pulls in.
  • Constant abdominal pain (bellyache)
  • Hard to wake up (lethargic), acts confused or does not know what they are doing.

Preventing the Spread of Infection

If a virus caused your child’s diarrhea, do the following to prevent the spread to others:

  • Make sure your child washes hands with soap and water after using the toilet and before eating.
  • Wash your hands with soap and water or an alcohol-based hand sanitizer after touching your child and their eating utensils, dirty laundry or diapers (Picture 3).Good handwashing is very important.
  • Keep your child’s utensils, toys and dirty clothes away from others. Wash them in hot soapy water.
  • Clean the toilet and hard surfaces often with disinfectant or an antimicrobial wipe. Let dry 15 seconds.

When to Call the Doctor

Call your child's doctor if you think your child is getting worse, does not get any better in 48 hours, will not breastfeed or has:

  • Severe stomach pain (more than occasional cramps)
  • Bloody diarrhea (more than a streak of blood)
  • Diarrhea that is more frequent or more severe
  • Signs of dehydration (See above)
  • A high fever. Use a digital thermometer and wash thoroughly after each use.
    • for age 3 months or younger, a rectal (in baby’s bottom) temperature of 100.4°F (38°C) or higher. 
    • for any age, a temperature over 102°F (38.9°C), that lasts more than 2 days. Take rectal, ear or axillary (armpit) temperatures in infants 4 months of age or older. When your child reaches 4 years of age, oral (mouth) temperatures are OK.

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HH-I-29 ©1977, Revised 2020, Nationwide Children’s Hospital