Diarrhea
Diarrhea is a condition where you have frequent, loose and watery bowel movements. It can be caused by viruses, bacteria or parasites and can lead to dehydration.
What Is Diarrhea?
Diarrhea (loose, watery bowel movements) is a common problem in young children. It rarely means a child has a serious illness. Diarrhea can be caused by:
- A virus or bacteria (a stomach bug).
- Something that your child eats or drinks, like too much fruit juice.
- Starting a new medicine.
The biggest risk of diarrhea is dehydration. This means that your child has lost too much fluid and doesn’t have enough electrolytes (salts) in their body for it to work the right way. Your child may need extra liquids given in smaller amounts more often until they’re well.
Mild Diarrhea (2 to 5 Watery Bowel Movements a Day)
Mild diarrhea usually goes away in a couple of days.
- 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. These include 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, give them more starchy foods like rice, 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 oral rehydration solution (ORS) like Pedialyte® to help prevent dehydration. An ORS replaces the electrolytes and fluids that your child needs.
- You can buy ORS in liquid or powder form or as popsicles at most pharmacies without a prescription. ORS store brands are just as good as a brand name.
- Do not water down (dilute) or mix an ORS with formula.
- Offer your child other things to drink. ORS should not be the only fluid given for more than 6 hours.
- If your child eats solid foods, give them more starchy foods like rice, cereal, and crackers. Do not give them red-colored foods that might look like blood in diarrhea.
- Try to go back to a normal diet after one day. Do not use sports drinks and home remedies instead of ORS.
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 can make your child feel worse.
Children Older Than 1 Year of Age
Same as above, and:
- Water
- Milk, if tolerated
- Ice popsicles made from ORS
- Flavored gelatin cubes
- Starchy foods like breads, pasta, mashed potatoes, pretzels
- Yogurt
WARNING: Do not give medicines to stop the diarrhea unless your doctor specifically orders it. These medicines can be very dangerous if they are not used properly.
Amount of Liquid to Give to Prevent Dehydration
Use the table on page 3 to know how much fluid your child needs each hour. Offer the liquids listed above, for their age. Measure the amount given to know when they have met their goal. Start slow. Give small sips of liquid often. Increase the amount until the goal is met.
|
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 (1 1/4 cups) |
* Minimum fluid goals per hour may increase if diarrhea, vomiting or fever are present.
Signs of Dehydration
Watch for signs of dehydration while treating your child’s diarrhea.
- Does not pee (urinate) enough
- Newborn (0 to 4 months of age) has less than 6 wet diapers in a day
- Child (4 months or older) has less than 3 wet diapers in a day or pees less than 3 times in a day.
- Urine is very dark.
- 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.
- Keep things your child uses, like 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 or health care provider if you think they are getting worse, do not get any better in 48 hours, will not breastfeed or eat, 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 children younger than 3 months of age - 100.4° Fahrenheit (F) or 38° Celsius (C) or above
- For children over 3 months of age - 104°F (40°C) or above, above 102°F (38.9°C) fore more than 2 days or keeps coming back, or treated to bring their fever down, but it hasn't worked
- Any age - has a fever and:
- Looks very ill, is fussy, or is drowsy
- Has a stiff neck, a bad headache, or very sore throat
- Has an unusual rash
- Has immune system problems that make them more likely to get sick, such as sickle cell disease or cancer, or takes medicines that weakens the immune system
Helping Hands Patient Education Materials
Written and illustrated by medical, nursing and allied health professionals at Nationwide Children's Hospital, Helping Hand instructions are intended as a supplement to verbal instructions provided by a medical professional. The information is periodically reviewed and revised to reflect our current practice. However, Nationwide Children's Hospital is not responsible for any consequences resulting from the use or misuse of the information in the Helping Hands.
HH-I-29 | ©1977, revised 8/2022, Nationwide Children’s Hospital
