Diarrhea

What is diarrhea?

Diarrhea is marked by sudden frequent, loose bowel movements. A few loose bowel movements are indicative of mild diarrhea. If your child has many watery bowel movements, that are also   green, he or she is experiencing a severe case of diarrhea.

Generally, diarrhea can last from days to week. Because this condition causes loss of body fluids, the main objective of treatment is to prevent dehydration.

What causes diarrhea?

Generally, diarrhea occurs as a result of a viral infection of the lining of the intestines (gastroenteritis). Bacteria, parasites, food allergy or a diet consisting of too much fruit juice can also stimulate diarrhea. The main treatment for diarrhea is increased fluids and dietary changes.

What should I feed my child?

Breast-Fed Infants

Regardless of the appearance, the bowel movement of breast-fed infants is normal unless they have a bad odor, or mucus or blood is present. It is also normal for some breast-fed babies to pass green bowel movements.

In general, during the first two to three months of life, babies who are breast-fed have a bowel movement following each feeding.  Also keep in mind, the mother’s diet can cause frequent or looser bowel movements as well. However, a sudden increase in bowel movements is a sign your infant may be experiencing diarrhea.

Continue to breast-fed, but do so more frequently. If bowel movements are severe, give the infant Pedialyte or Kao Lectrolyte between feedings for six to 24 hours. Do this only if the baby is not urinating as frequently as normal. If your child is unable to nurse, pump your breast milk to maintain normal flow. Add solid foods such as cereal, applesauce, and strained bananas or carrots or other foods that are high in fiber to the infant’s diet.

Formula-Fed (infants less than one-year old)

If your child is experiencing severe diarrhea and urine that is dark or if they are not urinating enough, give them Pedialyte or Kao Lectrolyte for four to six hours. Your baby can have as much of these liquid solutions as they want (at least 10ml for each pound your child weighs per hour). Until you can purchase these solutions, continue to give the baby a limited amount of formula. If you cannot purchase these solutions, make a homemade mixture as follows: Mix two cups of water, ½ cup of dry rice cereal and ¼ teaspoon of salt. Do not give your baby sports drinks, fruit juice or Jell-O mixed with water.

Following four to six hours of clear liquid, begin giving your baby full-strength formula. You can give the baby soy formula first if the diarrhea remains severe. If diarrhea does not improve after three days, begin giving your child a lactose-free formula.

If your baby is over four months old and has had diarrhea for more than 24 hours, add solid foods that are high in fiber, such as cereal, applesauce, strained bananas and carrots, and mashed potatoes to their diet.

Children over one-years old

If your child is having watery bowel movements, only give them water for the first 24 hours. Unless they are dehydrated, most toddlers do not need Pedialyte or Kao Lectrolyte. On the second day, they can drink milk as well.

While your child has diarrhea, continue giving them table foods. Starchy foods, such as cereal, bread, grains, rice, noodles, carrots, applesauce and bananas are best. Saltine crackers or pretzels are great for sodium. You may give your child protein, such as a soft-boiled egg, on the second day.

Remember:

  • Babies should never be given boiled skim milk. It contains too much salt and therefore can cause serious complications. Also, never give your child Kool-Aid, soda or water alone, as these liquids contain little to no salt. Only administer clear liquids alone for four to six hours.
  • To prevent the spread of diarrhea, always wash your hands.
  • To prevent diaper rash, after each bowel movement, wash the region near the anus, then apply a thick layer of petroleum jelly or other ointment for protection. Application is especially necessary during naps and during the night. Changing diapers quickly will also prevent diaper rash.
  • For children that are not toilet-trained, diarrhea can be a mess. Placing a cotton washcloth in the diaper can help trap some watery bowel movements. Using super absorbent, disposable diapers will reduce cleanup time.
  • If your child vomits more than two times, follow these recommendations until he or she goes without vomiting for eight hours.

When should you call our office?

CALL IMMEDIATELY if:

  • Your child has had more than eight bowel movements within the last eight hours.
  • Bowel movements are watery and blood is present.
  • Your child vomits the clear liquids three times.
  • Your child appears dehydrated.

Diarrhea: Gastroenteritis Diet

Formerly The Brat Diet

This diet is recommended for your child because he/she has had diarrhea.
If you are breast feeding your child you should continue, as breast milk is easy to digest.
If you are feeding a milk based infant formula to your child you should switch to a lactose free formula such as Lactofree, Isomil or Prosobee.
You should use this diet no more than three days since it is not adequate in all nutrients.

FOOD GROUP

ALLOWED / RECOMMENDED

AVOID / USE SPARINGLY

BREADS /
STARCHES
4 servings or more

CEREALS:

Potatoes / Pasta /
Rice

Most breads, dinner rolls, crackers and quick breads.

All unsweetened or dry cereals, except as indicated.

All that are prepared plain, nothing added.

Any that contain cocoa, chocolate, dried fruits, raisins, nuts or seeds.

Cereals which are sweetened, cocoa or chocolate flavored and which contains nuts or dried fruit.

Those prepared with spices, butter, oil and sauces are to be omitted.

VEGETABLES
2 servings or more

All cooked vegetables except as indicated.

Any that contain cocoa, chocolate, dried fruits, raisins, nuts or seeds.

FRUIT
2 servings

Canned fruits, fresh banana, fresh apple slices and fresh pear.

Dried fruits, fruit juices and fruits canned in heavy syrup are omitted.

MEAT & SUBSTITUTES

2 servings or more(4 to 6 oz. total/day)

All meat, fish, eggs, or poultry prepared simply.

Any meat or meat product that is prepared with or that contains spices, butter, oil and sauces. Examples, include hot dogs, sausage, beans, lunchmeat, pickled herring and peanut butter.

MILK / MILK PRODUCT

Plain yogurt.

All other milk, milk-based beverages and milk products including cheese.

SOUPS

2 strength broth, low sodium soups.

Avoid all other soups.

DESSERTS & SWEETS

Diluted Jello.

All that are not listed as allowed.

FATS & OIL

NONE.

ALL. Examples include margarine, butter, cooking oils, shortening, mayonnaise and mayonnaise-type salad dressing. Avocado, peanut butter, sour cream, whipped cream, gravy, cream cheese, bacon and sausage.

BEVERAGES

Gatorade, water, oral rehydration solutions.

(Examples include Infalyte, Pedialyte and Rehydralyte).

Coffee, tea, decaffeinated coffee, carbonated beverages (soda), cola and cocoa. All not listed as allowed.

CONDIMENTS / MISCELLANEOUS

Salt in moderation.

ALL others including, black pepper, white pepper, red pepper, cayenne, curry powder and chili powder. Other examples include BBQ sauce, steak sauce, Tabasco sauce, Worcestershire sauce and combination seasonings containing pepper. Catsup, vinegar and herbs.

Written by Children's Hospital of Orange County, Food and Nutrition Services

  
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