How can I tell if my child has diarrhea?
First, you'll need to consider what's normal for your child. Some kids have a couple of bowel movements a day, while others go several days without one. An occasional loose stool is nothing to worry about, but if your child's bowel movements suddenly change — that is, he poops more than normal and passes looser, more watery stools — then it's probably diarrhea.
While a severe case of diarrhea can alarm even the most unflappable parents, rest assured that in the United States most cases of diarrhea are relatively mild and don't pose a major health threat as long as your child doesn't get dehydrated. If your child is otherwise healthy and is getting plenty of fluids, the diarrhea will probably clear up in a couple of days.
What's causing my child's diarrhea?
The list of possibilities is long. Your child's diarrhea could be caused by a viral or bacterial infection. It might also be the result of a parasite, a course of antibiotics, or something he ate.
Bacteria — such as salmonella, shigella, staphylococcus, campylobacter, or E. coli — can also be responsible for diarrhea. If your child has a bacterial infection, he may have severe diarrhea, accompanied by cramps, blood in the stool, and a fever. (He may or may not be vomiting.)
Some bacterial infections clear up on their own, but some, like that from the E. coli that can be found in undercooked meat, can be very serious. So if your child has these symptoms, take him to the doctor. She'll examine him and probably evaluate a stool culture for signs of a bacterial infection
In some cases, an ear infection (which may be viral or bacterial) can be the culprit in a bout of diarrhea. In addition to ear pain, your child may also have nausea and vomiting and a poor appetite, and he may have recently had a cold.
Parasitic infections can also cause diarrhea. Giardiasis, for example, is caused by a microscopic parasite that lives in the bowel.
If your child has a parasitic infection, he may have diarrhea, bloating, gas, nausea, cramps, and greasy stools. These kinds of infections are easily spread in group-care situations, and treatment involves special medicine, so your child will need to see the doctor.
If your child has diarrhea during or after a course of antibiotics, it may be related to the medicine, which kills off good bacteria in the intestines along with the problem-causing bacteria. Talk to his doctor about alternatives and remedies, but don't stop giving any prescribed medication to your child until his doctor gives you the go-ahead.
Too much juice
Too much juice (especially fruit juice containing sorbitol and high levels of fructose) or too many sweetened drinks can upset a child's tummy and cause him to have loose stools. Cutting back the amount should solve the problem in a week or so. The American Academy of Pediatrics (AAP) recommends that you give your child no more than one small glass (4 to 6 ounces) of juice a day.
Call 911 if your child is having trouble breathing or if he has swelling of his face or lips.
A food allergy (in which the body's immune system responds to normally harmless food proteins) can cause mild or severe reactions — immediately or within a couple of hours. Symptoms might include diarrhea, gas, abdominal pain, and blood in the stool. In more severe cases, an allergy can also cause hives, a rash, swelling, and breathing difficulty. Milk protein is the most common food allergen. Other common food allergens include eggs, peanuts, soy, wheat, tree nuts, fish, and shellfish. If you think your child might have a food allergy, talk with his doctor.
Unlike a food allergy, a food intolerance (sometimes called a food sensitivity) is an abnormal reaction that does not involve the immune system. There are many possibilities, but one example is lactose intolerance.
If your child were lactose intolerant, it would mean that his body wasn't producing enough lactase, the enzyme necessary to digest lactose, the sugar in cow's milk and other dairy products. When the undigested lactose stays in the intestine, it can cause symptoms such as diarrhea, abdominal cramping, bloating, and gas. Symptoms usually start from half an hour to two hours after consuming milk products.
By the way, if your child has a severe case of diarrhea, he may temporarily have trouble producing lactase, and as a result he might have symptoms of lactose intolerance for a week or two.
If your child has diarrhea and is vomiting and you think he may have swallowed some kind of nonfood item like a medication, chemical, or plant, call the Poison Control Center right away (800-222-1222). Call 911 if he becomes unconscious or is having trouble breathing. Other symptoms may include fatigue and convulsions.
How should I treat my child's diarrhea?
While rarely serious when treated properly, diarrhea can send your child to the hospital if he becomes dehydrated, so your first concern should be giving him enough liquids. If your child isn't also vomiting, it should be fairly easy to give him extra water to drink.
If your child can't keep liquids down, though, or diarrhea is severe (a watery bowel movement every two hours or more), call his doctor, who may suggest a pediatric electrolyte solution, like Pedialyte, ReVital, or a generic brand. These solutions are available in drugstores and come in several flavors.
Avoid sweetened fluids like sodas (including ginger ale), athletic drinks (like Gatorade), sugar water, and undiluted fruit juices. Also avoid Jell-O. All of these contain sugar that draws water into the intestine and makes the diarrhea worse.
Doctors now advise continuing to feed solid foods to a child with diarrhea. While there's nothing wrong with feeding your child the classic BRAT diet (bananas, rice, applesauce, and dry toast), the AAP says a normal diet that includes such staples as complex carbohydrates (like breads, cereals, and rice), lean meats, yogurt, fruits, and vegetables is safe to eat. In fact, because it restores essential nutrients needed to fight infection, a standard, healthful diet may even shorten your child's bout a bit.
If your child temporarily refuses to eat, don't worry. As long as he stays hydrated, his appetite should return in a day or two.
Studies have shown that live bacterial cultures, found in yogurt, are a safe and effective way to cut down on the amount and duration of diarrhea. It's an easy way to treat the problem, especially if your child loves the taste of yogurt. Just be sure to buy yogurt that contains lactobacillus, or live cultures.
If your child is uncomfortable during a bout of diarrhea, try to cuddle and comfort him as much as possible. Be prepared to offer frequent changes of underwear if he doesn't make it to the toilet in time, and help him keep his bottom clean and dry so that it doesn't become irritated by the loose stools.
Is it okay to give my child an adult anti-diarrheal medication?
No, don't give your child any anti-diarrheal medicines without a prescription from his doctor. These medicines can be dangerous for children.
When should I call the doctor?
Call the doctor if your child has diarrhea and he doesn't seem to be improving in 24 hours. Also call if your child has diarrhea and any of the following:
- vomiting multiple times
- signs of dehydration, such as dry mouth and infrequent urination (less than every six hours
- blood in his stool or black stool
- a high fever — 103 degrees Fahrenheit (39.4 degrees Celsius) or higher
How can I prevent my child from coming down with infectious diarrhea?
Regular hand washing is your best defense, because the microorganisms that cause diarrhea are easily passed from hand to mouth. Your child can catch an infection by putting his finger in his mouth after touching toys or other objects that have been contaminated with the stool of an infected child, for example.
Teach your child to wash his hands thoroughly with soap and warm water before eating and after using the bathroom. Wash your own hands often, too, especially before preparing food and after handling soiled diapers or using the bathroom. Also, be sure you follow safe food preparation and cooking practices.