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Diarrhea

Care at Home

Mild Diarrhea: Continue regular diet. Eat more starchy foods. Drink more fluids.
(Exception: avoid all fruit juices and soft drinks because they make diarrhea worse.)
Formula-Fed Infants (less than 1 year old) WITH frequent, watery diarrhea:
Start Oral Rehydration Solutions (ORS)

ORS (such as Pedialyte or the store brand) is a special electrolyte solution that can prevent dehydration. It is readily available in supermarkets and drug sores. NOTE: formula is fine for average diarrhea.
Use ORS alone for 4 to 6 hours to prevent dehydration. Offer unlimited amounts.
If ORS is not available, use formula prepared as usual (unlimited amounts) until you can get some.
Avoid Jello water and sports drinks or fruit juice.

Return to Formula

Go back to formula by 6 hours at the latest (Reason: infant needs the calories.)
Use formula prepared as usual (Reason: it contains adequate water).
Offer the formula more frequently than you normally do.
Lactose: Regular formula is fine for most diarrhea. Lactose-free formulas (soy formula) are only needed for watery diarrhea lasting over 3 days.
Extra ORS: also give 2-4 oz. of ORS for every large watery stool.

Solids:
- Infants over 4 months old: Continue solids (such as rice cereal, strained bananas, mashed potatoes, etc.)
Breastfed Infants WITH frequent, watery diarrhea:

Continue breastfeeding at more frequent intervals. Continue solids as for formula-fed.
Offer ORS (in addition to breastfeeding) after every large watery diarrhea stool(especially if urine is dark.)

Older Children (over 1 year old) WITH frequent, watery diarrhea:
- Solids: Starchy foods are absorbed best. Give dried cereals (especially rice cereal), oatmeal, bread, crackers, noodles, mashed potatoes, rice, carrots, applesauce, strained bananas, etc. Pretzels or salty crackers can help meet sodium needs.
- Fluids: If taking solids, offer unlimited fluids--use water or half-strength Gatorade. If child refuses solids, give milk or formula.
- Avoid all fruit juices and soft drinks (Reason: Make diarrhea worse).
- ORS is rarely needed, but for severe diarrhea, also give 4-8 oz. of ORS after every large watery stool.
- Solids: Starchy foods are absorbed best. Give dried cereals, oatmeal, bread, crackers,noodles, mashed potatoes, rice, carrots, applesauce, strained bananas,etc. Pretzels or salty crackers can help to meet sodium needs.
- Yogurt: If over 12 months, give 2-6 oz of active culture yogurt twice a day.
  (Reason: restores healthy bacteria to GI tract.)
Diaper Rash:
- Wash buttocks after each stool to prevent a bad diaper rash. Consider applying a protective ointment (e.g. petroleum jelly) around the anus to protect the skin.
Contagiousness:
- Your child can return to day care or school after the stools are formed and the fever is gone. The school-aged child can return if the diarrhea is mild and the child has good control over loose stools.
Expected Course:
- Viral diarrhea lasts 5-14 days. Severe diarrhea only occurs on the first 1-2 days, but loose stools can persist for 1-2 weeks.
IF your child becomes worse: Review Should I Call? recommendations.