Patient information from the BMJ Group

Diarrhea in childrenIf your child has diarrhea, they will probably recover completely in a week. Butthere is a danger that they could lose too much fluid (become dehydrated). It’simportant to prevent this, and to treat it quickly if it happens.

We've looked at the best and most up-to-date research to produce this information.You can use it to talk to your doctor or pharmacist and decide which treatmentsare right for you.

What happens?

Diarrhea is usually caused by a virus, most commonly one called rotavirus.

Rotavirus is usually passed on through infected stools.You can catch or pass on a virusif you don’t wash your hands properly after using the bathroom. Viruses can inflame thelining of the intestines, so food and water aren’t absorbed properly.This causes diarrheaand sometimes vomiting. If a child can’t absorb enough fluid, they may becomedehydrated.

Doctors advise that all children in the United States are given a vaccine against rotavirus.The vaccine comes as a liquid that your doctor puts into your child's mouth.Your childwill need two or three doses of vaccine between the ages of 2 months and 6 months,depending on which vaccine your doctor uses.

Even if your child has the vaccine he or she could still get diarrhea.That's because thereare things that can cause diarrhea apart from rotavirus.These include bacteria, likeSalmonella in food that’s not thoroughly cooked, and parasites, like Giardia in dirty water.

Infections spread easily, especially among young children in day care. Most children getdiarrhea at least once before the age of 5. But you can do a lot to stop the infection fromspreading.

Make sure everyone in the family washes their hands properly after using the bathroom,after changing a baby's diaper, before preparing food, and before eating. Dispose ofdiapers properly. Keep your children away from anyone who has diarrhea or vomiting.

What are the symptoms?

If your child has diarrhea, they have watery stools that come more frequently than normal.The infection can also cause vomiting, abdomen pain, a low fever, and loss of appetite.

Your child will probably recover from diarrhea in a few days, without treatment. But thereis a chance they could become dehydrated. Dehydration is serious in young children. Ifthis happens, you should take them to a doctor right away.

© BMJ Publishing Group Limited 2014. All rights reserved.page 1 of 3

Here are the signs to look out for: being very thirsty, being restless or irritable, havingeyes that look sunken, having a fontanel that is sunken (the fontanel is the soft spot ona baby's head).

If your child has some of the above symptoms and is also urinating less than usual,listless, or groggy, they could be severely dehydrated.This is life-threatening.You shouldtake them to the hospital’s emergency room immediately.

If your child has a high fever (more than 101 degrees) or blood in their stools, theirinfection might be caused by bacteria. Take them to see a doctor. Very occasionallythese infections need to be treated with antibiotics.

What treatments work?

Diarrhea in children is usually caused by a virus (such as rotavirus). Most children willfight off the virus without treatment. Antibiotics work only for bacteria infections (likeSalmonella), so they don’t usually help. The main danger with diarrhea is that childrencan lose too much fluid and become dehydrated.There are treatments that can stop thisfrom happening.

Doctors don't recommend using medicines such as loperamide (brand name Imodium)to stop diarrhea in young children. These medicines can have side effects in children.

Things you can do yourself

The most important thing when your child has diarrhea is to replace the fluid they arelosing. They may be losing more fluid than you think.

If you are breastfeeding, continue with this. Feed your baby more often, and try to makethe feedings longer. If your baby is still thirsty or has lots of diarrhea, give extra fluids,such as water or rehydration drinks.

If your baby is bottle-fed, they can still have their usual formula milk. Don't dilute the milk.Offer your baby water or rehydration drinks as well as their formula. Giving small sipsevery few minutes is better than trying to get them to drink a lot at once.

Avoid sugary drinks, like fruit juice. These can increase the chance your child will getdehydrated. Give your child their normal diet if they are hungry. It's important to keeptheir energy up.

Rehydration

Rehydration drinks (also called oral rehydration solutions) help the body replace fluidsand salts. They don’t stop diarrhea. But they can prevent your child from gettingdehydrated. This is the safest treatment and it should be tried first.

Rehydration drinks come as powders that you dilute in water. Some come ready-madeas bottled drinks or popsicles.You can buy them from the pharmacy or grocery store.Some brand names are Gerber LiquiLyte, Pedialyte, and Rehydralyte.

© BMJ Publishing Group Limited 2014. All rights reserved.page 2 of 3

Diarrhea in children

There is good evidence that rehydration drinks help to prevent and treat dehydrationcaused by diarrhea. There don't seem to be any important side effects, although somechildren may not like the taste.

Sometimes children can't keep drinks down, won’t drink them, or need fluids very quickly.Doctors may then need to give them rehydration solutions through a drip into their arm(an intravenous infusion or IV for short), or down a tube through their nose into theirstomach. Both work well, although they may be uncomfortable.

Other treatments

Babies who have had diarrhea for a long time may benefit from lactose-free formula milkwhile they recover. Lactose-free formula milk is made from cow's milk but the lactosehas been removed (lactose is a natural sugar found in cow's milk). Children's bodies mayfind it harder to break down lactose for a short time after having diarrhea, so lactose-freeproducts might be easier to digest. But there’s not enough research to be sure that it’sbetter than standard formula milk. It doesn’t seem to have any side effects. Ask yourdoctor about which formula is suitable for your baby.

What will happen?

Most children who have diarrhea get better in about a week.They can usually be treatedat home. But take your child to the doctor if you are at all worried, if they do not get betteror are getting worse, or if they have a lot of diarrhea or vomiting.

If your child starts to get dehydrated, they may have to go to the hospital for rehydrationtreatment and to be kept a close eye on for a few days. Most children make a full recoveryif they get treatment quickly.

This information is aimed at a US patient audience. This information however does not replace medical advice.If you have a medical problem please see your doctor. Please see our full Conditions of Use for this content.For more information about this condition and sources of the information contained in this leaflet please visit the BestHealth website, http://besthealth.bmj.com . These leaflets are reviewed annually.

© BMJ Publishing Group Limited 2014. All rights reserved.Last published: Sep 05, 2014

page 3 of 3

Diarrhea in children