Springdale Mason Pediatrics

Diarrhea (Age 1-5)

Definition

  • Diarrhea is the sudden increase in the number and looseness of stools
  • Diarrhea means 3 or more watery stools. Reason: a few loose stools can be normal with changes in diet.
  • Most diarrhea is caused by a viral infection of the intestines.

Call or Return If

  • Blood in the diarrhea
  • Signs of dehydration occur
  • Diarrhea lasts over 2 weeks
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Diarrhea Scale

  • Mild: 3-5 watery stools per day
  • Moderate: 6-9 watery stools per day
  • Severe: 10 or more watery stools per day
  • The main risk of diarrhea is dehydration.
  • Loose or runny stools do not cause dehydration.
  • Frequent, watery stools can cause dehydration.

Dehydration: How to Know

  • Dehydration means that the body has lost too much fluid. This can happen with vomiting and/or diarrhea. Mild diarrhea or mild vomiting does not cause this.
  • These are signs of dehydration:
  • Decreased urine (no urine in more than 8 hours) happens early in dehydration. So does a dark yellow color. If the urine is light straw colored, your child is not dehydrated.
  • Dry tongue and inside of the mouth. Dry lips are not helpful.
  • Dry eyes with decreased or absent tears
  • Fussy, tired out or acting ill. If your child is alert, happy and playful, he or she is not dehydrated.
  • A child with severe dehydration becomes too weak to stand. They can also be dizzy when trying to stand.

Causes

  • Virus (such as Rotavirus). An infection of the intestines from a virus is the most common cause. It's called viral gastroenteritis.
  • Bacteria (such as Salmonella). Less common cause. Diarrhea often contains streaks of blood.
  • Food-poisoning. This causes rapid vomiting and diarrhea within hours after eating the bad food. It is caused by toxins from germs growing in foods left out too long. Most often, symptoms go away in less than 24 hours. It often can be treated at home without the need for medical care.

Prevention of Spread to Others

  • Careful hand washing after using the toilet or changing diapers.

After Care Advice

Overview:
  • Most diarrhea is caused by a virus.
  • Diarrhea is the body's way of getting rid of the germs.
  • Your job is to prevent dehydration.
  • Here is some care advice that should help.
Mild Diarrhea:
  • Keep on a normal diet.
  • Drink more fluids. Milk is a good choice for diarrhea.
  • Do not use fruit juices. Reason: They can make diarrhea worse.
  • Eat more starchy foods (such as cereal, crackers, rice).
Frequent, Watery Diarrhea:
  • Offer as much fluid as your child will drink.
  • If also eating solid foods, water is fine. So is half-strength Gatorade or half-strength apple juice.
  • If not eating solid foods, use milk as the fluid.
  • Caution: Do not use other fruit juices or soft drinks. Reason: They make diarrhea worse.
Solid Foods:
  • Starchy foods are the best. Reason: easy to digest.
  • Give dried cereals, oatmeal, bread, crackers, pasta, mashed potatoes, or rice. Pretzels or salty crackers can help meet salt needs.
  • Go back to a normal diet in 24 hours.
Probiotics and Yogurt:
  • Probiotics are healthy bacteria (such as Lactobacilli). They may replace harmful bacteria in the gut.
  • Probiotics may be helpful in reducing the number of diarrhea stools.
  • Yogurt is the easiest source of probiotics. Give 2 to 6 ounces (60 to 180 ml) of yogurt. Do this twice daily. (Note: look for "probiotic" yogurts)
  • Probiotic supplements can also be bought in health food stores.
Diaper Rash:
  • Wash buttocks after each stool to prevent a bad diaper rash. It may be necessary to get up once during the night to change the diaper.
  • To protect the skin, use an ointment (such as petroleum jelly). Put it on the skin around the anus.
What to Expect:
  • Viral diarrhea lasts 5-14 days.
  • Severe diarrhea only occurs on the first 1 or 2 days. But, loose stools can last for 1 to 2 weeks.
Return to Child Care or Preschool:
  • The younger child can go back after the stools are formed.
  • The toilet-trained child can go back if the diarrhea is mild. The older child also needs to have good control over loose stools.
  • The fever should also be gone.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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