Patient information from BMJ

Diarrhea in children

Last published:Aug 30, 2022

If your child has diarrhea he or she has loose, runny stools. Most children recover completely in about a week. But there is a danger that they could lose too much fluid (become dehydrated). It’s important to prevent this and to treat it quickly if it happens.

What happens?

Diarrhea is usually caused by a virus, most commonly one called rotavirus. Rotavirus is usually passed on through infected stools.

Doctors advise that all children in the United States are given a vaccine against rotavirus. It protects your child against rotavirus, but this does not mean he or she will never get diarrhea. Other germs can still cause diarrhea.

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

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

What are the symptoms?

If your child has diarrhea he or she has watery stools that come more frequently than normal. They might also vomit, get belly pain, a high fever, or lose their appetite.

Most children recover completely from diarrhea in a few days, without treatment. But there is a chance they could become dehydrated. If this happens you should take them to a doctor right away.

Signs of dehydration include:

• being thirsty

• passing urine less often than normal (a baby's diaper might be dry)

• being restless or irritable, and

• having dry eyes or mouth.

If your child's eyes look sunken, or if they are listless or drowsy, they could already be severely dehydrated.

In a baby, the fontanel (the soft spot on the back of a baby's head) may be sunken. Severe dehydration is life threatening. If your child has signs of severe dehydration take them to the emergency room immediately.

If your child has a high fever (more than 102°F) or blood in their stools, their infection might be caused by bacteria rather than a virus. Take them to see a doctor. Sometimes these infections need to be treated with antibiotics.

What treatments work?

Diarrhea in children is usually caused by a virus (such as rotavirus). Most children will fight off the virus without treatment. Antibiotics work only for bacteria infections (like Salmonella). The main danger with diarrhea is that children can lose too much fluid and become dehydrated. There are treatments that can stop this from happening.

Doctors don't recommend using medications such as loperamide to stop diarrhea in young children.

Things you can do yourself

The most important thing when your child has diarrhea is to replace the fluid they are losing. You should see your doctor for advice about how best to do this. This is particularly important if your child is vomiting or has difficulty keeping down fluids.

If you are breastfeeding, your doctor will probably recommend you continue breastfeeding. You might need to feed your baby more often, or make the feeds longer. If your baby is bottle-fed, they will probably continue with their usual formula milk.

Older children will probably be able to eat normal food if they are hungry and they are not vomiting, but check which foods are recommended.

Rehydration

Rehydration drinks (also called oral rehydration solutions) help the body replace fluids and salts. They don’t stop diarrhea but they can prevent your child from getting dehydrated. Your doctor might suggest rehydration drinks for your baby or child and explain the best way to give these.

You may need to help your child drink slowly with small sips. Avoid sugary drinks such as fruit juice.

Sometimes children can't keep drinks down, won’t drink them, or need fluids very quickly. Doctors might then need to give them rehydration solutions through a drip into their arm or a tube through into their stomach.

Other treatments

Some babies who have had diarrhea for a long time might benefit from lactose-free formula milk while they recover. Ask your doctor about whether you should try a lactose-free formula for your baby.

What will happen?

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

If your child starts to get dehydrated he or she might have to go to the hospital for rehydration treatment and to be kept a close eye on for a few days. Most children make a full recovery if they get treatment quickly.