The Credit Valley Hospital

Diarrhea

What to do when your child is vomiting and has diarrhea?

Diarrhea is when stools are more watery and occur more often than usual: two or more watery stools in 24 hours, or three times the usual number of stools in 24 hours.

Diarrhea can be dangerous if not treated properly. It drains waters and salts from your child. If these are not replaced quickly, your child can become dehydrated and may need to be hospitalized.

As soon as diarrhea starts, give your child an oral rehydration solution (ORS), such a Pedialyte, Gastrolyte (be sure to mix according to directions), or Lytren (available from your doctor only), because it contains the ideal balance of water, salts (electrolytes), and sugar. This will replace the water and salts that are lost with diarrhea. If your child is also vomiting, it is important to have your child start drinking and eating usual foods again as soon as vomiting stops.

At the start of vomiting or diarrhea:

If breat-feeding, continue to breast-feed on demand and offer oral rehydration solution (ORS), such as Pedialyte, Gastrolyte, or Lytren.

If not breast-feeding, stop all food and drink and give ORS, such as Pedialyte, Gastrolyte or Lytren as follows:

First 2 hours

6 months and under - 30-90ml every hour (1-3oz)
6 - 24 months - 90-125ml every hour (3-4oz)
Over 2 years - 125-250ml every hour (4-8oz)

If infant refuses ORS by the cup or bottle, give this solution using a medicine dropper or small spoon. If child vomits, continue to give ORS using a spoon. Give 15ml (1 tbsp) every 10-15 minutes until vomiting stops, then give regular amount as indicated above. If vomiting does not stop after 4 - 6 hours, take your child to the hospital.

6 - 14 hours: Recovery Stage

Keep giving the oral rehydration solution until diarrhea is less frequent.

When vomiting stops, offer usual formula or whole milk or food in small frequent feedings. Note: Whole milk is only given after an infant is 9 - 12 months of age.

Do not give fruit juices or sweetened desserts until the diarrhea has stopped.

Stools may increase at first (1-2 more each day). It may take 7 - 10 days or longer for stools to become completely formed. This is part of healing the bowel.

Sample menu for infants and toddlers:

Breakfast: iron fortified infant cereal, toast and margarine, formula or whole milk. Note: Whole milk is only given after an infant is 9 - 12 months of age.

Lunch/Dinner: plain meat, plain potato, plain vegetable, plain fruit, formula or whole milk. Note: Whole milk is only given after an infant is 9 - 12 months of age.

After 24 - 48 hours, most children can resume their normal diet.

Do not give over-the-counter medications to stop diarrhea. These will stop the body from getting rid of infection. Do not give sugary drinks such as: kool-aid, fruit juice/drinks, pop, jello-O, sweetened tea, broth or rice water to your child because they have the wrong amounts of water, salts and sugar and can make your child's diarrhea worse.

Do give oral rehydration solutions because they have the ideal balance of water, salts and sugar. They are available at drugstores.

When to get help:

Call your doctor or go to the hospital if:

Your child has diarrhea and is less than 6 months of age.
Your child has bloody or black stools.
Your child starts to vomit and is still vomiting after 4 - 6 hours.
Your child has a fever - temperature greater than 38.5C (101.5F)
Your child has signs of dehydration: decreased urination (less than 4 wet diapers in 24 hours); no tears; dry skin, mouth and tongue; sunken eyes; grayish skin; sunken soft spot (fontanel) on infant's head.

If diarrhea or cramping continues after 5 - 7 days, your doctor may suggest lactose-free milk until diarrhea improves.

Careful handwashing after toileting or changing diapers will prevent spread of infection to others.

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