Diarrhea is defined in infants as the passage of frequent (eight to ten per day) watery stools. It is important to understand that infants and children may occasionally have loose bowel movements. This is normal and of no concern. However, in infants excessive diarrhea can cause dehydration.

A newborn infant, especially if breast fed, may normally have six to eight bright yellow, loose, or seedy stools per day. When diarrhea occurs, the number and water content of the stools will increase and the color will become more green.

The change in the older infant is more apparent when diarrhea occurs.

Most episodes of diarrhea are caused by viruses and resolve on their own within a week. Dehydration from diarrhea alone is uncommon and usually occurs only when there is persistent vomiting or high fever associated with inadequate drinking.

Mild diarrhea (fewer than eight stools per day) without associated vomiting or cramps usually requires no specific treatment. It is better to continue a normal diet. This will maintain good nutrition and allow the illness to resolve on its own.

When more severe diarrhea is present, especially when dehydration may be a concern, certain dietary changes may be helpful to prevent dehydration and help the illness resolve.

INFANTS THROUGH 12 MONTHS OLD:

• Discontinue all usual formula and solids. Breast feeding should be continued and supplemented as in the next step.
• Feed only commercially available oral re hydration solutions such as Infalyte or Pedialyte in volumes as desired. These solutions should be used for a maximum of 24 hours. Stool numbers and size should decrease.
• After 24 hours, begin to reintroduce the normal diet. Solids best tolerated include rice cereal, bananas, applesauce, soda crackers or toast, potatoes, plain yogurt, pasta, lean meat, and poultry. Milk may also be reintroduced.
• If a particular food seems to result in significant cramps or severe diarrhea, avoid its use. It is important to continue a regular diet to aid the healing of the intestines and to shorten the duration of the diarrhea.

CHILDREN OLDER THAN 12 MONTHS

Follow the same steps as above, but other forms of clear liquid may be given. These include clear-colored, de-fizzed soft drinks, Gatorade, or diluted jello-water or Kool-aid.

CALL YOUR DOCTOR IF:

1) There are signs of dehydration, such as:

• decreased activity or excessive irritability
• absence of urine output or no wet diapers for more than eight hours
• absence of tears when crying F dry mouth or sunken eyes F weight loss

2) Fever of greater than 102 degrees for longer than 48 hours

3) Blood in the stool.

4) Abdominal pain that is continuous for longer than one hour. This is often shown by pulling the knees to the chest.

5) Vomiting more than twice an hour for two to three hours.

6) Excessive (more than eight stools per day) diarrhea lasting more than 72 to 96 hours (three or four days).

7) Significant change in your child's behavior or mood.

Remember, diarrhea is often contagious. Good handwashing and care when changing and disposing of diapers is important. Please call your doctor if you have ANY questions about your child's health.