(To be used if your child has vomiting or diarrhea)
- If your child is vomiting, give sips of commercially-prepared rehydration fluids called “Electrolyte Solutions”. Begin with ½ to 1 ounce every 30 to 60 minutes. If this amount is not tolerated, you can reduce the feedings to 5ml. (1sp.) every one to two minutes. The following oral rehydration solutions may be used:
- Pedialyte or Pedialyte Frozen Popsicles (Ross Laboratories)
- Infalyte (Mead Johnson Nutrionals)
- Generic brands of these solutions (ask your pharmacist for assistance)
Fruit juices, soda, tea, regular popsicles, jello, etc. all have very high sugar levels and very few electrolytes. Chicken broth is all salt, but no carbohydrates. Gatorade and other sports drinks are better balanced, but still have lower electrolyte amounts than the rehydration solutions.
- As your child’s vomiting subsides, increase the amount of fluids given at each feeding. Some children may need electrolyte solutions for 8-12 hours. Give as much as the child will take after the vomiting stops. If there is severe diarrhea, start with electrolyte solutions, but advance to the foods listed below within a few hours. If you see blood or mucus in the diarrhea, call us.
- Resumption of a normal diet-for-age has been shown to result in a more rapid recovery. Returning to a “limited regular diet” is recommended. Small, frequent feedings are tolerated better than 3 large meals. Foods to include are:
- Complex Carbohydrates:
Starchy: Oatmeal, barley, pasta, potatoes, rice, squash, whole grain breads, whole grain cereals, whole grain pancakes, yams
Legumes: Black beans, black-eyed peas, kidney beans, lentils, lima beans, navy beans, peas, red beans
Fiber: Broccoli, carrots, celery, cucumber, eggplant, green beans, lettuce, spinach, zucchini
- Lean meats
- Avoid feeding your children the following foods:
- Sugary foods: Ice cream, sherbet, popsicles, sweetened cereals, jello, candy
- Fatty foods: Grilled cheese sandwiches, cheeseburgers, french fries
- Plain water
- Boiled milk or other salty broth and soups
- If your child is on formula, make the following changes:
- Start a “ready-to-feed” soy-based formula (Isomil or ProSobee) or a lactose-free formula (Similac Lactose Free or Enfamil Lactofree) after the vomiting has stopped. Start with small, frequent feedings as discussed above. Slowly increase the amount at each feeding, as tolerated.
- Return to your child’s regular formula after four to five days
- Breast feeding is encouraged while a child has diarrhea. Pedialyte or Infalyte should be given for a few feedings if vomiting occurs (see Steps 1 and 2 above), after which breast feeding may be resumed.
- The American Academy of Pediatrics does not recommend medications for the treatment of diarrhea in children, especially younger ones. This includes anti-motility agents (Imodium, Lomotil, Paregoric), Bismuth subsalicylate (Pepto-Bismol), absorbents of fluids and toxins (Diasorb, Donnagel, Kaopectate), or Lactobacillus (Pro-Bionate, Superdophilus).
- It is not necessary to call our office if your child continues to look well, even though there may be:
- Frequent or large stools
- Lots of intestinal gas
- Green or yellow stools
Most of the time, mild diarrhea lasts from 3 to 6 days. Occasionally a child will have loose stools for several days longer. As long as your child acts well and is taking adequate fluids and foods, loose stools are not a great concern.
- Call our office if your child has any of the following symptoms ( especially in children less than six months of age):
- Blood or mucus in the stools
- Frequent vomiting
- Abdominal pain
- Urinates less frequently (or fewer than 6 diapers per day)
- No tears when crying
- Loss of appetite for any liquids
- Frequent diarrhea in an ill-appearing child
- Dry, sticky mouth
- Obvious weight loss
- Extreme thirst
- Sunken eyes
If your child develops the above listed warning signs of illness, he or she may require IV fluids in the emergency department for several hours to correct the dehydration. Usually overnight hospitalization is not necessary. Call us immediately for advice if symptoms of severe illness occur.