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Diarrhea in children - diet

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Recommendations:

In most cases, you should continue feeding your baby or child as usual. Bowel rest was once the treatment of choice, but now it is believed that continuing feeding will result in diarrhea that is easier to manage.

For babies, breastfeedings or formula should almost always be continued.

Many children develop mild and temporary lactose intolerance. Therefore, when young children have diarrhea, the safest course is to give clear liquids for 2 -3 days, then reintroduce formula or milk. If diarrhea occurs again, you may need to switch from regular milk or milk-based formula to a soy formula (such as Isomil, Prosobee, or Nursoy).

Babies who take solid foods may continue to do so, as tolerated. Suggested foods include bananas or apple sauce, white rice or rice cereal, noodles, potatoes, or toasted white bread. Small amounts of ground or finely chopped meats may also be offered if they have already been introduced into your child's diet.

The B.R.A.T. diet is a common treatment for diarrhea used with children who eat solid foods. The B.R.A.T. diet stands for:

  • Bananas
  • Rice (or other starchy food)
  • Applesauce
  • Toast

Similar foods may be offered to older children. Reduce or avoid fats and sweets until the diarrhea subsides.

In addition to these foods, give babies and children lots of clear fluids for the first 24 to 72 hours. Fluid is very important because it is easy for a child with diarrhea to become dehydrated. Dehydration is a serious condition in babies and young children. Fluids lost need to be replaced.

Babies should be given about 2 ounces per hour. In addition to breast milk, babies should be offered a rehydration solution (Pedialyte, Lytren, or similar product -- DO NOT give water or diet sodas). These solutions are available at the supermarket or pharmacy and you do not need a prescription.

Other clear liquids include jello water or jellow (not the diet kind), slightly sweetened teas, and rice water. Offer small amounts every few minutes between bowel movements, up to eight ounces. Avoid sweetened beverages like soda pop, non-carbonated soft drinks, sports drinks, and fruit juices (particularly apple juice). If you give juices at all, dilute them half and half with water.

Fruit popsicles are also an excellent source of clear fluids, especially if the child is vomiting. One can get surprisingly large amounts into the child slowly this way, and avoid over-filling a stomach that can also be irritated by the infection. Be sure there is NO milk in the popsicles!

Older children can be offered diluted juices or sports beverages. Be aware that too many sweetened beverages can worsen diarrhea, but your child does need to replace lost fluid. It is best that drinks be diluted. Older children should also avoid milk products for two to three days.

As stools become more formed, your child can gradually return to a normal diet. Begin adding other types of food. Add foods high in fiber, such as raw fruits and vegetables, last. After three to four days, you can begin introducing milk in small amounts. Too much milk too soon may create a setback. In children who have ever had lactose intolerance, the best approach is to wait a week before reintroducing any milk products.

Diarrhea caused by antibiotics may be reduced by giving the child yogurt with live active cultures. If the diarrhea persists, contact your health care provider to discuss changing or discontinuing the antibiotic.

CONTACT YOUR PROVIDER IF:

  • Diarrhea is severe or lasts longer than 2-3 days.
  • Diarrhea contains blood or mucous.
  • Diarrhea keeps returning or the child is losing weight.
  • The child has signs of dehydration. (Call immediately.)
  • Diarrhea is accompanied by multiple vomiting episodes, fever, or abdominal cramping.
  • Diarrhea develops within one week of travel outside of the US or after a camping trip. (The diarrhea may be due to bacteria or parasites and may require treatment.)

Medication may be prescribed by your provider to help control the diarrhea. Over-the-counter medications for diarrhea may be either ineffective or may be potentially dangerous. Call your provider before using over-the-counter remedies.

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